A Systematic Review for Clinical Assessment of Syncope Pediatric Patients

Definition: Syncope is a common clinical problem of pediatric emergency department that generates a great amount of anxiety among patients, families and even physicians. It is a sudden, brief loss of consciousness associated with loss of postural tone from which recovery is spontaneous. The etiology of syncope in children is most often benign but it can also occur as the result of more serious disease with the potential for sudden death (especially cardiac reasons). The differential diagnosis between seizures and syncope is very important. The classification of syncope is divided into three major categories as neurally mediated syncope, cardiovascular syncope, and non-cardiovascular syncope.

Clinical Features: The major difficulty for the assessment of children with syncope is that most of them are asymptomatic at the time of presentation, therefore taking a detailed history and performing a good physical examination are very important to rule out the cardiac reasons and avoid the misdiagnosis of epilepsy all patients. Excluding the life-threatening reasons, and management of the reason can decrease patient’s and family’s anxiety as well as improve quality of life.
Conclusion: The aims of the review is to conduct a systematic review of pediatric syncope in terms of etiologies to identify the most common causes. Detailed evaluation should be considered for patients who have syncope during exercise or who have a family history of syncope, sudden death, myocardial disease or arrhythmias. Additional testing will have a low yield and not be cost-effective for patients without risks of cardiac with a normal physical examination.

Keywords: Congenital Heart Diseases, Epilepsy, Syncope, Loss of Consciousness, Vasovagal.