Diagnosing syncope. With an emphasis on cardiac causes

Syncope in children

The sudden loss of consciousness in a child is concerning to both patients and their parents. Although most cases of syncope in children are benign, an adequate evaluation is required to exclude life-threatening disorders. Patient history and physical examination may be sufficient to define the cause of syncope in a large percentage of pediatric cases. The events and setting preceding the syncopal episode provide clues in defining the nature of the event.

Causes of syncope in children: a prospective study

We prospectively evaluated 80 patients with syncope, between January 1991 and January 1992 to determine the causes of syncope in children. There were 35 male and 45 female patients, whose mean age was 10.5 years. A single syncopal attack had occurred in 30 patients and multiple attacks in 50. A cardiovascular cause was established in 22 (27.5%) patients and a noncardiovascular cause in 36 (45%). The cause remained unknown in 22 patients (27.5%). Vasovagal syncope was the leading cause of syncope in these patients with an incidence of 32.5%. These findings suggest that every patient who has even one syncopal attack should be promptly investigated since the underlying cause could be a life-threatening one.