We review a general approach to syncope in children.
Hosts:
Brian Gilberti, MD
Ellen Duncan, MD
Download Leave a Comment Tags: Cardiology, Pediatrics
Show Notes
- Initial Evaluation and Management:
- Similar initial workup for children and adults: checking glucose levels for hypoglycemia and conducting an EKG.
- The history and physical exam are crucial.
- Dextrose Administration in Children:
- Explanation of the ‘rule of 50s’ for determining the appropriate dextrose solution and dosage for children.
- ECG Analysis:
- Importance of ECG in diagnosing dysrhythmias like long QT syndrome, Brugada syndrome, catecholamine polymorphic V tach, ARVD, ALCAPA, and Wolff-Parkinson-White syndrome.
- Younger children’s dependency on heart rate for cardiac output and the risk of arrhythmias in kids with congenital heart disease.
- History Taking:
- Key aspects include asking about syncope with exertion, syncope after being startled, and syncope after pain or emotional stress.
- Prolonged loss of consciousness may indicate seizures, and emotional stress and pain can trigger breath-holding spells.
- Breath-Holding Spells:
- Clarification of misconceptions about breath-holding spells, discussing their causes and characteristics, like cyanotic and pallid types.
- Association with iron deficiency and the fact that most children outgrow these spells by age 8.
- Physical Examination and History:
- A cardiac exam is vital, with specific signs to look for, like murmurs in hypertrophic cardiomyopathy.
- History can help identify the etiology of syncope, such as vasovagal responses or orthostatic hypotension.
- Vasovagal Syncope:
- Common in kids, especially teenagers, typically presenting with a prodrome of lightheadedness, diaphoresis, and pallor.
- Normal glucose and EKG are expected in these cases.
- Additional Lab Tests:
- Pregnancy tests in reproductive-age women, and checking for less common causes like pulmonary
Information
- Show
- FrequencyMonthly
- Published3 January 2024 at 00:31 UTC
- Length10 min
- Episode192
- RatingClean