Omdlenia kardiogenne u dzieci

*Agnieszka Tomik

Summary
Cardiac syncope in children are rare (about 6-20% of cases) and could be caused by primary cardiac arrhythmias or structural cardiac and cardiopulmonary diseases. Cardiac arrhythmia may be primary cause of syncope due to non-stable cerebral flow with increased heart rate (HR) in the course of tachyarrhythmias (supra- or ventricular tachycardia), or decreased HR in bradyarrhythmias (sinus node dysfunction or atrioventricular conduction disorders. Life threatening arrhythmias may occur in patients with channelopathies (e.g. long QT or Brugada syndrome) or with accessory conduction pathways (e.g. Wolff- Parkinson-White syndrome). Syncope, as a direct result of severe underlying cardiac diseases, can be seen in severe aortic stenosis or hypertrophic cardiomyopathy. Some clinical features suggests cardiac syncope: presence of definitive structural heart disease, syncope during exertion or supine position, syncope preceded by palpitations or sudden death in family history. In most of the patients presenting with syncope, a careful history, physical examination and 12-lead ECG can often establish the diagnosis. In children with cardiac syncope additional tests such as: echocardiogram, exercise test, prolonged ambulatory ECG monitoring: conventional 24 – hour ambulatory ECG monitoring (Holter type), mobile cardiac outpatient telemetry (MCOT), external event recorders or implantable loop recorders (ILR) may be useful in order to estimate diagnosis. Diagnostic procedures, management and treatment in these group of patients should be carried out according to the guidelines of the Task Force on Syncope of the European Society of Cardiology published in 2009.

To jest tylko fragment artykułu. Aby przeczytać całość, przejdź do Czytelni medycznej.