Syncope In Pediatric Patients: A Practical Approach To Differential Diagnosis And Management In The Emergency Department
Syncope is a condition that is often seen in the emergency department. Most syncope is benign, but it can be a symptom of a life-threatening condition. While syncope often requires an extensive workup in adults, in the pediatric population, critical questioning and simple, noninvasive testing is usually sufficient to exclude significant or life-threatening causes. For low-risk patients, resource-intensive workups are rarely diagnostic, and add significant cost to medical care. This issue will highlight critical diseases that cause syncope, identify high-risk “red flags,” and enable the emergency clinician to develop a cost-effective, minimally invasive algorithm for the diagnosis and treatment of pediatric syncope.
Keywords: syncope, neurocardiogenic syncope, vasovagal syncope, hypertrophic cardiomyopathy, Long QT syndrome, Wolff-Parkinson-White syndrome, supraventricular tachycardia, Brugada syndrome, heart block, postural orthostatic tachycardia syndrome, psychogenic pseudosyncope, breath-holding, pediatric, child
- The biggest challenge for emergency clinicians is to evaluate whether a patient's syncope is from a benign or vasovagal etiology or from a more concerning cause, such as cardiac syncope.
- Initial history should be brief and focused toward pertinent information, such as onset of symptoms, details of events, and underlying medical problems.
- In the pediatric population, critical questioning and simple, noninvasive testing is usually sufficient to exclude significant or life-threatening causes of syncope; for low-risk patients, resource-intensive workups are rarely diagnostic and add significant cost.
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- » Authors And Peer Reviewers
- » Case Presentations & Case Conclusions
- » Introduction
- » Critical Appraisal Of The Literature
- » Etiology And Pathophysiology
- » Differential Diagnosis
- » Prehospital Care
- » Emergency Department Evaluation
- » Diagnostic Studies
- » Treatment
- » Special Populations
- » Controversies And Cutting Edge
- » Disposition
- » Summary
- » Risk Management Pitfalls In Pediatric Patients With Syncope
- » Time- And Cost-Effective Strategies
- » Clinical Pathway For The Management Of Pediatric Patients With Syncope
- » Tables and Figures
- » References
- » Syncope: Identifying Patient Risk Is Key To Maximizing Effective Treatment - Hospital Medicine Practice - May 2015
- » Syncope: Risk Stratification And Clinical Decision Making - Emergency Medicine Practice - April 2014
- » Current Guidelines For Diagnosis And Management Of Syncope In The Emergency Department (FREE) - EM Practice Guidelines Update - December 2010
- » Syncope An ED Approach To Risk Stratification (FREE) - Emergency Medicine Practice - January 2004