PAEDIATRICS
SYNCOPE
PromptDefinition of syncope
ResponseAbrupt loss of consciousness and postural tone resulting from transient global cerebral hypoperfusion, followed by spontaneous and complete recovery
PromptMost common cause of syncope in children
ResponseVasovagal (Neurocardioenic) syncope
PromptPreschool aged specific syncope
ResponseBreath holding spells
PromptRed flags in pediatric syncope
ResponseSyncope during exercise/supine
Chest pain prior
Palpitations prior
Known structural heart disease
Family history of dysrhythmia or sudden cardiac death (<45 yo)
Chest pain prior
Palpitations prior
Known structural heart disease
Family history of dysrhythmia or sudden cardiac death (<45 yo)
PromptConcerning ECG findings in Syncope
ResponsePre-excitation/WPW - delta waves(slurred upstroke into QRS complex), short PR (<120, Broad QRS >100)
Long QT - risk of torsades
Short QT
Brugada - Coved STE V1-V3
HOCM: exercise induced syncope, ECG features – LVH with dagger Q waves lateral leads
AV nodal block
ARVC: TWI V1-V3, epsilon wave on ECG, RBBB, family Hx sudden death
Long QT - risk of torsades
Short QT
Brugada - Coved STE V1-V3
HOCM: exercise induced syncope, ECG features – LVH with dagger Q waves lateral leads
AV nodal block
ARVC: TWI V1-V3, epsilon wave on ECG, RBBB, family Hx sudden death