Syncope in Children and Adolescents - - - Sinkopa kod dece i adolescenata
Journal Title: Acta Facultatis Medicae Naissensis - Year 2017, Vol 34, Issue 3
Abstract
In the pediatric age group, most cases of syncope represent benign, neutrally-mediated alterations in vasomotor tone. Due to the global cerebral hypoperfusion, syncope is defined as a transient loss of consciousness followed by spontaneous recovery and/or a state of presyncope, including dizziness, lightheadedness, pallor, diaphoresis and palpitations which may precede the loss of consciousness. These symptoms could be a sign of a life-threatening event in a small subset of patients, even though most causes of syncope in childhood are benign, and life-threatening causes of syncope generally have cardiac etiology. In all these cases, routine evaluation includes history, physical examination and a 12-lead standard electrocardiogram which should be performed. Further investigation is indicated by worrying features which include syncope that occurs without warning, syncope during exercise, history of familial sudden death, and abnormalities on clinical exam or electrocardiography. The fact is that syncope generates great fear of injury or sudden death among parents and doctors, and the main aim of the present paper is to help the physician involved in the care of children to differentiate the life-threatening causes of syncope from the common, more benign neutrally-mediated syncope. - - - Sinkopa u pedijatrijskoj populaciji najčešće je benigna, neurološki posredovana promena vazomotornog tonusa. Definiše se kao prolazni gubitak svesti usled globalne cerebralne hipoperfuzije, posle čega dolazi do spontanog oporavka. Obično joj prethodi stanje koje nazivamo presinkopa, a koje karakteriše vrtoglavica, nesvestica, bledilo, dijaforeza ili lupanje srca. Iako je većina sinkopa u detinjstvu benigna, kod malog broja bolesnika mogu biti znak ozbiljnog oboljenja koje ugrožava život. Ove životno ugrožavajuće sinkope su uglavnom kardiovaskularnog porekla. Rutinska ispitivanja uključuju adekvatno uzetu anamnezu, fizikalni pregled i 12-kanalni elektrokardiogram kod svih bolesnika. Upozoravajući znaci koji zahtevaju dalju dijagnostiku su sinkopa koja se javlja u naporu, sinkopa bez prodroma, iznenadna srčana smrt u porodičnoj anamnezi, abnormalnosti u kliničkom pregledu i elektrokardiogramu. Kako je sinkopa stanje koje generiše veliki strah od povrede ili iznenadne srčane smrti, kako kod roditelja tako i kod lekara, glavni cilj ovoga rada je da pomogne pedijatru koji leči dete da razlikuje sinkope koje ugrožavaju život deteta od benignih, neurološki posredovanih sinkopa.
Authors and Affiliations
Ljliljana Pejčić, Marija Ratković-Janković, Radmila Mileusnić-Milenović, Karin Vasić, Ivana Nikolić
Keywords
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- EP ID EP347899
- DOI 10.1515/afmnai-2017-0017
- Views 88
- Downloads 0
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