39th South-east Pediatric Cardiology Society Meeting: September 27-28, Atlanta, Georgia.

The purpose of this study, presented by Dr. Thomas from Texas Children’s Hospital, was to describe the characteristics of syncope in patients less than 10 years of age. A retrospective review of all syncopal patients less than 10 years of age identified 181 patients with an average age of 5.7 years. The majority of patients (87%) were diagnosed with neurocardiogenic syncope. Cardiac causes were identified in 10 of 81 patients (6%), 5 with long QT syndrome, 2 with catecholaminesensitive polymorphic ventricular tachycardia (VT), 1 with atrioventricular block, 1 with sinus node dysfunction, and 1 with junctional ectopic tachycardia. All patients with cardiac causes had an abnormal baseline EKG, or in those presenting with syncope with exercise, an abnormal exercise stress test. Echocardiograms were performed in 38% of the group, and none revealed a cardiac etiology for their syncope. Exercise stress tests were ordered on those patients with exerciseinduced syncope, and the tests had a 21% yield, revealing a diagnosis of catecholamine-sensitive polymorphic VT in 2 patients and exerciseinduced bronchospasm in 1. Holter monitoring was performed in 27% of the patients, and no diagnosis was made based strictly on Holter monitor. The conclusions were that syncope in young children is typically a benign entity, with the majority of these patients having neurocardiogenic syncope. Cardiac causes are rare and can be diagnosed with either an EKG or an exercise stress test. The diagnostic yield of echocardiogram or Holter monitoring is low.