The clinical features and identification of autonomic nervous mediated syncope and pseudo psychogenic syncope in children / 临床儿科杂志

Objectives To analyze and compare the clinical features of autonomic nervous mediated syncope (NMS) and pseudo psychogenic syncope (PPS) in children.Methods Clinical features were retrospectively analyzed in children with syncope complaint not caused by cardiac syncope, situation of syncope, drug-induced syncope, and neurogenic and metabolic diseases that caused brief loss of consciousness, and the clinical features of similarities and differences between NMS and PPS were compared. Results In 106 children with syncope were included, there were 85 cases (80.2%) of NMS, 13 cases (12.3%) of PPS, and 8 cases (7.5%) of unexplained syncope. PPS was induced by recent mental stimulation; the syncope was more frequent; the score of orthostatic intolerance was higher; the omen was rare; the duration of attack was longer. NMS was induced by long time standing, movement and body position change; the omen was mainly dizziness, blurred vision and gastrointestinal symptoms; the duration of attack was short (<5 min).Conclusions NMS is the most common cause of syncope in children, while PPS is an important cause of transient consciousness of non-syncope. There are similarities in clinical features between NMA and PPA and differential diagnosis is needed.

Progress in the mechanism and treatment of coronary artery thrombosis caused by Kawasaki disease / 国际儿科学杂志

The mechanism of coronary artery thrombosis(CAT)caused by Kawasaki disease is not clear yet.Endothelial injury,hypercoagulability and hemodynamic change of coronary arteries are now considered as the main causes in recent studies.As The clinical symptom of acute thrombus caused by Kawasaki disease is un-conspicuous,cardiac ultrasound should be use actively and thrombolytic therapy should be performed within 12 hours after thrombus formation or the onset of acute myocardial infarction.Intervention or intravenous thrombol-ysis are both proved to be effective.Treatment with oral antitplatelet drugs,such as aspirin,combine with warfa-rin is suggested to relieve acute myocardial infarction in the chronic phase.The adverse reactions of antithrom-botic and anticoagulant drugs should be monitored though they are minor.