ABSTRACT
Objectives:To analyze the clinical characteristics, etiological distribution of inpatients with syncope in our center. Methods:Patients with syncope were consecutively enrolled from September 2014 to April 2017 in Center of Arrhythmia of Fuwai Hospital. Demographics, medical history, physical examination results and laboratory tests were collected according to screen algorism to investigate the possible etiologies of syncope. Risk stratification was performed based on guidelines for the diagnosis and management of syncope (version 2009,ESC)and Chinese expert consensus on the diagnosis and treatment of syncope (version 2014). Results:After collecting medical history, physical examination and performing laboratory tests, three hundred patients who experienced the latest syncope within 180 days before admission was identified from 5 191 patients, the average age was (57.7 ± 15.4) years, 177 (59.0%) were male, 235 (78.3%) experienced syncope within 30 days before admission, 9.7% patients had recurrent episodes, 80.7% were defined as high risk syncope patients, 144(48.0%)patients suffered structural heart disease. Cardiac syncope was the most common etiology (214 cases,71.3%), followed by reflex syncope(44 cases,14.7%) and orthostatic hypotension (8 cases,2.7%), while etiology was not identified in the rest 34 patients (11.3%). Among all the etiologies of syncope, brandy arrhythmia was the most common reason for syncope (37.3% [112 cases]). During onset of syncope prior to hospitalization, five patients were diagnosed with severe intracranial hematoma or cerebral hemorrhage, six cardiopulmonary resuscitations were performed, and eleven patients received external direct current cardioversion. Conclusions:Etiology could be defined in most of the syncope patients admitted to our center, the prevalence of high-risk syncope and syncope due to brady arrhythmias is high in this patient cohort, treatments of the syncope patients could be improved by etiological and timely prognosis.
ABSTRACT
Cardiac syncope is due to cardiac disorders or rhythm disorders as the main cause of syncope,etiolo-gy is accounted for the second in the cause of syncope in children. Compared with other causes of syncope,cardiac syn-cope is the risk for sudden death with high mortality and the prognosis is relatively poor. A preliminary assessment was made through medical history,physical examination and routine electrocardiogram exam. Routine electrocardiogram is the most basic examination for these patients. Long term electrocardiogram,color Doppler ultrasound and electrophysio-logic examination are recommended for the patients with cardiac syncope. In clinical work,the doctor should further im-prove the understanding of syncope in order to early identify cardiac syncope and comprehensive assess the risk of it, then effort to identify the cause of the cardiac syncope. Early diagnosis and standardized management will improve the quality of life and reduce the risk of sudden death in children with cardiac syncope.
ABSTRACT
Objective To explore causes and high risk electrocardiogram expression of cardiac syncope caused by malignant rapid ventricular arrhythmia.Methods Forty-eight patients were analysed, they had cardiac syncope once or more that after which were admitted to the hospital. Results The basic causes of cardiac syncope were individed following types in 48 patients: coronary heart disease with acute or dated myocardial infarction,dilated or hypertrophic cardiomyopathy,hypokalaemia were ordinarist inducer.Torsade de pointes(TdP) were most common type of malignant rapid ventricular arrhythmia.They had some high risk electrocardiogram expression: secondary long QT syndrome,Brugada's syndrome,idiopathic abnormal J wave,complex ventricular ectopic beats,acute myocardial infarction with ST-T electrical alternation; or extensive anterior myocardial infarction with tombstone ST segment elevation,dilated cardiomyopathy with advance QRS complex low voltage.They were different electrocardiographic and clinical characteristic. Conclusion The cardiac syncope caused by malignant rapid ventricular arrhythmia is not single and independent clinical entity, which presents different the causes and high risk electrocardiogram expression.