Prognosis and Etiological Treatment of Cardiogenic Syncope in Children / 实用儿科临床杂志

ABSTRACT

Objective To explore the prognosis and etiological treatment of cardiogenic syncope in children.Methods The cause,clinical manifestation,treatment and prognosis of 45 children with syncope were made in affiliated hospital of Qingdao medical university were su mmarized and analyzed.They were divided into arhythmia group and other groups,the former included myocarditis,dilated cardiomyopathy,and post-operation of congenital heart disease and the latter included tetralogy of fallot,pulmonary stenosis,hypertrophic cardiomyopathy,pericarclial effusion,and right atrial myxoma.Results There were 29 cases(64.44%) with arrhythmia in this group,of which there were 18 cases with complete atrioventricular block(CAVB),2 cases with second degree type Ⅱ atrioventricular block,3 cases with ventricular tachycardia,2 cases with bradycardia,2 cases with atrial flutter,1 case with supraventricular tachycardia,and 1 case with nonconducting atrial premature.There were 16 cases(35.56%) with other etiologies,of which there 8 cases with tetralogy of Fallot,2 cases with pulmonary stenosis,hypertrop-hic cardiomyopathy,pericardial effusion,and right atrial myxoma,respectively.Children with CAVB,bradycardia,or ventricular tachycardia resulted from viral myocarditis were given anti-virus medicine,protecting myocardium,neoepinephrine,and intravenous vitamin C 100-200 mg/(kg?d).Dexamethasone 1-2 mg/(kg?d) was given in earlier period for short course,and some children were given human ?-globulin.Eight cases were placed temporary pacemaker because of unsatisfactory therapeutic efficacy,and 1 case was placed permanent pacemaker.In all,38 cases(84.44%)were cured,1 case(2.22%)was improved,and 4 cases(8.88%) died.Conclusions Cardiogenic syncope is pediatric emergency and shall be treated immediately.Temporary pacemaker shall be placed at the right moment.