SYNCOPE IN CHILDREN AND ADOLESCENTS

Objectives. The objectives of this study were to 1) define the inciden ce of syncope coming to medical attention among children and adolescen ts, 2) determine the outcome of syncope in these patients, and 3) dete rmine changes over time in the evaluation and charges for evaluating t his problem. Background. Syncope occurs commonly in children and adole s cents. However, the mid- and long-term outcome of children and adole scents who experience syncope is unknown. Methods. Utilizing the Roche ster Epidemiology Project, we determined the incidence, outcome and ch arges for medical evaluation for patients seeking medical attention fo r syncope during an early 5-year period (1950 to 1954) and a more rece nt 5-year period (1987 to 1991). Results. The incidence of syncope com ing to medical attention was 71.9 and 125.8/100,000 population for the early and more recent cohort, respectively. The incidence was higher for female than for male patients. The incidence peaked in 15- to 19-y ear old patients. Acute illness and noxious stimuli were associated wi th 24% and 23% of the episodes, respectively. Although long-term survi val was not different from that of the general population, one child d ied suddenly, and another had hereditary prolonged QT interval syndrom e. These were two of only six patients who had exertional syncope. Tot al charges for evaluation of syncope were similar in the two time peri ods. However, charges for testing procedures were greater for the more recent cohort. Conclusions. In general, syncope in children and adole scents is a benign event. Syncope occurring during exercise may identi fy patients with a potentially fatal condition. Detailed evaluation sh ould be considered for patients who have syncope during exercise or wh o have a family history of syncope, sudden death, myocardial disease o r arrhythmias. It may be prudent to obtain an electrocardiogram for al l patients who seek medical attention for syncope. (C)1997 by the Amer ican College of Cardiology.