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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, May 15, 2023

Pediatric Syncope (ECG)

PEMBLOG - May 15, 2023 - By Stephen Rineer
Syncope is described as a brief loss of consciousness and postural tone caused by transient global cerebral hypoperfusion. It is followed by a complete recovery. An estimated 80% of pediatric syncope is due to autonomic (vasovagal or neurocardiogenic) syncope. Our role as providers is to identify the patients who have a life-threatening etiology to their syncope. The majority of these are cardiac and so today we will review what to look for in your screening ECG. 
Cardiac Syncope
Most life-threatening etiologies are related to cardiac syncope and are estimated to be 1.5%-6% of pediatric syncope. This is why ECG is recommended for all initial episodes of syncope with a reported sensitivity as high as 96%. Therefore, what are we looking for with our ECG?
Concerning ECG findingsLong QT syndrome: 
  • QTc longer than 480 msec. 
  • Brugada syndrome: ST elevation in V1-V3 with a negative T wave (slide or saddleback morphology).
  • Wolf-Parkinson-White syndrome: Short PR interval of <120 ms with associated slurred. upstroke and wide QRS complex (delta wave).
  • Hypertrophic Obstructive Cardiomyopathy: Precordial high voltages with deep Q waves.