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Review Article
Neurology
Pediatric syncope: pearls and pitfalls in history taking
Jung Sook Yeom, Hyang-Ok Woo
Clin Exp Pediatr. 2023;66(3):88-97.   Published online February 15, 2023
An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking.
Original Article
Cardiology
Vasovagal syncope with mild versus moderate autonomic dysfunction: a 13-year single-center experience
Han Eoul Lee, Dong Won Lee
Clin Exp Pediatr. 2022;65(1):47-52.   Published online June 1, 2021
Question: It is well known that autonomic dysfunction contributes to vasovagal syncope (VVS). Does the degree of autonomic dysfunction contribute to clinical manifestations, diagnostic methods, treatment, and prognosis?
Finding: The clinical manifestations, diagnostic methods, treatment, and prognosis differ between patients with mild and moderate degrees of autonomic dysfunction.
Meaning: VVS is caused by autonomic dysfunction, but autonomic dysfunction severity need not be classified.
Assessment of cardiac function in syncopal children without organic causes
Heoungjin Kim, Lucy Youngmin Eun
Clin Exp Pediatr. 2021;64(11):582-587.   Published online March 10, 2021
Question: Does a subtle deterioration in cardiac function affect the severity of syncope in patients without underlying disease?
Finding: For syncope patients with reasonable cardiac function but without underlying disease, tissue Doppler imaging (TDI) measurements helped reveal subtle differences in cardiac function with syncope and predicted the severity of syncope or a potential recurrent event.
Meaning: TDI measurements might be a useful indicator for predicting the severity of syncope.
Case Report
Neurology
Type I Chiari malformation presenting orthostatic syncope who treated with decompressive surgery
Hyun-Seung Shin, Jeong A Kim, Dong-Seok Kim, Joon Soo Lee
Clin Exp Pediatr. 2016;59(Suppl 1):S149-S151.   Published online November 30, 2016

Chiari malformations are a congenital anomaly of the hindbrain. The most common, Chiari malformation type I (CM-I), is characterized by herniation of the cerebellar tonsils extending at least 3 mm below the plane of the foramen magnum. Consequently, CM-I is associated with hydrocephalus and symptoms involving compression of the cervicomedullary junction by ectopic tonsils. Several studies have reported the clinical...

Original Article
Cardiology
P wave dispersion on 12-lead electrocardiography in adolescents with neurocardiogenic syncope
Dong-Hyuk Lee, Kyung-Min Lee, Jung-Min Yoon, Jae-Woo Lim, Kyung-Ok Kho, Hong-Ryang Kil, Eun-Jung Cheon
Clin Exp Pediatr. 2016;59(11):451-455.   Published online November 18, 2016
Purpose

Neurocardiogenic syncope (NCS) is the most frequent cause of fainting during adolescence. Inappropriate cardiovascular autonomic control may be responsible for this clinical event. The head-up tilt test has been considered a diagnostic standard, but it is cumbersome and has a high false-positive rate. We performed a study to evaluate whether P-wave dispersion (PWD) could be a useful electrocardiographic parameter of...

Baseline heart rate variability in children and adolescents with vasovagal syncope
Sun Hee Shim, Sun-Young Park, Se Na Moon, Jin Hee Oh, Jae Young Lee, Hyun Hee Kim, Ji Whan Han, Soon Ju Lee
Clin Exp Pediatr. 2014;57(4):193-198.   Published online April 30, 2014
Purpose

This study aimed to evaluate the autonomic imbalance in syncope by comparing the baseline heart rate variability (HRV) between healthy children and those with vasovagal syncope.

Methods

To characterize the autonomic profile in children experiencing vasovagal syncope, we evaluated the HRV of 23 patients aged 7-18 years and 20 healthy children. These children were divided into preadolescent (<12 years) and adolescent groups....

Case Report
Anomalous origin of left coronary artery arising from the right coronary cusp presenting with chest discomfort and syncope on physical exercise
Ran Baik, Nam Kyun Kim, Han Ki Park, Young Hwan Park, Byung Won Yoo, Jae Young Cho
Clin Exp Pediatr. 2010;53(2):248-252.   Published online February 15, 2010
Anomalous origins of coronary arteries are a rare type of disease among children. These anomalies can be categorized into 3 types according to the anatomical relationship of the aorta and pulmonary trunks. Among these types, the interarterial type, as observed in our case, needs early diagnosis and treatment, because it can increase the risk for the patient, causing sudden cardiac...
Original Article
Effectiveness of head-up tilt test for the diagnosis of syncope in children and adolescents
Ka-Young Yu, Ji-Hye Choi, Chun Ja Yoo, Kyoung Suk Rhee, Chan Uhng Joo
Clin Exp Pediatr. 2009;52(7):798-803.   Published online July 15, 2009
Purpose : We aimed to examine the effectiveness of the head-up tilt test (HUT) for the diagnosis of syncope or presyncope in children and adolescents. Methods : HUT results and clinical features of 160 children and adolescents with syncope or presyncope were studied from May 2003 through March 2008 at the Chonbuk National University Hospital. The children and adolescents were subjected...
The characteristics of neurocardiogenic syncope in children
Kyung Yeon Lee, Jin Young Lee, Myoung Hyun Kim, Jeong Eun Lee, Yong Dae Kim, Eun Ju Lee, Young Su Lim, Won Seop Kim
Clin Exp Pediatr. 2008;51(5):512-517.   Published online May 15, 2008
Purpose : Syncope is relatively common in children and adolescents. Among the etiologies of syncope, neurocardiogenical syncope is the most common, but it is often confounded with seizure. We investigated the clinical features of patients under the age of 15 with neurocardiogenical syncope, compared to patients with neurologic disorders including epilepsy. Methods : Among the children who visited the...
Case Report
A Case of Micturition Syncope in a Child
Sun Youn Lee, Su Jeong Ryu, Deok Soo Kim, Young Hwue Kim, Tae Sung Ko, Jae Moon Kim
Clin Exp Pediatr. 2003;46(12):1274-1278.   Published online December 15, 2003
Syncope in children and adolescents have a common occurrence according for up to 15% before adulthood. Micturition syncope, a kind of situational syncope, can be considered a form of reflex syncope. It can typically occur in healthy young men after rising from bed in the early morning who experience sudden loss of consciousness during or immediately after urination. The mechanism...
Original Article
Change of Cerebral Blood Flow during Tilt Tests in Children with Vasovagal Syncope
Su Jung Kim, Hye Won Yom, Young Mi Hong, Jung Hyen Yoo, Sook Hee Lee, Chong Hee Kim
Clin Exp Pediatr. 2003;46(10):983-988.   Published online October 15, 2003
Purpose : Syncope appears to be common. However, the mechanism of syncope is not clear. Increased vagal activity and withdrawal of sympathetic stimulation cause hypotension, bradycardia and finally loss of consciousness. The purpose of this study was to evaluate changes of cerebral blood flow velocity, blood pressure, and heart rate during tilt test in children with vasovagal syncope. Methods : Sixty...
Abnormal Fractal Correlation of Heart Rate in Children with Neurocardiogenic Syncope
Keoung-Young Kim, Eun-Young Joo, Myung-Kul Yum, Je-Wen Oh, Chang-Ryul Kim, Nam-Su Kim, Cheol-Beom Lee, Chung-Ill Noh
Clin Exp Pediatr. 2002;45(9):1114-1119.   Published online September 15, 2002
Purpose : The purposes of this study were to determine short- and long-term fractal correlation behavior of heart rates during daily activity in patients with neurocardiogenic syncope. Methods : Twenty five patients with histories of neurocardiogenic syncope episodes were included. Their analogue 24h ambulatory Holter electrocardiograms were analyzed. The tape was digitized and the digitized electrocardiograms were partioned into...
The Usefulness of the Head-up Tilt Test for Diagnosis of Syncope in Pediatric Patients
Hye Jin Yun, Sun Hee Rim, So Young Yun, Jae Kon Ko, Young Hwue Kim, In Sook Park
Clin Exp Pediatr. 2001;44(12):1441-1447.   Published online December 15, 2001
Purpose : The purpose of this study is to examine the usefulness of the head-up tilt test for diagnosis of unexplained syncope in children. Methods : Head-up tilt test results and clinical features of 41 children with unexplained syncope, presyncope, dizziness and seizure were studied from January, 1997 through January, 2001 at Asan Medical Center. Medical records of children were reviewed retrospectively. The children...
Case Report
A Case of Congenital Long QT Syndrome with Reccurent Syncope
Jong Hwa Hwang, Hong Bae Kim
Clin Exp Pediatr. 2000;43(5):725-729.   Published online May 15, 2000
Congenital long QT syndrome(LQTS) is a disease characterized by prolongation of ventricle repolarization and by the occurrence, usually during emotional or physical stress, of life-threatening arrhythmias that lead to sudden death in most symptomatic and untreated patients. Two variants have been initially identified : the original Jervell and Lange-Nielsen syndrome of congenital deafness and autosomal recessive inheritance, and the more...
Original Article
Causes of Syncope in Children
Jae Young Lee, Chung Il Noh, Eun Jung Chun, Sun Sung Park, Myung Ja Yun, Hong Ryang Gil, Ho Sung Kim, Jung Yun Choi, Yong Su Yun
Clin Exp Pediatr. 1998;41(1):81-89.   Published online January 15, 1998
Purpose : Syncope is not rare and is caused by various conditions ranging from common physiologic derangements to life-threatening conditions. However, there are limited reports regarding syncope in children. We retrospectively analyzed our experiences of the syncope in children. Methods : Retrospective analysis of the medical records of patients with syncopal episodes between October 1985 and June 1996. Results : Sixty-eight patients(male; 36, female; 32,...
Clinical Lecture
Surgical Emergencies of the Abdomen in Children
Soo-Myung Oh
Clin Exp Pediatr. 1996;39(11):1504-1511.   Published online November 15, 1996
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