Ahmet Midhat ELMACI, FATİH AKIN, Sevim KARAARSLAN

Clinical analysis and follow-up results of children with vasovagal syncope

Amaç: Senkop özellikle çocukluk ve adolesan yaş grubunda daha sık olmakla birlikte her yaş grubunda görülebilen klinik bir problemdir. Bu çalışmada, vazovagal senkoplu hastalarda semptomların devamı ve medikal tedavi verilen hastalarda tedavinin etkinliği araştırıldı. Ayrıca tilt testi sonuçlarının pozitif ve negatif olması ile devam eden senkop şikâyetleri arasındaki ilişki incelendi. Yöntemler: Vazovagal senkop tanısıyla 6 ay veya daha uzun süredir takip edilen 49 hasta telefon ile irtibat kurularak hastanemize çağrıldı. Hastaların takip süreleri, senkop ve presenkop sıklığı, ilaç kullanım öyküleri kaydedildi ve tüm hastalara tekrar tilt testi uygulandı. Elde edilen bulgular istatistiksel olarak değerlendirildi. Bulgular: Hastaların 27si kız (%55), 22si erkek (%45), ortalama yaş 14,9±7,9 yıl, ortalama takip süresi 15,6±8,9 aydır. Kız ve erkekler arasında tilt testi sonucunun pozitif veya negatif olması açısından anlamlı bir fark yoktu (p>0,05). İkinci tilt testinde pozitiflik oranı ilk teste göre anlamlı olarak düşük bulunmuştur (p

Vazovagal senkoplu çocuklarda klinik değerlendirme ve takip sonuçları

Objective: Syncope is a common clinical problem that occurs at all ages and is particularly prevalent in childhood and adolescence. In this study we aimed to investigate the continuity of the symptoms and effectiveness of the therapy in patients who received medical therapy. In addition, we investigated the association of tilt positivity or negativity with the continual syncope complaints by repeating head-up tilt test (HUTT). Methods: Forty-nine patients with vasovagal syncope followed-up for 6 or more months were contacted with telephone call. Follow-up period, syncope and presyncopal attack frequency and status of drug usage of the patients were recorded. The HUTT was repeated in all patients. Data were evaluated by statistical methods. Results: There were 27 female (55%) and 22 male (45%) patients with a mean age of 14.9±7.9. The mean followup period was 15.6±8.9 months. No significant sexual differences were determined for the negativity and the positivity of the test (p>0.05). Tilt test positivity rate was significantly lower than the first tilt test (p<0.05). Among the patients with continual complaints whose first HUTT results were negative, the positivity rate of the repeated test was 40%. The negativity rates of second tilt test was significantly lower in syncope-free patients than in patients with continual syncope attacks (p<0.05). The impact of syncope complaints on the positivity of the HUTT were significantly higher than presyncope complaints (p<0.05). Conclusion: We suggested that HUTT must be repeated in pediatric patients with continual syncopal attacks even though the first test result was negative.

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