Çocuk Kardiyoloji Polikliniğine Senkop Şikayetiyle Başvuran Hastaların Etiyolojik ve Elektrokardiyografik Analizi

Amaç: Polikliniğimize senkop şikayetiyle başvuran çocuk hastaların etiyolojik, laboratuar ve elektrokardiyografik açıdan analizini yapıp bu hastalara doğru yaklaşımı belirlemek amaçlanmıştır. Gereç ve Yöntem: Ağustos 2020 ile Temmuz 2021 tarihleri arasında senkop şikayetiyle başvuran hastaların retrospektif olarak epidemiyolojik, etiyolojik ve laboratuar verileri analiz edildi. Hastaların elektrokardiyografik verileri sağlıklı kontrol grubuyla karşılaştırıldı. Bulgular: Çalışmaya 50 hasta ve 41 sağlıklı kontrol grubu dahil edildi. Hastaların 22 (%44,00)’sinin ilk senkopla başvurduğu, 35 (%70,00)’inde senkop süresinin 2 dakikadan az ve senkop sayısının median 2 (1-20) olduğu gözlendi. Senkobu en sık uzun süre ayakta kalma tetikliyordu. En sık eşlik eden bulgu solukluk olarak saptandı. Etiyolojik olarak en sık vazovagal senkop (%64,15), ortostatik hipotansiyon (%15,09) ve psikojenik sebepler (%15,09) bulundu. Hastaların birine uzun QT sendromu, ikisine epilepsi tanısı kondu. Hasta ve kontrol grubu arasında elektrokardiyografik bulgulardan PR, PRd, QT, QTd, QTc, QTcd, TPe, TPe/QTc, Paks, Taks, QRSaks, QRS-T açısı ölçümleri açısından anlamlı fark saptanmadı. Sonuç: Senkoplu hastalarda iyi alınmış bir anamnez, fizik muayene ve elektrokardiyografik incelemeyle tanı büyük oranda konabilmektedir. Diğer tetkiklerin tanıya katkısı düşüktür. Elektrokardiyografide başta repolarizasyon anomalileri olmak üzere malign aritmilerin öngördürücüsü olan parametreler sağlıklı hastalardan farklılık göstermemektedir.

Etiological and Electrocardiographic Analysis of Patients Presenting to the Pediatric Cardiology Outpatient Clinic With the Complaint of Syncope

Objective: It was aimed to analyze the etiological, laboratory and electrocardiographic aspects of pediatric patients who applied to our outpatient clinic with the complaint of syncope, and to determine the correct approach to these patients. Material and Method: Epidemiological, etiological and laboratory data of patients who applied with the complaint of syncope between August 2020 and July 2021 were analyzed retrospectively. Electrocardiographic data of the patients were compared with the healthy control group. Results: Fifty patients and 41 healthy control group were included in the study. It was observed that 22 (44.00%) of the patients presented with the first syncope, in 35 (70.00%) the syncope duration was less than 2 minutes and the median number of syncope was 2 (1-20). Prolonged standing was the most common trigger for syncope. The most common accompanying finding was pallor. Etiologically, vasovagal syncope (64.15%), orthostatic hypotension (15.09%) and psychogenic causes (15.09%) were found most commonly. Long QT syndrome was diagnosed in one patient and epilepsy was diagnosed in two patients. There was no significant difference between the patient and control groups in terms of PR, PRd, QT, QTd, QTc, QTcd, TPe, TPe/QTc, Pax, Taks, QRSax, QRS-T angle measurements. Conclusion: In patients with syncope, the diagnosis can be made to a great extent with a well-received anamnesis, physical examination and electrocardiographic examination. The contribution of other examinations to the diagnosis is low. Parameters that are predictive of malignant arrhythmias, especially repolarization anomalies, on electrocardiographic do not differ from healthy patients.

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