We review a general approach to syncope in children.
Hosts:
Brian Gilberti, MD
Ellen Duncan, MD
January 2, 2024 • 10 mins
Show Notes
- Initial Evaluation and Management:
- Similar initial workup for children and adults: checking glucose levels for hypoglycemia and conducting an EKG.
- The history and physical exam are crucial.
- Dextrose Administration in Children:
- Explanation of the ‘rule of 50s’ for determining the appropriate dextrose solution and dosage for children.
- ECG Analysis:
- Importance of ECG in diagnosing dysrhythmias like long QT syndrome, Brugada syndrome, catecholamine polymorphic V tach, ARVD, ALCAPA, and Wolff-Parkinson-White syndrome.
- Younger children’s dependency on heart rate for cardiac output and the risk of arrhythmias in kids with congenital heart disease.
| Condition | Characteristic ECG Findings | Congenital/Acquired |
|---|---|---|
| Long QT Syndrome (LQTS) | Prolonged QT interval | Congenital/Acquired |
| Wolff-Parkinson-White Syndrome (WPW) | Short PR interval, Delta wave | Congenital |
| Brugada Syndrome | ST elevation in V1-V3, Right bundle branch block | Congenital |
| Atrioventricular Block (AV Block) | PR interval prolongation (1st degree), Missing QRS complexes (2nd & 3rd degree) |