Authors: Nicoletto, Heather A.; Ellis, Mark W.; Laskowitz, Daniel T.; Kanter, Ronald J.; Perry, April E.; Burkman, Marilyn

Source: Journal for Vascular Ultrasound, Volume 31, Number 2, June 2007 , pp. 81-86(6)

Publisher: Society for Vascular Ultrasound

Abstract:

Childhood syncope is common, and there are three categories of causes of syncope: noncardiovascular pseudosyncope, cardiovascular syncope, and neurally mediated syncope. Tilt table testing has become a valuable tool in the evaluation for the cause of syncope in children. Adding transcranial Doppler (TCD) to the tilt table test to monitor the middle cerebral arteries (MCA) adds valuable information about the cerebral blood flow during a syncopal episode and can help the physician differentiate between the various causes of syncope. Three children with frequent syncopal episodes were evaluated using tilt table testing with multimodal monitoring, including TCD. One child, during her syncopal episode, had an increase in blood pressure, heart rate, and MCA flow velocities. This finding was consistent with noncardiovascular pseudosyncope, and she was sent for psychiatric treatment. The other two patients had hypotension, bradycardia, a significant decrease in MCA flow velocities, and an increase in pulsatility indices. Additionally, one of them experienced a 6-sec period of asystole. Both were diagnosed with neurally mediated syncope and were placed on fludrocortisone and a water and salt regimen.

Document Type: Research article

Publication date: 2007-06-01

More about this publication?

• The Journal for Vascular Ultrasound (JVU) is the official journal of the Society for Vascular Ultrasound. It consists of original scientific and educational articles, case studies, book reviews, technical reviews, ultrasound principle reviews, viewpoints, letters to the editor, and CME tests. Regular reading of JVU, published quarterly, will keep you current in your field and provide essential information that can be applied in your practice.
  
  Previously known as the Journal of Vascular Technology - View Volumes 16-26 here
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• In this Subject: Radiology & Imaging ,  Acoustics
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