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Background: Vasovagal syncope (VVS) is the most common type of syncope and a wide variety of stimuli can trigger this reflex. The morbidity is high in children with VVS. The aim of this review is to describe the diagnosis and treatment of children with VVS.
Data sources: Related articles in PUBMED and CNKI in the last decade were reviewed. The data on the diagnosis and management of VVS were extracted and analyzed.
Results: The diagnosis of children with VVS includes basic method (inquiring history of syncope and physical examination), head-up tilt table test (baseline head-up tilt test, sublingual nitroglycerin tilt test and isoproterenol head-up tilt test), and standing test. The therapy includes education, behavior modification, training, standing training, oral fluid therapy, pharmacological treatment (beta blockers, fludrocortisone, alpha agonists, selective serotonin re-uptake inhibitors and captopril), and permanent use of pacemaker.
Conclusions: Basic method (inquiring history of syncope and physical examination) is most important. Sublingual nitroglycerin tilt test is recommended in the diagnosis of VVS. Education, behavior modification, training, standing training, and oral fluid therapy are effective in preventing VVS, but the effect of all medicines needs to be further investigated.
Key words: vasovagal syncope; head-up tilt test; children; diagnosis; therapy
World J Pediatr 2007;3(2):98-103
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