Search for: [Abstract = "The term „syncope” denotes sudden, transient loss of consciousness resulting from temporarily decreased cerebral blood flow accompanied by loss of muscle tone. Consciousness is regained promptly and spontaneously. Syncope episodes pose a common \(they occur in 15\-50% of children\) and serious clinical problem, since they may lead to dangerous injuries or else be a sign of a serious underlying disease. Since syncope is associated with an increased risk of sudden death, it is a source of anxiety for the patients and their families. The following causes of syncope are described\: neurogenic \(neurocardiogenic\), orthostatic, cardiological \(resulting from serious cardiac anomalies and diseases or arrhythmias and\/or conduction disturbances\) and cerebrovascular. Neurocardiogenic syncope \(NS\) is a sudden loss of consciousness resulting from abnormal autonomous reflex reactions, which affect heart rate variability and peripheral vascular resistance. An inexpensive, simple and effective test in diagnostic management of NS is the tilt test \(TT\) employed in accordance with the Westminster protocol \(the target tilt angle\: 60o, duration\: 45\-60 min., non\-invasive blood pressure assessment\). There are three general types of reactions to TT, where the basis of diagnosis is determination of the dominant sign\: \- hypotension \(the vasodepressive reaction – VD\), \- depressed heart rhythm \(the cardioinhibitory reaction \- CI\), \- depressed heart rhythm and hypotension \(the mixed reaction \- MX\). Valuable indirect indices of the autonomous system activity, the dysfunction of which leads to neurocardiogenic syncope, include heart rate variability \(HRV\) detected in 24\-hour EKG Holter monitoring. As it follows from the observations of numerous investigators, in individuals with NS, tilting reveals disturbances in sympathetic\-parasympathetic balance, manifested by HRV changes, in particular in the value of specific parameters of temporal and frequential HRV analysis. Such balance disturbances are also observed in some patients with mitral valve prolapse \(MVP\). Assuming that the background of NS and disturbances observed in MVP lies in dysfunction and dyscoordination of the vegetative system components, the analysis of heart rate variability may be of assistance in determination of the incidence of NS and selection of appropriate therapeutic management. The objective of the investigation was\: 1. to select from children and adolescents seen due to syncope episodes a group of patients with NS \(along with assessment of their age and gender\) and to determine the prevalence of NS among other causes of follow\-up examinations in patients of Cardiology Outpatient Department, 2. to establish the type of cardiovascular reaction and the time of its occurrence in reaction to TT in children with NS, 3. to analyze the type of changes in selected temporal and frequential HRV parameters in EKG Holter monitoring as compared to the type of reaction observed during TT in children with NS, 4. to evaluate the type of reaction to TT and HRV result during 24\-hour EKG monitoring in children with MVP, 5. to determine whether children with NS without any other cardiac abnormalities and children with MVP and a history of NS, demonstrate disturbances in basic sympathetic\-parasympathetic balance, detectable by means of HRV analysis, 6. to develop an examination protocol aiming at optimizing diagnostic management in children and adolescents with syncope of unclear etiology. The clinical material consisted of the total of 185 \(103 F and 82 M\) children aged between 7.4 and 18.5 years diagnosed at Cardiology Outpatient Department, University Children’s Hospital of Cracow, in the years 2005\-2008. The children were divided into three groups\: Group 1 \- children with NS, Group 2 – patients with MVP, Group 3 – the controls, consisting of normal children."]

Number of results: 0