Key result
Key clinical manifestations predict vasovagal syncope with ~72% diagnostic accuracy.
Why the study?
The haemodynamic diagnosis of orthostatic intolerance currently relies mainly on the head-up tilt table test, which can be risky for patients, necessitating safer diagnostic methods.
Can clinical manifestations predict the diagnosis of vasovagal syncope in children with orthostatic intolerance?
Observational (n=629)
Yes
Can clinical manifestations predict the diagnosis of vasovagal syncope in children with orthostatic intolerance?
Specific clinical symptoms can predict the diagnosis of vasovagal syncope in children with orthostatic intolerance with moderate accuracy (71.5%), potentially reducing the need for tilt table testing.
May aid noninvasive diagnosis via targeted history; leaves open need for prospective validation before routine adoption.
OBJECTIVE: At present, the haemodynamic diagnosis of orthostatic intolerance is based mainly on the head-up tilt table test, which is sometimes risky for patients. Thus, it is important to find objective and safe methods to differentiate haemodynamic patterns of orthostatic intolerance cases. METHODS: In all, 629 children with orthostatic intolerance, either vasovagal syncope or postural orthostatic tachycardia syndrome, were included in the multi-centre clinical study. We analysed the association between the clinical manifestation and haemodynamic patterns of the patients. RESULTS: Syncope after motion with a prodrome of chest distress or palpitations and the concomitant symptom(s) after a syncopal attack, with debilitation, dizziness or headache, were the most important variables in predicting the diagnosis of vasovagal syncope. The overall diagnostic accuracy was 71.5%. CONCLUSION: Complaint of syncope after motion with prodromal chest distress or palpitation and the concomitant symptom after a syncopal attack, with subsequent debilitation, dizziness or headache, were the most important variables in the diagnosis of vasovagal syncope in children with orthostatic intolerance.
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Chen et al. (2013) conducted an observational in Orthostatic intolerance (n=629). Clinical manifestations was evaluated on Overall diagnostic accuracy for vasovagal syncope. Specific clinical manifestations, including syncope after motion with prodromal chest distress and post-syncopal symptoms, predicted vasovagal syncope diagnosis with 71.5% overall accuracy.
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