Background: 15-40% of children and young adults have had at least one episode of syncope. The most frequent types are the reflex-mediated syncopes (60-70%). 5-6 % are cardiac syncopes that include several life-threatening diseases that are essential to diagnose. This article presents reasons, assessment and treatment of syncopes in children and young adults.
Material: PubMed has been searched for relevant literature.
Results: A thorough medical history, ECG and echocardiography can reveal life-threatening cardiac causes of syncope. Reflex -mediated syncopes often have a typical history and always completely normal physical examinations and ECGs. A tilt test can be necessary and give further information. Cardiac syncope often occurs suddenly or during exercise. Reflex syncopes are treated with education, medication and sometimes insertion of a pacemaker. Treatment of cardiac syncope depends on the underlying disease and includes medication and device therapy.
Conclusion: Syncopes in children and young adults are mostly benign, but diagnosis of underlying life- threatening and treatable cardiac disease is essential.
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