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Of the 15% of children and adolescents who experience syncope, <5% have a cardiac cause. However, publicity about sudden cardiac death among athletes has increased referrals to cardiologists for evaluation of syncope. Investigators at a children's hospital in New York State retrospectively compared clinical presentations of 17 patients (mean age, 11 years) with cardiac syncope and 89 patients (mean age, 13 years) with vasovagal syncope in a cardiology referral population.
The cardiac syncope group was significantly more likely than the vasovagal group to have no previous syncopal event (71% vs. 36%), syncope surrounding activity (65% vs. 18%) or at peak exercise (53% vs. 6%), or worrisome family history (heart disease before age 50 years or …