Syncopes in adolescents in sport
- 作者: Shablinova T.1, Shirmankina M.1, Tyurina A.1, Pigacheva O.2, Naumenko E.1, Ivyanskiy S.1, Balykova L.1
-
隶属关系:
- National Research Mordovia State University named after N.P. Ogarev
- Children’s republican clinical hospital
- 期: 卷 29, 编号 5 (2023)
- 页面: 409-418
- 栏目: Reviews
- URL: https://journals.rcsi.science/0869-2106/article/view/232007
- DOI: https://doi.org/10.17816/medjrf567803
- ID: 232007
如何引用文章
详细
The study analyzes current data on syncope in children and adolescents. The study presents the classification of syncope and briefly describes the clinical manifestations of neurally mediated syncope and the main methods of its diagnosis and treatment. Syncopes associated with organic cardiac pathologies and primary cardiac arrhythmias are caused by hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, coronary artery anomalies, primary long QT syndrome, Wolff–Parkinson–White syndrome, and bradyarrhythmias. The diagnostic features of syncope in children and young athletes and modern approaches to treatment and prevention are discussed.
Although most syncopes in athletes are not associated with physical activity and have a neurotransmitter genesis, a thorough medical examination is needed. Factors that induce the development of syncopes in athletes must be identified. A prerequisite for admission to sports is the exclusion of the cardiac and arrhythmogenic reasons of syncopes. The decision to expand the sports regime should be made only after a thorough collection of medical history, including family history, and a comprehensive examination. In addition, the degree of risk in view of injuries, provocation, or fatal events following the loss of consciousness during sports must be estimated. This is extremely relevant for sports such as swimming, complex coordination sports (gymnastics and acrobatics), auto and motor sports, and alpine skiing.
Although syncopes are common problems in pediatric practice, with only a few cases with cardiac causes based on structural or primary electrical myocardial diseases, they pose the greatest danger in sports medicine. Thus, such conditions must be excluded in young athletes because sports load can aggravate cardiac pathologies, which cause syncopes, due to untimely diagnosis before the start of a sports career.
关键词
作者简介
Tatyana Shablinova
National Research Mordovia State University named after N.P. Ogarev
编辑信件的主要联系方式.
Email: Doc.Parshina@yandex.ru
ORCID iD: 0000-0003-4401-8395
SPIN 代码: 7409-3568
graduate student
俄罗斯联邦, 98 Bolshevistskaya street, 430005 SaranskMarina Shirmankina
National Research Mordovia State University named after N.P. Ogarev
Email: shirmankina99@mail.ru
ORCID iD: 0000-0002-9049-5662
SPIN 代码: 2141-2903
resident
俄罗斯联邦, 98 Bolshevistskaya street, 430005 SaranskAnastasia Tyurina
National Research Mordovia State University named after N.P. Ogarev
Email: nas.leskina@yandex.ru
ORCID iD: 0009-0005-7346-429X
resident
俄罗斯联邦, 98 Bolshevistskaya street, 430005 SaranskOlga Pigacheva
Children’s republican clinical hospital
Email: oyupigacheva@rambler.ru
ORCID iD: 0009-0009-6581-1211
head of the pediatric department
俄罗斯联邦, Saranskn FederationElena Naumenko
National Research Mordovia State University named after N.P. Ogarev
Email: ei-naumenko@yandex.ru
ORCID iD: 0000-0002-5332-8240
MD, Cand. Sci. (Med.), associate professor
俄罗斯联邦, 98 Bolshevistskaya street, 430005 SaranskStanislav Ivyanskiy
National Research Mordovia State University named after N.P. Ogarev
Email: stivdoctor@yandex.ru
ORCID iD: 0000-0003-0087-4421
SPIN 代码: 9931-6767
MD, Cand. Sci. (Med.), associate professor
俄罗斯联邦, 98 Bolshevistskaya street, 430005 SaranskLarisa Balykova
National Research Mordovia State University named after N.P. Ogarev
Email: larisabalykova@yandex.ru
ORCID iD: 0000-0002-2290-0013
SPIN 代码: 2024-5807
MD, Dr. Sci. (Med.), professor, associate member of Russian Academy of Sciences
俄罗斯联邦, 98 Bolshevistskaya street, 430005 Saransk参考
- Shen WK, Sheldon RS, Benditt DG, et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society. Circulation. 2017;5(136):e60–e122. doi: 10.1161/CIR.0000000000000499 Erratum in: Circulation. 2017;136(16):e271–e272.
- Tereshchenko SYu. Cardiogenic syncopal states in children and adolescents. Current Pediatrics (Moscow). 2011;10(2):64–70. (In Russ).
- Chen L, Wang C, Wang H, et al. Underlying diseases in syncope of children in China. Med Sci Monit. 2011;17(6): PH49–PH53. doi: 10.12659/msm.881795
- Makarov LM, Komolyatova VN, Kiseleva II, et al. Epidemiology of the syncope in children and adolescents in elite sport (EPISODE-S research). Russian Bulletin of Perinatology and Pediatrics. 2019;64(6):62–67. (In Russ.) doi: 10.21508/1027-4065-2019-64-6-62-67
- Drezner JA, Fudge J, Harmon KG, et al. Warning symptoms and family history in children and young adults with sudden cardiac arrest. J Am Board Fam Med. 2012;25(4):408–415. doi: 10.3122/jabfm.2012.04.110225
- Hastings JL, Levine BD. Syncope in the athletic patient. Prog Cardiovasc Dis. 2012;54(5):438–444. doi: 10.1016/j.pcad.2012.02.003
- Han J, Lalario A, Merro E, et al. Sudden cardiac death in athletes: facts and fallacies. J Cardiovasc Dev Dis. 2023;10(2):68. doi: 10.3390/jcdd10020068
- Brignole M, Moya A, de Lange FJ, et al. Practical instructions for the 2018 ESC guidelines for the diagnosis and management of syncope. Eur Heart J. 2018;39(21):e43–e80. doi: 10.1093/eurheartj/ehy071
- Shkolnikova MA, Polyakova EB, Ildarova RA, et al. Syncope in children and adolescents. Journal of Arrhythmology. 2017;(87):59–71. (In Russ).
- Zavala R, Metais B, Tuckfield L, et al. Pediatric syncope: a systematic review. Pediatr Emerg Care. 2020;36(9):442–445. doi: 10.1097/PEC.0000000000002149
- Lisboa da Silva RMF, Oliveira PML, Tonelli HAF, et al. Neurally mediated syncope in children and adolescents: an updated narrative review. The Open Cardiovascular Medicine Journal. 2022;16. doi: 10.2174/18741924-v16-e2205110
- Blevins B. Syncope for the general pediatrician. Curr Treat Options Peds. 2015;1:168–179. doi: 10.1007/s40746-015-0017-5
- Ommen SR, Mital S, Burke MA, et al. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. Circulation. 2020;142(25):e558–e631. doi: 10.1161/CIR.0000000000000937 Erratum in: Circulation. 2020;142(25):e633.
- Bozkurt B, Colvin M, Cook J, et al. Current diagnostic and treatment strategies for specific dilated cardiomyopathies: a scientific statement from the American Heart Association. Circulation. 2016;134(23): e579–e646. doi: 10.1161/CIR.0000000000000455 Erratum in: Circulation. 2016;134(23):e652.
- Smith W; Members of CSANZ Cardiovascular Genetics Working Group. Guidelines for the diagnosis and management of arrhythmogenic right ventricular cardiomyopathy. Heart Lung Circ. 2011;20(12):757–760. doi: 10.1016/j.hlc.2011.07.019
- Makarov LM, Miroshnikova JuV, Poljaev BA, i dr. Metodicheskie rekomendaciĭ po kriterijam dopuska nesovershennoletnih sportsmenov k trenirovkam i sportivnym sorevnovanijam v sootvetstvii s vidom sporta, sportivnoĭ disciplinoĭ, polom i vozrastom pri zabolevanijah, patologicheskih sostojanijah i otklonenijah so storony serdechno-sosudistoĭ sistemy. Moscow: FMBA Rossii; 2019. (In Russ).
- Costa Oliveira C, Vieira C, Galvão Braga C, et al. Syncope in the athlete — minor changes, major diagnosis! Rev Port Cardiol. 2023;42(1):71.e1–71.e6. doi: 10.1016/j.repc.2019.08.012
- Sanatani S, Chau V, Fournier A, et al. Canadian cardiovascular society and Canadian pediatric cardiology association position statement on the approach to syncope in the pediatric patient. Can J Cardiol. 2017;33(2):189–198. doi: 10.1016/j.cjca.2016.09.006
- Shkol’nikova MA, Kovalev IA, Leont’eva IV, editors. Sinkopal’nye sostojanija u detej. Moscow; 2016. (In Russ).
- Colivicchi F, Ammirati F, Santini M. Epidemiology and prognostic implications of syncope in young competing athletes. Eur Heart J. 2004; 25(19):1749–1753. doi: 10.1016/j.ehj.2004.07.011
- Holtzhausen LM, Noakes TD, Kroning B, et al. Clinical and biochemical characteristics of collapsed ultra-marathon runners. Med Sci Sports Exerc. 1994;26(9):1095–1101.
- Monda E, Rubino M, Lioncino M, et al. Hypertrophic cardiomyopathy in children: pathophysiology, diagnosis, and treatment of non-sarcomeric causes. Front Pediatr. 2021;9:632293. doi: 10.3389/fped.2021.632293
- Veselka J, Anavekar NS, Charron P. Hypertrophic obstructive cardiomyopathy. Lancet. 2017;389(10075):1253–1267. doi: 10.1016/S0140-6736(16)31321-6
- Arghami A, Dearani JA, Said SM, et al. Hypertrophic cardiomyopathy in children. Ann Cardiothorac Surg. 2017;6(4):376–385. doi: 10.21037/acs.2017.07.04
- Malhotra A, Sharma S. Hypertrophic cardiomyopathy in athletes. Eur Cardiol. 2017;12(2):80–82. doi: 10.15420/ecr.2017:12:1
- Rage M, Mohamed M, Nor MA, et al. Cardiomyopathy and sudden cardiac death among the athletes in developing countries: incidence and their prevention strategies. Cureus. 2023;15(2):e35612. doi: 10.7759/cureus.35612
- Maron BJ, Doerer JJ, Haas TS, et al. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation. 2009;119(8):1085–1092. doi: 10.1161/CIRCULATIONAHA.108.804617
- Eckart RE, Shry EA, Burke AP, et al. Sudden death in young adults: an autopsy-based series of a population undergoing active surveillance. J Am Coll Cardiol. 2011;58(12):1254–1261. doi: 10.1016/j.jacc.2011.01.049
- Agbaedeng TA, Roberts KA, Colley L, et al. Incidence and predictors of sudden cardiac death in arrhythmogenic right ventricular cardiomyopathy: a pooled analysis. Europace. 2022;24(10):1665–1674. doi: 10.1093/europace/euac014
- Corrado D, Tintelen PJ, McKenna WJ, et al. Arrhythmogenic right ventricular cardiomyopathy: evaluation of the current diagnostic criteria and differential diagnosis. Eur Heart J. 2020;41(14):1414–1429. doi: 10.1093/eurheartj/ehz669
- Cadrin-Tourigny J, Bosman LP, Wang W, et al. Sudden cardiac death prediction in arrhythmogenic right ventricular cardiomyopathy: a multinational collaboration. Circ Arrhythm Electrophysiol. 2021;14(1):e008509. doi: 10.1161/CIRCEP.120.008509
- Rich L, Rarick J, Prahlow J. Arrhythmogenic right ventricular cardiomyopathy in a young athlete. Am J Forensic Med Pathol. 2021;42(1):64–66. doi: 10.1097/PAF.0000000000000616
- Wasfy MM, Hutter AM, Weiner RB. Sudden cardiac death in athletes. Methodist Debakey Cardiovasc J. 2016;12(2):76–80. doi: 10.14797/mdcj-12-2-76
- Groeneweg JA, Bhonsale A, James CA, et al. Clinical presentation, long-term follow-up, and outcomes of 1001 arrhythmogenic right ventricular dysplasia/cardiomyopathy patients and family members. Circ Cardiovasc Genet. 2015;8(3):437–446. doi: 10.1161/CIRCGENETICS.114.001003
- Towbin JA, McKenna WJ, Abrams DJ, et al. 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy. Heart Rhythm. 2019;16(11): e301–e372. doi: 10.1016/j.hrthm.2019.05.007
- Gao Y, Zhang Q, Sun Y, Du J. Congenital anomalous origin of coronary artery disease in children with syncope: a case series. Front Pediatr. 2022;10:879753. doi: 10.3389/fped.2022.879753
- Cheitlin MD, MacGregor J. Congenital anomalies of coronary arteries: role in the pathogenesis of sudden cardiac death. Herz. 2009;34(4):268–279. doi: 10.1007/s00059-009-3239-0
- Schnell F, Behar N, Carré F. Long-QT syndrome and competitive sports. Arrhythm Electrophysiol Rev. 2018;7(3):187–192. doi: 10.15420/aer.2018.39.3
- Komoljatova VN, Makarov LM, Kolosov VO, I dr. Jelektrokardiograficheskie osobennosti u junyh jelitnyh sportsmenov. Pediatriya. Zhurnal im G.N. Speranskogo. 2013;92(3):136–140. (In Russ).
- Makarov LM, Balykova LA, Gorbunova IA, Komolyatova VN. Changes in the QT interval during the test with dosed physical activity in healthy adolescents aged 11–15 years. Kardiologiia. 2012;52(9):15–21. (In Russ).
- Gomez AT, Prutkin JM, Rao AL. Evaluation and management of athletes with long QT syndrome. Sports Health. 2016;8(6):527–535. doi: 10.1177/1941738116660294
- Sawyer TJ, Cianci M. Wolff–Parkinson–White in a college athlete: why didn’t we pursue an EP study? JACC Case Rep. 2022;9:101531. doi: 10.1016/j.jaccas.2022.05.036
- Leung LWM, Gallagher MM. Review paper on WPW and athletes: let sleeping dogs lie? Clin Cardiol. 2020;43(8):897–905. doi: 10.1002/clc.23399
- Kabra N, Gupta R, Aronow WS, Frishman WH. Sudden cardiac death in Brugada syndrome. Cardiol Rev. 2020;28(4):203–207. doi: 10.1097/CRD.0000000000000259
- Ayabe K, Komiyama T, Hasegawa M, et al. Clinical significance of the head-up tilt test in improving prognosis in patients with possible neurally mediated syncope. Biology. 2021;10(9):919. doi: 10.3390/biology10090919
- Malloy-Walton L, Tisma-Dupanovic S. The approach to pediatric syncope with exercise. Heart Rhythm Case Rep. 2019;5(10):485–488. doi: 10.1016/j.hrcr.2019.04.012
- Sharykin AS, Badtieva VA, Kljuchnikov SO, i dr. Kriterii dopuska sovershennoletnih lic k zanjatijam sportom (trenirovkam i sportivnym sorevnovanijam) v sootvetstvii s vidom sporta, sportivnoj disciplinoj, polom i vozrastom pri zabolevanijah, patologicheskih sostojanijah i otklonenijah so storony serdechno-sosudistoj sistemy. Metodicheskie rekomendacii. B.A. Poljaev, E.V. Shljahto, editors. Moscow: FMBA Rossii; 2020. 101 p. (In Russ).