Hong Cai1, Shuo Wang1,2, Runmei Zou1, Ping Liu1, Hong Yang1, Yuwen Wang1, Cheng Wang1. 1. Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, 12570Central South University, Changsha, Hunan, China. 2. 480673Jishou University School of Medicine, Jishou, Hunan, China.
Abstract
OBJECTIVE: To develop an orthostatic intolerance symptom scoring system to assess orthostatic intolerance and then to compare the symptom score among different head-up tilt test responses. METHODS: 272 subjects (5-18 years) presenting with orthostatic intolerance symptoms finished questionnaire and head-up tilt test. According to head-up tilt test hemodynamic responses, the subjects were divided into head-up tilt test negative, vasovagal syncope, and postural tachycardia syndrome groups. RESULTS: We built up a symptom score according to the frequency of dizziness, headache, blurred vision, palpitations, chest discomfort, gastrointestinal symptoms, profuse perspiration, and syncope. The median score in postural tachycardia syndrome subjects was highest. A score of 2.5 for predicting vasovagal syncope yielded a sensitivity of 75.0% and specificity of 50.3%, a score of 5.5 for predicting postural tachycardia syndrome yielded a sensitivity of 69.7% and specificity of 72.0%. Furthermore, the median score in postural tachycardia syndrome subjects was significantly higher than that in head-up tilt test negative subjects with heart rate increment of 30-39 beats/min (P < .01). CONCLUSIONS: This suggests that the symptom score has some predictive value in head-up tilt test results, which can be served as a preliminary assessment instrument.
OBJECTIVE: To develop an orthostatic intolerance symptom scoring system to assess orthostatic intolerance and then to compare the symptom score among different head-up tilt test responses. METHODS: 272 subjects (5-18 years) presenting with orthostatic intolerance symptoms finished questionnaire and head-up tilt test. According to head-up tilt test hemodynamic responses, the subjects were divided into head-up tilt test negative, vasovagal syncope, and postural tachycardia syndrome groups. RESULTS: We built up a symptom score according to the frequency of dizziness, headache, blurred vision, palpitations, chest discomfort, gastrointestinal symptoms, profuse perspiration, and syncope. The median score in postural tachycardia syndrome subjects was highest. A score of 2.5 for predicting vasovagal syncope yielded a sensitivity of 75.0% and specificity of 50.3%, a score of 5.5 for predicting postural tachycardia syndrome yielded a sensitivity of 69.7% and specificity of 72.0%. Furthermore, the median score in postural tachycardia syndrome subjects was significantly higher than that in head-up tilt test negative subjects with heart rate increment of 30-39 beats/min (P < .01). CONCLUSIONS: This suggests that the symptom score has some predictive value in head-up tilt test results, which can be served as a preliminary assessment instrument.
Authors: Hong Cai; Shuo Wang; Runmei Zou; Fang Li; Juan Zhang; Yuwen Wang; Yi Xu; Cheng Wang Journal: Front Pediatr Date: 2021-05-13 Impact factor: 3.418