SYNCOPE, SCD, INHERITED ARRHYTHMIAS, LQTS, SQTS, BRUGADA SYNDROME, CPMV

1. Dr. Murtaza Kamal MD, DNB, DrNB
Pediatric Cardiologist
March 12, 2023; Kakinada
Paramitha Hospitals, Hyderabad
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3. Syncope: Sudden, transient LOC associated with an
absence of postural tone secondary to relatively abrupt
cerebral hypo perfusion
SCD: Unexpected natural death from a cardiac cause
within a short time period, generally ≤1 hour from the
onset of symptoms, in a person with a known or unknown
cardiac cause
What???
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5. Syncope: Children & adolescence
• Unlike adults: Cardiac abnormality as a cause of syncope: Rare
Autonomic syncope
Vasovagal syncope
Postural hypotension
Dyautonomia
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6. Breath-holding spells Pallid spells Cyanotic spells
6 months-6Y 1Y--2Y 6months -2Y
Iron deficency Early form of VVS VSD+ PS physiology
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7. Syncope: Evaluation to be done seriously
Main purpose is to determine whether the child
has increased risk of death
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8. Suspect cardiac
syncope
• Lack of prodrome
• Palpitations/ chest pain
• Cardiac murmur/CVS exam
• Exercise induced syncope
• Family H/o-SCD/
arrhythmia/early death
• Previous h/o of cardiac
disease
Refer to
cardiologist
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10. •BRUGADA SYNDROME
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11. Brugada syndrome
RBB pattern
ST/J point elevation / coving pattern
V1-V3 leads
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12. Management
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Quinidine
Epicardial ablation
Fever treatment

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14. •LQTS
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22. •SQTS
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23. • ICD: Therapy of choice
• Propafenone/ quinidine/
sotalol: May help prolong QTi
and decrease potential for VF
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24. •CPVT
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25. CPVT: Catecholaminergic polymorphic ventricular
tachycardia
Flecanide, Verapamil
LCSD
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26. Non cardiac
IEM
Metabolic
Downs syndrome
5% channelopathies
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28. Take home message…
• Exertional syncope: Points to cardiac cause of syncope
• All Syncope cases: Consider arrhythmia—> Get ECG done
• Inherited arrhythmias—> High index suspicion and genetic
testing of patient and family
• SCD: Warning and prodromal symptoms—> Taken seriously
and evaluated—> Prevent SCD
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29. THANK YOU…
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