Modified Calgary score in differential diagnosis between cardiac syncope and postural orthostatic tachycardia syndrome-associated syncope in children

• Published in: Cardiology in the young 2013-06, Vol.23 (3), p.400-404
• Main Authors: Yang, Jinyan, Zhu, Lulu, Chen, Stella, Li, Xueying, Zhang, Qingyou, Zhang, Fengwen, Chen, Li, Tang, Chaoshu, Du, Junbao, Jin, Hongfang
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Infant; Male; Original Articles; Postural Orthostatic Tachycardia Syndrome - diagnosis; ROC Curve; Sensitivity and Specificity; Syncope - diagnosis; Tilt-Table Test
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S1047951112001266

The present study was designed to analyse the usefulness of a modified Calgary score system during differential diagnosis between cardiac syncope and postural orthostatic tachycardia syndrome-associated syncope through a large sample sized clinical investigation. The study included 213 children, including 101 boys and 112 girls, with cardiac syncope or postural orthostatic tachycardia syndrome-associated syncope in the age group of 2–19 years (mean 11.8 ± 2.9 years). A modified Calgary score was created, which was analysed to predict differential diagnoses between cardiac syncope and postural orthostatic tachycardia syndrome-associated syncope using a receiver operating characteristic curve. The median of modified Calgary scores for cardiac syncope was −5.0, which significantly differed from that of postural orthostatic tachycardia syndrome (0.0; p < 0.01). The sensitivity and specificity of a differentiation score of less than −2.5 was 96.3% and 72.7%, respectively. Owing to the fact that the modified Calgary score was an integer, when less than −3.0 the diagnosis could be considered as cardiac syncope. The modified Calgary score could be used to make an initial differential diagnosis between cardiac syncope and postural orthostatic tachycardia syndrome-associated syncope in the clinic.