Causes and clinical characteristics of syncope in combat and auxiliary police in Korea

Choi, Kyu Young; Ahn, Seok Jin; Kim, Hyun Keun; Lee, Se Han; Yu, Chang Min; Cho, Jae Hyun; Yoo, Ji Won; Suh, Seong O; Kim, Eun Sil; Jung, Jun Oh; Park, Sang Joon; Kim, Youn Kwon; Kim, Soyon; Kim, Young Jung

Abstract

BACKGROUND/AIMS: The most common type of syncope in young adults is neurocardiogenic in origin, which is not related to organic problems and has a benign nature. Therefore, there have been few reports regarding syncope in young Korean adults. Here, we examined the causes of syncope and its clinical characteristics in young combat and auxiliary police in Korea.
METHODS
We performed a retrospective study of the medical records of 193 combat and auxiliary police in Korea admitted to the National Police Hospital for syncope or presyncope between January 2004 and December 2007.
RESULTS
The subjects' mean age was 21+/-1.2 years, and there were 2.8+/-2.9 episodes of syncope (mean+/-SEM). The first syncope occurred after enlistment in the police in 102 patients (52.8%). Basic diagnostic studies showed two cases of elevated creatine phosphokinase and one case of anemia to be related to syncope. Syncope-related traumatic injuries occurred in 38 patients (19.7%), and syncope was more prevalent in the summer. Head-up tilt test was performed in 175 of the 193 patients, and 123 showed a positive response. Other evaluations, including brain magnetic resonance imaging, electroencephalography, and echocardiography, were not helpful for diagnosis. Syncope was neurocardiogenic in origin in the majority of cases. Other causes of syncope were exhaustion (n=2), hyperventilation syndrome (n=2), Meniere's disease (n=1), anemia (n=1), and psychiatric problems (n=5). The causes of syncope could not be identified in 59 patients (30.5%).
CONCLUSIONS
Neurocardiogenic syncope was the most common type in our study population. More than half of our patients experienced their first episode after enlisting with the police. Further studies in these groups are necessary.