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- Bryan Cannon, MD*
- Philip Wackel, MD*
- *Mayo Clinic, Rochester, MN
AUTHOR DISCLOSURE
Dr Cannon has disclosed that he is a consultant for Medtronic, USA, and serves on the Board of Directors for Mayo Support Services-Texas. Dr Wackel has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Educational Gap
Syncope is a common problem in children and adolescents, but the diagnostic yield for most tests used in its evaluation in pediatric patients is low, and testing should be guided by a careful history and physical examination. (1)
Objectives
After completing this article, readers should be able to:
List the most common causes of syncope in pediatric patients.
Understand the elements in the history or physical examination that may be related to a life-threatening cause.
Describe the basic evaluation for a patient who presents with syncope.
Discuss basic education principles for patients who present with uncomplicated syncope.
Screen and identify patients who require referral to a pediatric subspecialist.
Case Presentations
Case 1
A 14-year-old boy with no significant past medical history presents to the clinic following a syncopal episode. He reports that he had been standing in church and felt lightheaded before passing out. The event was witnessed and his parents describe brief seizure-like activity when he was syncopal. He woke up 2 seconds after he passed out and was alert and oriented. What is the most likely cause of the syncope? What further evaluation is necessary? What recommendations would you make for this patient? Would you refer him to a pediatric cardiologist or neurologist?
Case 2
A 14-year-old girl with no significant past medical history presents to the clinic following a syncopal episode. She explains that she was running a 100-meter dash and passed out in the middle of running. She had no symptoms before her syncope. She woke up after 4 to 5 …
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