Syncope

Syncope, which is the medical term for fainting, happens when there is a sudden drop in blood pressure, reducing blood flow through the body and the amount of oxygen delivered to the brain. As soon as the body becomes horizontal, lying on the ground, the blood pressure returns to normal and carries oxygen back to the brain. As a result, in most cases, the child quickly recovers.

Most of the time, fainting is not a sign of a critical medical condition. There are several common causes of fainting which may cause a temporary drop in blood pressure, including:

• Breath-holding – this is more common with toddlers who may hold their breath when they are mad or scared.
• Dehydration – this is the most common cause of fainting. Children and teens, especially those who are active outdoors or involved in sports, may not get enough fluid intake to replace what they lose.
• Hyperventilation-rapid breathing due to fear, or even extreme laughter, can lead to fainting.
• Medications – some prescription and over-the-counter medicines (like cough syrups) can cause fluctuations in blood pressure. It is a good idea to check with your child's pediatrician and/or the pharmacist to ask about any side effects your child might experience and to be sure that any medicine you give your child is safe.
• Reflex – this occurs when the body reacts to pain, trauma (such as the sight of blood), a fright, hearing about or seeing something gory (like in a scary movie or the discussion of blood or traumatic events).
• Sudden change in position – standing up quickly from a sitting or lying position can cause a momentary fluctuation in blood pressure.

Fainting can also be a symptom of a more serious medical condition. Children with heart or vascular disorders that restrict the flow of blood to the brain may experience syncope:

• Aortic stenosis – a defect which restricts the blood flow from the left ventricle to the aorta, reducing blood flow to the brain.
• Arrhythmias – irregular or rapid heart rhythms can trigger a fainting spell and may signal a more serious underlying cause.
• Myocarditis –an inflammation of the heart muscle that weakens the heart's ability to pump blood, decreasing the flow of blood and oxygen to the brain.

Some other serious medical conditions that might cause fainting may be:

• Anemia
• Brain tumors
• Diabetes or prediabetes
• Eating disorders
• Epilepsy
• Inner ear disorders
• Stroke

Most kids who faint have symptoms just beforehand. These may include:

• Dizziness
• Feeling lightheaded
• Skin is cold and sweaty (sometimes referred to as breaking out in a cold sweat)

Preventing a fainting spell

If your child is prone to fainting spells, there are some things you can do to help them head off an episode.

First, know the symptoms. Some people feel dizzy immediately before they faint. They may also notice changes in vision (such as tunnel vision), a faster heartbeat, sweating and nausea. Someone who is about to faint may even throw up. If your child experiences any of these symptoms, he or she can try the following:

• If possible, lie down. This can help prevent a fainting episode as it allows blood to circulate to the brain. Just be sure to have your child stand up again slowly when he or she feels better – start by moving to a sitting position for several minutes first, then to standing.
• Sit down with the head lowered forward between the knees. This will also help blood circulate to the brain, although it's not as good as lying down. When your feels better, have them move slowly into an upright seated position, then stand.
• Don't get dehydrated. It is very important for a child, teen or young adult to drink enough fluids, especially if his or her body is losing more water due to sweating or being in a hot environment. They should also drink enough fluids before, during and after sports and exercise.
• Keep blood circulating. If your child has any activity that requires standing or sitting for a long time, teach them to periodically tense their leg muscles or cross their legs to help improve blood return to the heart and brain. Whenever possible, your child should avoid overheated, cramped or stuffy environments.

In the majority of cases, syncope will not be serious. However, you should still make an appointment with your child's pediatrician to rule out any causes that could put your child's life at risk. During your visit your pediatrician will take a detailed history of the event and symptoms associated with the fainting episode. He or she will also perform a careful examination, checking blood pressure and your child's heart rate lying down and standing up. This is usually all that is required. However, if your pediatrician feels there is concern, you will be referred to a pediatric heart specialist for further evaluation. With state-of-the-art testing and diagnostics, the specialists at Cook Children's Heart Center can diagnose your child's condition and work with you and your pediatrician to determine the best course of treatment for your child's particular condition.