Last week, we chatted about younger children and fainting so now it’s time to talk about older kids who faint. I’ve seen many teens that have fainted…even my own son (he fainted numerous times while he was an adolescent).   I decided to “read up” on causes of syncope (fainting) and I found out just how common it was. The highest incidence of syncope (and pre- syncope as in “I almost fainted”) occurs in up to 40% of adolescents and may be even higher among females!

The most common form of fainting among this age group is called “vasodepressor, vasovagal or neurocardiogenic” syncope. These terms all have the same meaning and describe the typical fainting event: a teen’s been standing for a period of time, and they begin to feel light headed and dizzy.

This often progresses to the feeling of having tunnel vision, the skin becomes pale, there may be the sensation of a rapid heartbeat, and feeling hot, although they may be cold and clammy to the touch. If these symptoms are not recognized and the teen does not sit down or lie down then fainting will occur.

The biggest fear from this type of fainting is really not due to the fainting episode itself (which usually does not last more than 15-30 seconds) but rather concern over a head injury when the patient falls. It is important to teach these “fainters” about the importance of paying attention to these symptoms and to sit down or lie down to prevent injury. Simple syncope will not hurt you!!

When seeing your child’s pediatrician it is important that a good history is taken.  I always ask my patients “when the fainting episode occurred, had they eaten, were they standing when fainting occurred and most importantly did the fainting happen with exercise or while at rest?  Did anything provoke the episode such as being anxious while standing to give a speech, or scared or grossed out during a movie etc.” Most patients have a good history as to why the fainting occurred.  Anyone fainting DURING exercise should be referred to a pediatric cardiologist for evaluation.

For all other fainters who have negative family history for sudden cardiac death, who have history consistent with simple syncope and who have a normal physical exam, the only test I order is an EKG, which should also be normal.  When all of this is done, I reassure both the patients and their parents that this is solely a fainting episode and may likely reoccur.

So, stay well hydrated, make sure not to skip meals, don’t get up too fast from bed first thing in the am and above all if you feel like you are going to faint, LIE DOWN.

That’s your daily dose for today.  We’ll chat again tomorrow.