Fainting (Syncope) in Children and Adolescents
Fainting, or syncope, is very common among children and particularly among teenagers. The most common cause is the "common faint" which is related to low blood pressure, and can be triggered by many causes including:
Standing up too quickly or prolonged standing
A frightening or painful stimulus (such as the sight of blood)
A hot shower
Dehydration (not drinking enough fluids)
Having the hair combed or brushed
Breath-holding spells are a special case of fainting that occurs with a painful or angering stimulus and follows a very vigorous scream (or "silent scream" if no sound comes out).
Other causes of fainting include low blood sugar, migraines, overexertion, hyperventilation, abnormal heart rhythms, some types of heart problems and a variety of other conditions.
Only a small percentage of children with fainting turn out to have a serious problem, but warning signs that should prompt immediate evaluation by a physician include fainting associated with:
Exercise (fainting with exercise should prompt evaluation by a cardiologist)
No clear trigger or warning
Triggered by a surprise (such as a loud or sudden noise)
Congenital deafness (deafness since birth)
Palpitations (the sensation of a fast or irregular heart beat)
Known heart problems or a history of heart surgery
A family history of heart disease or sudden death
A history of drug abuse
The use of certain medications, including tricyclic antidepressants and some others.
The most effective treatment of the "common faint" involves two components: 1) recognize the symptoms that come before a faint (dizziness, seeing spots, sweatiness) and sit down, or lay down, right away to prevent a faint; and 2) increase the amount of fluid intake to 6-8 glasses per day, especially during hot weather or in the setting of vigorous exercise. These two measures should, in most cases, prevent a faint from occurring. If fainting continues, or if any of the factors in the second list above hold true, it is important to see evaluation from a pediatric cardiologist.
Web Links: Here are some Internet links that might be helpful. They look pretty good, but I cannot vouch for their accuracy or quality. As always with the Internet, browser beware!
Pennsylvania Children's Hospital: Fainting