Syncope: A Guide for Parents

Common triggers include:

• Dehydration
• Standing for long periods
• Emotional stress
• Sudden changes in posture
• Medical conditions affecting the heart or nervous system

Syncope happens when the heart and blood vessels fail to maintain enough blood pressure to deliver oxygen to the brain.

How Does Syncope Affect Children?

When a child experiences syncope, it affects their body in several ways:

Before fainting (Presyncope):

• Dizziness or lightheadedness
• Nausea or feeling warm
• Sweating
• Blurred or tunnel vision
• Palpitations or a racing heartbeat

During syncope:

• Temporary loss of consciousness
• Collapse or limpness
• Brief twitching (sometimes mistaken for a seizure)

After fainting (Post-syncope):

• Confusion or disorientation
• Weakness and fatigue

What Causes Syncope in Children?

The most common types of syncope in children include:

• Vasovagal Syncope:
• Triggered by emotional stress, pain, or prolonged standing.
• Often harmless and resolves on its own.
• Orthostatic Hypotension:
• Caused by a sudden drop in blood pressure when standing up quickly.
• Situational Syncope:
• Triggered by specific actions like coughing, laughing, or urination.
• Cardiac Syncope:
• Caused by underlying heart problems, such as arrhythmias or valve issues.
• Less common but may require urgent medical attention.
• Neurological Syncope:
• Linked to seizures or other neurological conditions.

Risk Factors for Syncope in Children

Your child may be at higher risk of syncope due to:

• Dehydration: Not drinking enough water or losing fluids through sweat or illness.
• Emotional stress: Fear, anxiety, or the sight of blood.
• Prolonged standing: Particularly in hot environments.
• Medications: Certain medicines can lower blood pressure or affect heart rate.
• Medical conditions: Heart rhythm issues, structural heart problems, or autonomic dysfunction.

What Can Parents Do to Prevent Syncope?

While not all episodes can be prevented, these strategies can reduce the risk:

• Stay Hydrated: Encourage your child to drink plenty of water, especially during hot weather or physical activity.
• Identify Triggers: Help your child recognise and avoid triggers such as prolonged standing or skipping meals.
• Encourage Slow Transitions: Teach your child to stand up slowly after sitting or lying down.
• Use Physical Counterpressure Techniques. Teach them to cross their legs, clench their fists, or tense their leg muscles when feeling faint.
• Healthy Lifestyle: Ensure your child gets enough sleep, eats a balanced diet, and exercises regularly.
• Medical Management: If your child has an underlying condition, work closely with their doctor to manage it effectively.

When Should You Seek Medical Help?

Occasional fainting can be normal, but see a doctor if:

• The fainting episode occurred during exercise.
• There was no warning before the episode.
• The child has a known heart condition or family history of sudden cardiac death.
• Syncope happens frequently or is accompanied by chest pain, palpitations, or shortness of breath.
• After the episode, your child experienced confusion, weakness, or other neurological symptoms.

Diagnosing Syncope

A doctor may perform the following to identify the cause:

• Medical history and physical examination: To check for any patterns or risk factors.
• Diagnostic tests:
• Electrocardiogram (ECG): Evaluates the heart’s rhythm.
• Tilt-table test: Assesses blood pressure and heart rate responses to position changes.
• Echocardiogram: Uses ultrasound to examine the heart’s structure and function.
• Holter monitoring: Tracks heart activity over 24+ hours to detect irregular rhythms.

Treating Syncope in Children

Treatment depends on the cause:

• Lifestyle changes: Increasing water and salt intake (under a doctor’s guidance) and avoiding triggers.
• Medications: If the syncope is linked to low blood pressure or heart issues, medication may be prescribed.
• Pacemaker or cardiac intervention: In rare cases, when syncope is due to a heart problem.
• Therapy: For syncope related to stress or anxiety.

What if Syncope is Left Untreated?

While most cases of syncope in children are harmless, untreated recurrent episodes can lead to:

• Injuries from falls during fainting.
• Underlying heart or neurological conditions remaining undiagnosed.
• Anxiety about fainting, which may limit your child’s activities.

Supporting Your Child

As a parent, you can help by:

• Reassuring your child that occasional fainting is often not serious.
• Helping them track symptoms or patterns to share with their doctor.
• Encouraging open communication about their health and feelings.

If you’re concerned about your child’s syncope, consult a healthcare professional to ensure their health and safety. Most children can manage syncope and lead active, healthy lives with proper care.