What is fainting (syncope)?
Fainting is defined as a sudden loss of consciousness and muscle strength due to a temporary and widespread decrease in cerebral blood flow. It constitutes 1% of emergency department visits in childhood. It is seen in 15-25% of children, most frequently in the 15-19 age group. It has been reported that 20% of boys and half of girls under the age of twenty have had at least one fainting attack. The risk of these attacks recurring within five years is between 33% and 51%. This frequency and repetition, as well as possible head traumas and life-threatening heart-related underlying diseases, increase the importance of fainting.
Causes of fainting in children
Fainting associated with heart disease is less common in children than in adults. Fainting (vasovagal syncope), which develops as a result of low blood pressure due to improper pooling of blood in the legs in the body and the associated decrease in brain blood flow, is more common in children, especially after a triggering situation such as a sudden change of position, standing for a long time, anger, pain, fear. Apart from this, heart rhythm disorders, structural heart diseases, migraine, seizures, cerebrovascular diseases, blood sugar and electrolyte disorders or psychiatric disorders can also cause fainting in children.
Diagnosis of fainting
Mostly, fainting can be diagnosed with a good clinical history. However, the lack of objective diagnostic findings causes problems in approach, treatment and follow-up. In addition, detailed examinations are required due to the fear of families that their children may have a serious nervous system or heart-related disease and the concern that physicians treating these patients may not be able to diagnose a serious underlying disease. It has been reported that the diagnostic value of tests such as blood tests, lung x-ray, electroencephalography (EEG) and brain tomography is quite limited. However, with detailed history, physical examination, electrocardiography (ECG) and echocardiography (ECHO) performed by a Pediatric Cardiology Specialist, in most childhoods, The cause of death can be determined and it is shown that there are no heart diseases that pose a risk of sudden death. Thus, families' concerns can be eliminated. Rarely, advanced tests such as exercise ECG (stress test), long-term ECG recording or tilt table test may be required to diagnose fainting.
Treatment for fainting
Once it is shown that there are no life-threatening diseases, diet (especially drinking water), exercise and/or medication may be recommended depending on the patient's fainting type.
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