Neurocardiogenic/Vasovagal Syncope (Fainting)

Neurocardiogenic syncope (SINK-oh-pee) is a sudden loss of consciousness, often called fainting or “passing out.” It occurs in 15 to 25% of otherwise healthy children and teens.

Causes of syncope

Fainting (syncope) is often caused by:

• Changes in position (lying or sitting to standing).
• Emotional stress.
• Injury or pain.
• Anger.
• The sight of blood.
• Exercise.
  
  

Symptoms of syncope

Symptoms can occur before, during or after the fainting episode. They can include:

• Feeling weak.
• Feeling shaky.
• Nausea.
• Dizziness.
• Feeling light-headed.
• Increased heart rate.
• Blurred vision.
• Loss of vision.
• Skin color changes, such as looking pale or flushed.
• Stiffening or jerking of the arms or legs that can look like a seizure.

These symptoms are often due to a sudden drop in blood pressure and/or heart rate. Sudden drops in blood pressure can cause a decrease in blood flow to the brain, which causes the symptoms listed above.

What do I do when my child has symptoms of syncope?

• Have your child sit or lie down to prevent them from falling to the ground and being injured. This may also help prevent them from losing consciousness.
• When the symptoms stop, have them sit up. They can stand after a few minutes of sitting.
• Drinking water will help them feel better once they are conscious.

Preventing syncope

The best ways to prevent syncope are to stay hydrated and to increase salt intake.

How much water should my child drink each day?

We recommend that  children under 10 years of age should drink an 8-ounce glass of water for each year of their age.

• Your child should not drink more than 100 ounces of water per day unless their health care provider tells them to.
• Other fluids, like milk and juice, do count toward your total fluid goal.
• Your child should not drink caffeine and energy drinks. They can contribute to dehydration.
  
  

How can I add salt to my child’s diet?

Increase salt by adding salt to meals or eating salty snacks during the day. Ideas for salty snacks are:

• Saltine crackers.
• Pretzels.
• Pickles.
• Roasted peanuts or almonds.
  
  

What else can I do to help my child avoid fainting and syncope symptoms?

Try these ideas to decrease symptoms or make them less intense:

• Make slower position changes.
• Avoid standing in one spot for a long time.
• Encourage daily exercise. This will help increase muscle tone and promote blood flow back to the heart.
  • Ask your child’s doctor for a recommended exercise program for people with vasovagal syncope and dysautonomia, including POTS (postural orthostatic tachycardia syndrome).
• Compression stockings may be helpful for your child.
  • You can find generic, over-the-counter stockings at Amazon, Walmart, etc.
    
    

When should I get medical help for my child after a syncopal event?

Call your child’s doctor or visit the Emergency Room if a syncopal event (fainting) occurs along with:

• An irregular heartbeat.
• Chest pain.
• During exertion, such as running a race.

Or if the syncopal event causes:

• Large cuts to the head.
• Significant bruising.

Please seek medical attention for a more thorough cardiac evaluation if there is a history of family members who have syncope, or a history of sudden cardiac death.

You may need to use CPR if a fainting event lasts for several minutes. Talk to your child’s doctor about when and how to use CPR for your child.

Will my child’s syncope (fainting) get better?

For most children, symptoms of syncope will get better or go away within 9 to 12 months. Overall, neurocardiogenic syncope alone is not a sign of significant heart disease.

Often, the first thing your child’s doctor will recommend is some lifestyle changes, such as:

• Increase your child’s fluid and salt intake.
• Make sure they are getting daily exercise.
• Get them on a consistent sleep schedule.

If you have tried all these things and your child continues to have episodes of syncope or presyncope (feeling like they are about to faint), your cardiology provider can talk with you about medication options. Usually, they will recommend you try the lifestyle changes listed above for at least 3 to 4 months before adding medication.

Questions? Call your care team!

If you have any questions about your child’s care:

• Call Children’s Mercy Cardiology at (816) 234-3880.
• Send a message to Cardiology via the Patient Portal.
• Contact your child’s primary care provider.