Syncope: Why Kids Faint


By Bernie on 09 Sep 2009




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Fainting by ~LordOfTheCarry
Photo Credit: deviantArt

Before I discuss children fainting, let me first say: take your kid to the doctor. I write "doctor" rather than "health care professional" because you may be reading this a few years from now and if Obama gets his Health Care Bill passed the term "health care professional" will mean a government idiot bureaucrat - but I'm being redundant.

Now don't get nervous, most causes of syncope (the medical term for fainting) in children are not life-threatening. However some dangerous medical conditions may first present as syncope.

Fainting occurs in 1 out of every 6 youth especially teenagers. Kids with low blood pressure may faint if they rise too fast from a lying or sitting position. Hopefully once they are horizontal on the ground, blood returns to the heart and brain and they should quickly regain consciousness. If they do not, do not call a doctor, call an ambulance.

I fainted the first time I took a blood test before I got married - the sight of blood leaving my body along with the fact that blood was actually leaving my body was too much for me. Since then, I have psyched myself to prepare seeing my blood and I no longer faint during blood tests or at the sight of blood (or as the medicine men say, "blood/injury syncope" which occurs 80% of the time with those afflicted with Blood/injury phobia, a common psychiatric disorder, with an estimated prevalence of 3% to 4% in the general population 1).

Twenty years ago when my children were 9 and 15 years old I would entertain them and their friends to campfire stories around our dining room table with all the curtains drawn and lights turned off. Although I know better now, I would have a very small candle flickering in the center as I told them stories involving cemeteries, ghouls, and creatures of the night. One particular young boy of 12, let me call him Joe (because that was really his name), would fold his ears and clasp his hands over them to avoid hearing my story when it seemed to be getting to the scary part. During one particularly frightening story, as I stretched out the heart-thumping ending, Joe fainted in his seat. He recovered a few seconds later and ran out of the room rather than listen any more.

This kind of fainting over frightening or graphic subjects is called "vasovagal syncope" and is the most common type of fainting. It can have many other triggers 2.

I used to smoke and one day in 1977 I coughed so strongly that I almost fainted and only avoided doing so by quickly lying down on the ground. Those who faint from coughing have what is appropriately called "cough syncope".

At many parties or weddings I attend it is not unusual for the guests around the table to burst into uncontrollable laughter at my jokes. I've had occasions where some could not stop laughing and had to force themselves to breathe deeply to keep themselves from fainting. But "Laughter syncope" is rare and in my decades of telling jokes no one has actually died laughing. Wouldn't my face be red if they did.

Less common, syncope may occur while urinating, known as "micturition syncope". To be as non-technical as possible, the involuntary nervous system sometimes has to open and close different valves while fluids are leaving your body; blood to the heart is slowed and at the same time blood flow to the legs is increased. Blood pressure is reduced and whatever blood is circulating goes to the legs instead of to the brain.

In a related manner, many of my readers may have noticed that it is almost impossible to pee and sneeze at the same time although it is possible to urinate while sneezing, just not voluntarily.

Some kids play too hard and vigorous whirling or arching of the back or neck may cause "stretch syncope". When I was 12 years old some of my friends would induce a "stretch syncope" by holding their breath for as long as they could while bending over and compressing their stomach. It was of paramount importance to have someone hold you while you were doing this because you would pass out in a few seconds and hit your head on the sidewalk otherwise. In about a minute or two you would recover. I caution all my readers who are parents to speak to their children that this can in some cases result in brain damage or death.

If your teenager only faints at concerts (usually girls between 11 and 17 years of age), it is most likely due to excitement with the caveat that any syncope that is preceded by palpitations or chest pain warrants a more complete evaluation, and if the child is young certainly by a pediatric cardiologist. A related syncope is Stendhal syndrome which occurs when one is exposed to a particularly beautiful or large amount of art in a single place.

There are hundreds of other causes that may contribute to blood not reaching the brain, and without going into as much detail as above, here are a few more: sitting or standing in one position too long; hyperventilation, hysteria (although that is covered in fainting at concerts), inner ear problems, dehydration, sunbathing, hurling (anorexia), pregnancy, low blood sugar, and more.

Which reminds me to tell you that all of the reflexive syncopes described here spontaneously terminate and are usually only dangerous if the youngster bangs his or her head during the syncopal episode.

I will postpone discussion of "Pallid breath-holding spells" that affect toddlers in response to sudden fright, anger, frustration, pacifier denial, or mild head trauma in another post.

If your teen faints because she is in the arms of a monster (King Kong Syncope), fear not, this is quite normal and considered De rigueur in Hollywood.

I recall my first sunset in Jerusalem (in 1965) when I almost fainted at the beauty before me. The illness here is appropriately called Jerusalem syndrome although in my case, because I am an atheist, I did not go through any religious psychotic experience.

Which brings me to my final note, religious syncope: if your child faints while fasting for some religious festival, it is strongly suggested you change your religion; if your child faints from rapture during prayer, it is strongly suggested you change your religion; if your child faints when he hears God speaking to him immediately take the child for psychiatric help.

Disclaimer:

It is not my intention to provide specific medical advice but rather to provide my readers with information so that they may better understand their health and their diagnosed disorders. Specific medical advice will not be provided, and I urge you to consult with a qualified physician for diagnosis and for answers to your personal questions. If the law of this country endangers your life by preventing you from obtaining medical treatment because of stupidity, government rationing or a misplaced sense of morals, then by all means take my specific medical advice since it may be illegal for you to consult with a qualified medical professional (and just hope for the best).


The above is an excerpt from my more detailed Disclaimer.







Notes



(1):

NCBI PubMed (A service of the U.S. National Library of Medicine and the National Institutes of Health), The epidemiology of common fears and phobia.

Blood/injury phobia is a common psychiatric disorder, with an estimated prevalence of 3% to 4% in the general population. It is classified as one of the specific phobias and is defined as a marked and persistent fear of clearly discernible, circumscribed objects or situations. The fear can be triggered by seeing blood, by sustaining an injury, or by receiving an injection or some other invasive medical procedure. In {approx}80% of the cases, the phobic response is characterized by syncope or presyncope. This response is peculiar to blood phobia and is not a characteristic of other specific phobias.

(2):

USA Today Health Encyclopedia, Causes and Risk Factors of Vasovagal Syncope

Vasovagal syncope is frequently recurrent and tends to take place during emotional stress (especially in a warm, crowded room), after an injurious, shocking accident, and during pain. Mild blood loss, poor physical condition, prolonged bed rest, anemia, fever, organic heart disease, and fasting are other factors which increase the possibility of fainting in susceptible individuals.





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