Passing Out: Not for the Faint of Heart

LEXINGTON, Ky. (Oct. 24, 2016) — With the arrival of fall, children and teens become fully immersed in school and club sports. Although athletics are healthy and beneficial activities for youth, a cardiovascular event on the playing field can occur without warning and at any age.

Before any child or teen participates in varsity athletics, they should have a pre-participation physical. Your pediatrician, family practitioner or nurse practitioner can perform a routine physical exam. Unfortunately, despite the thorough job done by primary care practitioners screening for medical problems, a child might still experience an adverse health event on the field during intense play. 

Syncope, a medical term for passing out, is a temporary loss of consciousness after collapse known as “fainting.” If this occurs during athletic activity, the child should be taken out of play and evaluated by a physician before being cleared to return to activity. Up to 50 percent of people will experience syncope at some point in their lifetime, with the first episode often during the teenage years. 

Many of us have experienced a feeling of “lightheadedness” when we stand up quickly or have not eaten in a long time. This is different than true syncope when a person completely loses consciousness and collapses to the ground. If there is concern for possible serious problems by the primary physician, a child with syncope may be referred to a pediatric cardiologist, who can perform specialized testing including an electrocardiogram or echocardiogram, which is an ultrasound picture of the heart or a stress test.

Only 1.5 to 5 percent of cases of syncope will have a cause related to the heart, but the consequence of not making the diagnosis in these cases are tragic. The most common cause of “fainting” is dehydration and not taking in enough fluids or skipping meals and with proper eating habits and hydration. In children with recurrent episodes or those which raise concern for the primary physician, the pediatric cardiology team at Kentucky Children’s Hospital can evaluate their condition and guide them and their family through a diagnosis, possibly allowing them to return to play.

In the past year, the pediatric cardiology team at Kentucky Children’s Hospital entered into a partnership with Cincinnati Children’s Hospital Medical Center to create the Joint Pediatric Heart Care Program. Under this program, children born with a heart condition and children and youth with heart-related concerns across Kentucky can receive advanced specialty care. For more information about pediatric heart health, visit http://ukhealthcare.uky.edu/peds-cardiology.

Dr. Shaun Mohan is a pediatric cardiologist at UK Health/UK Children’s Hospital. Dr. Tim Knilans is the director of cardiac electrophysiology at Cincinnati Children’s Hospital Medical Center.

Media Contact:  Elizabeth Adams, elizabethadams@uky.edu