Syncope is a common problem in children and adolescents, but the diagnostic yield for most tests used in its evaluation in pediatric patients is low, and testing should be guided by a careful history and physical examination. (1)
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A 14-year-old boy with no significant past medical history presents to the clinic following a syncopal episode. He reports that he had been standing in church and felt lightheaded before passing out. The event was witnessed and his parents describe brief seizure-like activity when he was syncopal. He woke up 2 seconds after he passed out and was alert and oriented. What is the most likely cause of the syncope? What further evaluation is necessary? What recommendations would you make for this patient? Would you refer him to a pediatric cardiologist or neurologist?
A 14-year-old girl with no significant past medical...