My 7 Yr Old Has Had 2 Episodes Of Presyncope

Posted on Wed, 30 Jan 2019

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 30 Jan 2019 Answered on

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Question : My 7 yr old has had 2 episodes of presyncope with a 4 month difference 1 in Sept another in XXXXXXX It has happened after recess. He gets blurred vision, hearing loss and feels like vomiting or passing out for a few seconds to minutes. He hasnt passed out but I am extremely worried. He has been seen about it and the Doctor only said it can be due to him having border line normal low Blood pressure or him being tall and thin habing long legs takes the blood flow a while. I really need more opinions on this. Other times he isrunning around jumling sweating and this hasnt happened outsife of school. I have noticed its usually a hot day but other hot days it doesnt happen. I read about sudden death happening to kids?

Answered by Dr. Ilir Sharka (37 minutes later)

Brief Answer:
I would recommen as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

I passed carefully through your question and would explain that his symptoms could be related to low blood pressure values.

I don't think that he is at any increased risk for sudden death.

For this reason, I would recommend closely monitoring his blood pressure values and performing some tests in order to investigate for the possible underlying causes:

- a resting ECG and a cardiac ultrasound
- complete blood count for anemia
- thyroid hormone levels for thyroid gland dysfunction
- blood elecytrolytes for possible imbalance.

A prolonged ambulatory ECG monitoring (Holter) would help exclude any possible cardiac arrhythmia and thus calm your anxiety.

In the meantime, I recommend avoiding prolonged standing up position especially in hot places, increase salt and water intake in order to stay well hydrates.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Ilir Sharka, Cardiologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (4 hours later)

In the past his ferritin has been on the low side but no Anemia which I have him in iron supplements (Nova Ferrum) he is 7 years old and his height is 4ft 3inches or more now weight around 56/57lbs. Every time they take his blood pressure is low but tell me not to worry.
He gets sick more often than other kids but blood works comes out good. Besides white blood cells a little on the low side and ferritin.

Answered by Dr. Ilir Sharka (35 minutes later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Coming to this point, I would recommend checking again his iron plasma levels and take iron in case of deficiency.

Increasing salt intake can help increase his blood pressure and avoid low blood pressure values.

Anyway, I would recommend performing a prolonged (24-48 hours)ECG Holter monitoring and a cardiac ultrasound in order to totally exclude any cardiac issues, although his symptoms do not seem to be related to the heart.

You should discuss with his doctor on this test.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (2 hours later)

Would you suggest a cat scan? Do you think it has to go with anything in the brain?

Answered by Dr. Ilir Sharka (3 hours later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

I understand your concern and would not recommend performing a brain CT scan because I don't think it is necessary and it has a high radiation risk.

Regarding the brain, I would just recommend performing an EEG in order to investigate for possible seizures, although his symptoms are not typical of seizures (the blurring vision, noise in the ear are typical of low blood pressure).

Regarding sudden cardiac death, it is usually related to Brugada Syndrome and a prolonged ECG Holter monitoring would help investigate for this issue.

On the other hand, a cardiac ultrasound would help examine his heart function and structure and investigate for any cardiac birth defects.

You should discuss with his doctor on the above issues.

Hope you will find this answer helpful!

Wishing good health,

Dr.Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee