Pediatric Syncope 15-25% of children experience at least one syncopal episode by young adulthood Heart Disease has been the attributed etiology in as high as 10-28% of these cases ==> Historical features suggestive of Cardiac etiology (similar to adults): (1) Onset with exertion (2) No prodome or premonitory symptoms; Resulted in bodily injury (3) Incontinence, Seizure-like activity (4) Abnormal Cardiac Structure or previous cardiac surgery (5) Family Hx of unexplained Death or Accidents (MVC) (6) Required CPR (7) Resulted in neurological insult ==> Get the EKG! Look for (1) WPW (2) Prolonged QTc (3) AV blocks (4) BRUGADA Syndrome Yes, even in kids! Johnsrude, C.L., Current approach to pediatric syncope. Pediatr Cardiol, 2000. 21(6): p. 522-31.