• Diagnosing the Cause of Fainting

     
     
     
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    11/23/2009

    To determine the cause of your child’s fainting, your child’s physician may use a number of diagnostic tests. [Link to III.F.4]   Of critical importance to the doctor, however, are details about how fainting episodes happen, how frequently they occur and the symptoms that are observed before and after the episodes.  

    Your child’s doctor may perform one or more the following tests to determine what’s behind the fainting episodes:  

    Electrocardiogram (ECG or EKG).  Abnormalities in heart rhythm, recorded by an ECG even when the child is feeling well, may provide clues to the cause of fainting. 

    Head-up tilt table test.  Used specifically to test for cardioneurogenic syncope, the head-up tilt table test is used to induce fainting.  (A special medication may also be given to enhance fainting.) Lying flat on a table, the patient is tilted to an almost upright position.  If the patient feels dizzy, usually with drop in blood pressure and slowing of the heart (the patient's heart rate and rhythm and blood pressure are constantly monitored during the test), a diagnosis of cardioneurogenic syncope is confirmed.

    24-hour Holter monitor.
      This test records the patient's heart rhythm for a whole day in order to catch any abnormalities during routine daily activities.

    Event monitor.  An event monitor is provided to the patient for a month.  If fainting occurs, heart rhythm is recorded and transmitted to the physician via a telephone line. 

    Echocardiography.  This ultrasound test, which creates a moving picture of the inside of the heart, is used to enable physicians to see if abnormalities of cardiac structure or function are the cause of too little blood leaving the heart for the brain.

    Treatments for Fainting

    The treatment chosen for fainting depends on its cause.  Cardioneurogenic syncope, the most common cause for fainting, can be prevented by keeping well hydrated all the time.  If this is not effective, then the use of some medications, such as florinef and beta blockers, may be prescribed to prevent it from occurring.

    Treatment for fainting that results from pulmonary hypertension and left ventricular outflow tract obstruction depends on the cause and nature of these conditions.  Both are severe cardiac diseases requiring extensive testing.