Syncope in Children and Adolescents

Palpitations, Dizziness, and Syncope in Teenage Girls: Practical Approach of a Pediatric Cardiologist

Palpitations, dizziness, and syncope are common in seemingly healthy teenage girls. Unfortunately, these symptoms can raise significant concerns in the patient and family, present diagnostic challenges to health care providers, and result in unhelpful and expensive testing and unnecessary restrictions on the patient. The possibility of serious underlying pathology may prompt referral to pediatric subspecialists including cardiology. This article presents some relevant background principles and practical guidelines from the perspective of a pediatric cardiologist. Elements of initial personal and family medical history and physical examination often distinguish benign conditions from more nefarious ones, or direct limited additional testing that ultimately confirms the presence or absence of heart disease. In addition, whether these symptoms are due to a condition that is serious or benign, every patient can benefit from an intervention, sometimes simple education and reassurance, behavioral or dietary modifications, medications, invasive procedures, or referral to other health care providers. [Pediatr Ann. 2022;51(11):e440-e447.].

Symptomatic Coronary Anomalies and Ischemia in Teenagers - Rare but Real

Three cases of teenagers with anomalous aortic origin of the coronary arteries (AAOCA) are presented with typical exercise induced symptoms (chest pain, syncope or dizziness). Using multimodal imaging, diagnoses was confirmed showing interarterial and/or intramural course of the coronary artery explaining the ischemia induced symptoms. Successful surgical correction with unroofing of the AAOCA was performed in all three cases with a favorable outcome. Even though AAOCA are rare, some variants may be relevant and potentially life threatening, therefore treating physicians should be aware of correctly diagnosing and treating these individuals.