Current approach to pediatric syncope

Syncope is the abrupt loss of consciousness and postural tone that reverses without intervention. Typically, syncopal episodes in pediatric patients a re brief, lasting seconds (rarely minutes), and are followed by complete re covery without residual neurological sequelae. Syncopal presentations may b e dramatic and lead family members and primary care providers to suspect a malignant cardiac condition, prompting referral to a pediatric cardiologist . Significant advances in the understanding of syncope in infants, children , and adolescents have occurred in the past decade. This review emphasizes neurally mediated syncope, but other etiologies are reviewed to complete th e spectrum encountered by pediatric cardiologists. Some clues are provided to distinguish the more common and benign forms of syncope from those due t o significant underlying heart disease.