Syncope toolkit

Syncope in children and young adults

In early childhood:

  • Vasovagal syncope in young children or Reflex Anoxic Seizures (RAS) - see more on vasovagal syncope in younger children.
  • Cyanotic (or blue) breath holding spells or reflex expiratory apnoea syncope or infantile reflex expiratory apnoea syncope – this is a common phenomenon and tends to occur when children stop crying after prolonged crying

In late childhood and young adults:

  • Vasovagal Syncope – there is a peak incidence of VVS around the age of 15, and it is twice as common in females compared to males
  • Initial orthostatic hypotension
  • Postural tachycardia syndrome – not all people with PoTS experience syncope
  • Mess trick or the ‘Fainting Lark’– the person first hyperventilates while squatting, then standing up quickly, strains (valsalva manouevre) then faints
  • Adolescent stretch syncope – a rare phenomenon seen in teenagers and young adults. It is due to hyperextension of the neck and mechanical compression of the vertebral arteries.

See sections on Cardiac syncope and Syncope and sudden death in athletes.

Further reading

Read Anomalous origin of left coronary artery in a child with syncope case history

Case histories