My 14-year-old daughter fainted three days back in the morning. What could have caused it?

Question

Hello doctor,

My 14 years old daughter fainted three days back in the morning when she woke up to study for her test. Her pulse was normal during the episode. She is good now, but I want to know what could have caused it to prevent further occurrence.

Answer 1

Hello,

Welcome to icliniq.com.

I hope she is doing fine now. There are numerous causes for fainting (syncope), such as dehydration due to improper intake of water, anemia, or menstrual cycle may also lead to syncope in female adolescents. It can also be due to vasovagal, which is the emotional upset, anxiety, sudden standing from sitting position, prolonged standing leading to vagal stimulation, and fall in cerebral perfusion causing fainting attacks. It can be due to cardiac - arrhythmia, structural heart disease, family history of heart disease, or sudden death in the family, neurological- may mimic seizure or vascular event. The specific triggers are positional changes, intercurrent illness, and emotional or painful stimulus, or a hot environment. These symptoms are typical for vasovagal syncope. Chest pain or palpitations immediately before syncope points toward cardiac disease and may require referral to a pediatric cardiologist and complete work up- blood pressure monitoring, ECG (electrocardiogram), 2-D ECHO (echocardiography), and 24 hours Holter monitoring. If the above-mentioned causes are normal, then seek a neurologist's opinion. My advise is to take adequate fluid and salt intake, correction of anemia, avoidance of anxiety or pain or emotional upset. Seek cardiology opinion if history or symptoms points towards the cardiac origin (if hypertensive or cardiac disease, then salt restriction). I hope this has given you some insight. Feel free to revert back in case of any doubt.