A parent’s guide to understanding how fainting relates to common heart problems in children
If you ask a child to draw a picture of a heart, you get a curvaceously-shaped, pink or red figure. Heart means love.
If you ask a pediatrician to draw a picture of a heart, you get valves, arteries, chambers – maybe even some blue mixed in with red. Heart means pump.
But to both, heart means life, and if something isn’t working properly, the body is susceptible to injury or illness.
The Heart of the Matter
Syncope, the medical term for fainting, is actually quite common. An estimated 15-25 percent of kids will have at least one episode of passing out before reaching adulthood.
One common cause in toddlers is breath-holding—a rather effective temper-tantrum technique that terrifies parents.
While low blood sugars and migraine headaches can also cause syncope, 60 to 80 percent of the time it’s caused by low blood pressure or dehydration. This is the most common reason for fainting in kids between 15 and 19 years old. It is seen more often in females, because of puberty and hormones. Sports, particularly in Texas and especially in the summer, are a major cause of dehydration in tweens and teens, which is why we tell them to drink 36 to 48 ounces of water a day—more if they are athletes.
This type of fainting has a fairly clear reason behind it. More worrisome is the possibility of structural deformities of the heart, or early onset heart disease.
Sick at Heart
An indicator of heart abnormalities or disease is what your child is doing when he faints. If he has chest pain or heart palpitations right before, that’s not normal. If she’s running one minute, on the ground the next, that’s not normal. If he’s simply hanging out on the couch and faints away – not normal. If someone has to start CPR because not only has she passed out, but also her heart has stopped – that’s definitely not normal.
The above-mentioned symptoms are unexpected, but we should also take note of lingering problems that get worse with time. If there’s an increase in fatigue or exercise intolerance, we get concerned that something’s wrong with the heart. In other words, a child whose regular routine is affected by tiredness or increasing inability to run the football field needs to be checked out.
Matters of the Heart
No matter the reason behind it, fainting is not much fun to experience or witness. Some kids say they feel light-headed and dizzy, their visual field starts to narrow, they see spots, might hear a rushing sound – or nothing at all – feel dazed…then pass out.
Fainting is actually a self-preservation response. It’s the quickest way to begin breathing again. The brain is telling the body to drop down, because the heart is not getting enough blood. The heart has an easier time pumping blood sideways instead of up and down, which is why somebody goes from vertical to horizontal in a heartbeat.
You often see people who feel faint sit down and tuck their head between their knees. That works, but the best position is on the back, feet propped up. This helps blood from the legs make its way to the brain via the heart more efficiently.
Beat of a Heart
Some children will say it felt like their heart skipped a beat, fluttered or flip-flopped. This is called “arrhythmia.” True arrhythmias are not very common, but they can cause fainting. Arrhythmia is treatable, so it’s important to receive diagnosis as early as possible.
Another common concern is heart murmurs, a sound that is not the regular “lub” or “dub” of a heartbeat. It may be normal for your child, it may not be. It can be caused by a hole in the heart, or narrowing or leakage of a heart valve. But heart murmurs do not cause fainting, and quite often are “innocent,” meaning harmless. In fact, according to the American Academy of Pediatrics, as many as four in five youngsters have one. That being said, a pediatrician can determine whether or not further diagnostic testing is required.
Heart to Heart
The first time you hear an unborn baby’s heartbeat, the heart is already formed – now it just has to grow in size. It’s your job to take care of it when your kids are little, and their job to take over as they grow. Talk about nutrition, healthy habits – like not smoking – and exercise.
As always, consult a pediatrician any time you’re concerned about your little one’s ticker.
A Parent’s Nightmare: Sudden Cardiac Death
• Defined as non-traumatic, non-violent and unexpected
• Most often caused by a previously undetected heart problem – Rare: 10-13 cases reported in the U.S. each year – whereas 15,000 teens will die in car accidents
• More common in boys, African Americans, and football and basketball players – for reasons yet unknown
*Source: American Academy of Pediatrics at www.healthychildren.org
Parents’ Healthy Heart Checklist:
• become familiar with family history of early onset heart disease
• pay attention to symptoms experienced immediately before a fainting episode
• encourage nutrition, exercise, adequate intake of water and healthy lifestyle habits