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A previously healthy 5 year old girl fainted while walking with her mother at a grocery store. She first complained of bad belly pain and fell on the floor and became unresponsive for about 15 seconds. She was fine otherwise except that in the past several weeks she seemed to tire easily. During the fainting episode, she did not have seizure, loss of bladder or bowel control. She was not on any medication. There was no family history of sudden death, seizures, or heart irregularity.

Upon arrival at the ER, she was normal looking without any signs of respiratory difficulty. Her vital signs were normal.

An ECG was done which showed low voltages and inverted T-waves in all precordial leads (this is abnormal). Chest x-ray showed an abnormal shape of the left side of the heart.

A sonogram of the heart showed a large solid tumor in the interventricular septum.

She was given amiodarone but continued to have fainting spells. When she was stable, surgery was done and the tumor at the heart was removed. It was benign fibroma.

She remained symptom free two years after the surgery.

Reference: Pediatric Emergency Care, Oct. 1998, page 342

Comment: All children with fainting spells should have an ECG (heart tracing). Other blood tests and EEG might help also.

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