Vasovagal Syncope and Dizziness in Kids: Why Your Child Is Passing Out and What Actually Helps
If your child has ever come home from school and said, “I feel dizzy,” you probably know how quickly that simple statement can make a parent's mind start racing.
And if your child has actually passed out? That can be downright terrifying.
As a pediatrician and pediatric cardiologist, I see a lot of children and teenagers with dizziness, lightheadedness, near-fainting, and fainting. And there is something I tell families over and over:
In many otherwise healthy kids, especially teenagers, dizziness and fainting are caused by a very common condition called vasovagal syncope.
And thankfully, there are things we can do about it.
What is vasovagal syncope?
Syncope is the medical word for fainting.
Vasovagal syncope is the most common type of fainting. It happens when the body's automatic nervous system responds in a way that causes blood pressure to drop, sometimes along with a slowing of the heart rate. For a brief period of time, not enough blood reaches the brain, and the person may feel dizzy or actually lose consciousness.
It often happens after standing for a long time, standing up quickly, being overheated, becoming dehydrated, or experiencing an emotional trigger. Some kids will notice symptoms before they actually faint, while others may lose consciousness fairly quickly.
The good news is that vasovagal syncope is generally a benign condition.
But that doesn't mean it isn't scary.
I understand how miserable this can feel because I've experienced it myself.
This is one of those conditions where I can tell families about the medical science, but I can also tell them from personal experience: I get it.
I experienced dizziness and vasovagal symptoms myself as a teenager.
And then I experienced them again during pregnancy and while breastfeeding.
I remember how miserable it can feel to constantly wonder when the next episode is going to happen. Feeling dizzy or like you might pass out can make you afraid to stand up, afraid to be somewhere alone, or worried that something is seriously wrong with your heart.
So when a teenager sits in my office and tells me, “I feel dizzy all the time,” I don't just hear a symptom on a medical history.
I understand how disruptive it can be.
And when a parent tells me, “My child passed out and I'm terrified,” I understand that fear, too.
Why does this seem to happen so often during the teenage years?
Adolescence is a perfect storm for these symptoms.
Kids are growing quickly. Hormones are changing. Their bodies are adjusting to changes in blood volume and circulation. And, let's be honest, teenagers are not always the best about drinking enough water.
They may go through an entire school day with very little to drink. They may skip breakfast. They may spend hours standing at school, practicing a sport, or sitting in class and then suddenly stand up.
Add heat, illness, stress, or dehydration to the mix, and the body may have a harder time maintaining adequate blood flow to the brain.
The result can be dizziness, blurry or tunnel vision, nausea, a racing heart, weakness, or fainting.
What can we do about it?
This is the part I wish more families knew.
For many children with vasovagal syncope or orthostatic symptoms, the first treatment is surprisingly simple: water and salt.
Not a prescription.
Not an expensive supplement.
Not a complicated medical procedure.
Water and salt.
Increasing fluid and sodium intake can help increase blood volume and make it easier for the body to maintain blood pressure when your child is standing.
I usually want families to think about hydration as something that happens throughout the entire day—not something a child tries to catch up on after they already feel terrible.
And salt matters, too. For children who are appropriate candidates for increased sodium intake, adding salt to food and incorporating salty foods can be helpful.
Of course, the exact amount of fluid and salt that is appropriate depends on the individual child. This is one reason I like to spend time talking through the child's symptoms, daily routine, diet, activity level, and triggers rather than simply saying, “Drink more water.”
What if water and salt aren't enough?
Sometimes they aren't.
And that's important.
If your child is drinking plenty of fluids and increasing salt appropriately but continues to have significant dizziness, near-fainting, or fainting, there are other treatment options.
Prescription medications can be used when lifestyle measures aren't enough.
Which medication, if any, makes sense depends on the child's symptoms and the underlying physiology. Medication isn't where I start for most kids, but it can be an important part of treatment for children who continue to struggle despite adequate fluid and salt intake.
The goal isn't simply to tell your child to “deal with it.”
The goal is to help them feel better and get back to doing the things they enjoy.
How do I know if my child's fainting is just vasovagal syncope?
This is an important question—and one of the reasons I don't recommend automatically assuming that every fainting episode is vasovagal.
Most fainting in children is not caused by a dangerous heart problem, but there are certain situations that deserve more careful evaluation.
I am particularly interested in things like:
Fainting during exercise or physical exertion
Fainting associated with chest pain
A racing or irregular heartbeat immediately before fainting
A family history of unexplained sudden death or significant heart rhythm problems
Multiple episodes occurring over a short period of time
Fainting without any warning symptoms
Significant injury associated with an episode
Symptoms that don't fit the typical pattern of vasovagal syncope
These situations don't automatically mean that something is seriously wrong. They simply mean we should take a closer look.
Sometimes that evaluation involves an EKG, checking blood pressure and heart rate in different positions, or additional cardiac testing depending on the history and examination.
What should my child do if they feel like they are going to faint?
The most important thing is to get down safely.
If your child starts feeling dizzy, lightheaded, nauseated, weak, or notices their vision changing, they should sit or lie down rather than trying to push through it.
Lying down gives the body a much better chance of restoring blood flow to the brain and also prevents a fall.
Once they are feeling better, we can work on figuring out what triggered the episode and how to prevent it from happening again.
Why I spend so much time talking with families about dizziness
There isn't one treatment plan that works for every child.
Two teenagers can both tell me, “I get dizzy when I stand up,” but their stories may be completely different.
One may barely drink anything during the school day.
Another may be drinking plenty of water but not getting enough salt.
Another may have symptoms primarily after exercise.
Another may have symptoms related to prolonged standing.
And another may have symptoms that don't fit a straightforward vasovagal pattern at all.
That's why the history matters so much.
I want to know when the symptoms happen, what your child was doing beforehand, what they had eaten and drank, whether they had been sick, whether they experience a racing heart, whether they have warning symptoms, and what makes the symptoms better or worse.
That information helps us understand what is actually happening and build a treatment plan around your child—not just around a diagnosis.
The good news: your child doesn't have to feel this way forever.
One of my favorite parts of caring for kids with dizziness and syncope is seeing the change that can happen when they finally understand what is going on.
Sometimes the solution really is as simple as:
More water.
More salt.
A few changes to daily habits.
And sometimes we need to go further.
But either way, your child deserves to be heard.
If your child is experiencing frequent dizziness, near-fainting, or fainting, especially if it is interfering with school, sports, or everyday life, it's worth having a conversation with their pediatrician.
And if the symptoms suggest that we need to look more closely at the heart, that's where my pediatric cardiology training and experience become especially helpful.
Sometimes we find something that needs treatment.
And sometimes, just as importantly, we are able to look at a worried parent and say:
“Your child's heart is okay.”
And I know how much that can mean.
Dr. Meagan Peek
I'm a pediatrician and pediatric cardiologist in Louisville, Kentucky, and I care for children and teenagers with dizziness, fainting, heart murmurs, chest pain, palpitations, high blood pressure, high cholesterol, and other concerns involving the heart and circulation.
After experiencing vasovagal symptoms myself as a teenager—and again during pregnancy and breastfeeding—I have a particular appreciation for how frustrating and frightening these symptoms can be.
My goal is to help families understand what is happening, figure out what their child needs, and create a plan that allows them to get back to being kids.
If your child is struggling with dizziness or fainting, I'd be happy to help.