Exercise-related syncope in the young athletes

Abstract

Syncope in the young is a frequent occurrence, which is usually harmless. Syncope on exertion can be a sign of a life-threatening situation or even sudden death, hence diagnostic work-up is always necessary. Syncope during exertion is more serious than syncope which occurs immediately after exertion. Whenever it is associated with exertion, it is most frequently neurocardiogenic, but other forms, such as cardiac, nervous/reflex or metabolic, are not excluded. There is still no specific test with which the type of syncope can be determined with certainty, hence it is necessary to obtain a precise history and carry out a clinical examination, laboratory investigations and electrocardiogram (ECG). If cardiac syncope is suspected, additional diagnostic tests such as echocardiogram and stress test are necessary. With the collected data, decisions are made on further management and a judgement is made as to whether the child can continue to be involved in sport.