6 yr old with PVC and MVP

my 6 yr old son has fainted twice on us and becomes very letheragic and pale afterwards. We have had an EKG and echo. He is having PVC (over 2000 on his 24 hr monitor) and also has mitral valve prolapse. What can be done for him and his newest symptom is feeling of a spinning sinsation.

[Jeffrey R Boris, M.D.]

Dear Alice,

Fainting, or syncope, is unusual in children (or, at least much more so as compared to adolescents).  It sounds as if he has already had a Holter monitor performed that demonstrated >2000 premature ventricular contractions.  Although this sounds like a lot, this is a relatively low number as compared to the total number of heart beats during the day that a 6 year-old would have.  It would be good to know, however, if he had any "runs" of PVCs in a row, as this could be ventricular tachycardia, a potentially lethal arrhythmia.  If he does not have this, though, he still could be having regular syncope.  For all patients with syncope, it is important to ensure that they have enough fluid and salt in their system to make their "tank" full of fluid.  Without evaluating him further, though, I cannot tell you what further evaluation or treatment needs to be done.  The spinning sensation may be vertigo, so it may be that he should be seen by an ENT.  However, it also just could be dizziness associated with his syncope.  His cardiologist should be able to get a further history to determine what further therapy should be used, as there are medications that can be used for typical syncope if routine fluid and salt replacement fail.