my sixteen year old is lightheaded, weak, and passed out

[annmarie13]

my daughter has been light headed, weak, tired and passed out last week. took her to her doctor, he heard a extra heart beat did some labs. her hemoglobin is a little low, potassium little low, he ordered a 2d echo. overall it was normal. im concerned the right ventricle says normal size with adequate systolic function. the left ventricle is normal size and wall thickness with good systolic function. i dont like the wording is their something to be concerned. she still is weak and dizzy alot. she eats healthy (shes a vegetrian for 5 years) goes to sleep by (9:30 gets up at 6:30) does not do sports, shes a artist, and active reader. her doctor says we dont need to see a cardioligst, or do anymore testing does this sound right

[Jeffrey R Boris, M.D.]

Dear Annmarie,

Although I have no access to the report, it sounds as if the echocardiogram is normal.  The symptoms that you mention are consistent with neurocardiogenic syncope, which is the fancy term for passing out.  The most common cause of this is dehydration.  Therefore, I would make sure that she is adequately hydrated.  I recommend that she have four 8-12 ounce glasses of fluid (water, juice, milk) per day as well as a salty snack (pretzels, saltines, pickles) in addition to everything she is eating and drinking.  Notice that I didn’t include chips—don’t want to give too much fat!  I also recommend that she not skip meals and that she eliminate caffeine intake (coffee, tea, soda, energy drinks), if she is doing either of these things.  Hopefully, this will fix her symptoms.  If she is still symptomatic, her primary care provider should be able to help her with more therapy.  I can’t say for sure if your daughter needs no further evaluation, since I’m not assessing her myself, but if this is typical syncope, there are also medications that can be used if the initial interventions don’t work.  One more thing—these interventions are not something that should be done for a week, or so.  This is something we see in adolescents quite frequently, and they typically last till adulthood, so adequate hydration is something she will need to continue during that time.

[EchoTech]

I am not a doctor.

The echo report basically says that the right side of the heart normally and that the left side of the heart pumps normally.  The wording is medical jargon so that when one doctor talks to another, everybody is on the same page as to what structures they are talking about.

She might think about taking in more fluids to help her feel better.  She might be dehydrated to a certain degree.  I personally prefer Gatorade, but any sports drink will help.