• Kathleen E Walsh, Lindsay K Sanders, Joshua C Ross, and Azita G Hamedani.
• Department of Internal Medicine, Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
• J Emerg Med. 2012 Nov 1;43(5):e319-24.

BackgroundSyncope in the pediatric population is a common and mostly benign event. There is a subset of patients, however, in whom exertional syncope is the manifestation of a life-threatening cardiac abnormality.ObjectiveWe present a rare but serious cause of syncope in children that often presents as sudden cardiac death.Case ReportA 9-year-old boy presented to the Emergency Department (ED) after an episode of exertional syncope while in physical education class. This was the patient's second episode of exercise-induced syncope within a 2-year period. There was no family history of sudden death or cardiac disease. The child had not undergone any prior diagnostic work-up for the syncope. He was admitted to the hospital for further evaluation, and was found to have an anomalous left coronary artery on transthoracic echocardiogram.ConclusionAs a potential precursor of sudden death, exertional syncope in pediatric patients should prompt a thorough evaluation for a cardiac etiology.Published by Elsevier Inc.

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