title: A 9-year-old boy with exertional syncope.
abstract: BACKGROUND
  Syncope 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.
  
  
  OBJECTIVE
  We present a rare but serious cause of syncope in children that often presents as sudden cardiac death.
  
  
  METHODS
  A 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.
  
  
  CONCLUSIONS
  As a potential precursor of sudden death, exertional syncope in pediatric patients should prompt a thorough evaluation for a cardiac etiology.
authors.affiliation: Department of Internal Medicine, Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Walsh
authors.forename: Lindsay K
authors.initials: LK
authors.lastname: Sanders
authors.forename: Joshua C
authors.initials: JC
authors.lastname: Ross
authors.forename: Azita G
authors.initials: AG
authors.lastname: Hamedani
mesh_terms: D002648:Child; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004562:Electrocardiography; D015444:Exercise; D006801:Humans; D008297:Male; D013575:Syncope / Q000209:etiology*; D014463:Ultrasonography