The patient is overall well-appearing, sitting up in the exam bed on her phone. She denies chest pain, palpitations, difficulty breathing, phonophobia, or photophobia. With a repeat episode, mom brought her to urgent care for further evaluation. Earlier this week, she was diagnosed with vasovagal syncope and instructed to increase fluid and electrolyte intake and to follow up with her primary care physician. She has also had intermittent frontal headaches for the last 4 days and left sided tinnitus for the last 3-4 months. She states that she has only had one bottle of water in the last 24 hours. The episodes do not appear to be related to exercise. She reports feeling dizzy when this happens. Each episode has occurred when she stands up from a sitting or supine position and lasts a few seconds. Nehal Bhandari, MD, FAAP and Abbas Zaidi, MD, FAAP CASE PRESENTATIONĪ 12-year-old previously healthy female presents to urgent care with several episodes of “blacking out” over the past 4 days. As such, it is essential to keep a broad differential and to eliminate potentially life-threatening etiologies. ICD-10-CM R55 is grouped within Diagnostic Related Group(s) (MS-DRG v41.Urgent message: Syncope in pediatric patients may be attributed to a wide variety of sources.
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