Question of the Week

For November 24, 2015

An 11-year-old boy reports that he was walking to school when he started to feel dizzy and saw "spots" in his field of vision. He briefly lost consciousness and started to fall down, but he was caught by a classmate. He did not hit his head and was carefully laid on the ground. He "woke up" within seconds, after which he felt well and acted normally.

He has not had any recent illnesses, he has no medical history, and there is no family history of early cardiac or sudden death.

His vital signs are age-appropriate. His heart rate is regular with no murmurs, rubs, or gallops; he has normal first and second heart sounds; and he has good pulses and perfusion. No focal neurologic deficits are evident. The rest of his examination is within normal limits.

Which one of the following next steps is most appropriate in evaluating this child?

Tilt-table testing