Complete cardiovascular, neurologic, and pulmonary examinations are crucial, but the findings are normal in the vast majority of children with syncope, regardless of the seriousness of the etiology. The cardiovascular examination includes assessment of blood pressure, resting heart rate, oxygen saturation, and respiratory rate. Blood pressure and heart rate should also be measured during positional changes (orthostatic vital signs). Auscultation should be performed to identify any murmurs, abnormalities in rhythm, and variations or abnormalities in heart sounds. Any abnormalities in the cardiovascular assessment require an in-depth cardiac evaluation. 14
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