If a 16-year-old boy recently experienced syncope during hard training, what is the next best step in his management?

In the case of a 16-year-old boy who experiences syncope during strenuous activity, it is critical to consider the underlying causes of his fainting episode. Syncope can be a sign of potentially serious cardiovascular issues, especially in adolescents engaged in intense physical training.

Referral to cardiology is a prudent next step because specialists in this field can conduct a thorough evaluation of the boy's cardiovascular health, which may require advanced diagnostic tests and assessments beyond the scope of a general physician. This could include echocardiograms, Holter monitoring, or exercise testing to rule out conditions such as arrhythmias, structural heart disease, or other heart-related anomalies that could pose risks during physical exertion.

While advising rest might alleviate immediate symptoms, it doesn't address the underlying cause and may leave the patient exposed to further risk if a serious condition is present. An ECG could provide valuable information, but it may not be comprehensive enough on its own to identify all potential issues that could lead to syncope. A physical exam is essential for initial assessment but should ideally precede or accompany a referral to ensure all potential causes are investigated comprehensively.

Thus, referring the patient to cardiology ensures that he receives the appropriate level of care and diagnostic exploration needed to safely manage his