Syncope in a 2-year-old: ED presentation of primary pulmonary hypertension.

We describe the case of a previously well 2-year-old girl who was found to have primary pulmonary hypertension (PPH) after presenting to the ED with syncope. Although physical examination findings were normal, an ECG and chest radiograph showed signs of PPH. The patient's hospital course was significant for syncopal episodes and sudden death while she awaited a heart transplant. This case illustrates that suspected cardiac syncope in the young warrants a focused ED evaluation with attention to causes of a life-threatening nature.