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     Hi SB,   I can't tell you exactly what the problem is with your child but I can tell you that it is very important that your child have an evaluation to find out what is causing the spells you described.   There are various heart and lung disorders that may be associated with shunting of low oxygenated blood to channels or chambers of the heart which bypass the lung where oxygen is taken up. Crying increases pressure in the chest (similar to grunting or bearing down as one would do when they are constipated and trying to pass stool). The increase in pressure within the chest may cause or enhance the shunting.   The passing out and breathlessness which accompanies your son's episodes is of much concern. I cannot over stress the importance of a full work-up which should be coordinated by your pediatrician or family doctor. Some non-invasive test evaluating the heart, lungs and blood should be ordered as a starting point.   Please give us a follow-up report (possibly create a SharePost) at your convenience.     Yours,   J. Thompson, MD