14 yr old fainted while sitting 4 weeks ago. in last 5 mnths lost 17 pounds unintentional. 1st am urine shows protein of 30, midday 100. aorta bruit heard. ecg shwd possible atrial enlrg. aorta velocity of 1.89 on vasc u/s. r/o ideas? go from here?

Proper workup: Junior needs a full history and physical, including a stool guaiac, and probably a Holter monitor for 24 hours. There are red herrings here -- I suspect the proteinuria is orthostatic. Aortic bruits are common in healthy young kids, and need to be distinguished from a renal artery bruit. Ultrasonography could clarify this, as well as whether there is real pathology in the heart.