Heart Palpitations in Children
Basics of Heart Palpitations
A heart palpitation brings an uneasy feeling that the heart is beating irregularly — whether it’s thumping, pounding, skipping, flopping, stopping, jumping or racing. A child may have difficulty putting into words what he or she is feeling during a heart palpitation. Some children may notice this odd sensation during exercise, with the heart possibly continuing to race even after they’ve stopped exercising.
Causes of Heart Palpitations
Many factors can cause a child to experience heart palpitations, including:
- Not drinking enough fluids on a regular basis
- Being out of good physical conditioning due to lack of exercise
- Feeling startled, frightened or stressed
- Cold, allergy and asthma medications
In rare circumstances, a child’s heart palpitations may be a red flag that the child has a serious medical condition, such as:
- Thyroid problems
- An arrhythmia, which is an irregular heartbeat caused by a malfunctioning of the heart’s built-in electrical system
Diagnosis of Heart Palpitations
A child’s pediatrician may refer the child to a pediatric cardiologist, a doctor who specializes in children’s heart problems. To diagnose the condition, the pediatric cardiologist takes a detailed medical history, may perform a physical examination and may order additional diagnostic tests such as:
- Electrocardiogram (ECG or EKG). A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias) and detects heart muscle stress.
- Echocardiogram (or “echo”). This procedure evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and its valves.
- Exercise electrocardiogram (ECG or EKG). An exercise EKG assesses the heart's response to stress or exercise. An EKG measures the electrical activity of a child's heart while the child exercises on a treadmill or stationary bike.
- Cardiac catheterization. This invasive procedure gives very detailed information about the structures inside the heart. Under sedation, a small, thin, flexible tube (catheter) is inserted into a blood vessel in the groin, and then guided to the inside of the heart. Blood pressure and oxygen measurements are taken in the four chambers of the heart, the pulmonary artery and aorta. In addition, contrast dye is injected to more clearly visualize the structures inside the heart.
The pediatric cardiologist may also recommend that a child wears a Holter monitor. This ECG recording device is worn over a period of 24 or more hours. Three electrodes are attached to the child's chest and connected to a small, portable ECG recorder by lead wires. The child goes about most of his or her usual daily activities (except showering, swimming or strenuous exercise) during this procedure. A physician may prescribe Holter monitoring when an arrhythmia is suspected but not seen on a resting ECG. Arrhythmias may be brief and not seen during a resting ECG’s shorter recording time.
Treatment for of Heart Palpitations
In the rare circumstances when a pediatric cardiologist discovers a child has heart palpitations due to an underlying heart condition, treatment options may include: