Palpitations in Children

What does palpitation mean?

Palpitation is the feeling of one’s own heartbeat as fast, irregular, or strong heartbeats. If the heart rate at the time of the child’s palpitation is not within the normal range for his age, this complaint should be considered significant and evaluated.

Is every palpitation a sign of illness?

We can feel our heartbeat more in times of excitement, sadness, anger and stress, feverish situations and during exercise. In such situations, which are considered physiological or normal, the reason for feeling palpitations is usually the heart pumping faster and stronger than normal.

Which palpitations are more important?

If the described palpitations start suddenly and end abruptly, if there are complaints of nausea, dizziness, blackout, chest pain, weakness and fainting, it should be kept in mind that the patient may have a serious rhythm disorder. Fainting is remarkable in these patients while sleeping, swimming, with sudden/unexpected sounds or while exercising. Patients with a family history of sudden death before the age of 35 are also more likely to have life-threatening rhythm disorders.

What is rhythm disorder?

All disorders in the electrical conduction system that regulates the contraction and relaxation of the heart, whether there is a structural disorder in the heart or not, are called rhythm disorders. There are many types of rhythm disturbances, from simple sinus tachycardia to very serious and life-threatening ventricular tachycardia (tachycardia originating from the ventricles).

Causes of palpitations in children

Apart from the physiological causes of palpitation mentioned above and not considered a disease, caffeinated foods and beverages (tea, coffee, chocolate, cola, energy drinks), cigarettes, alcohol, cocaine, some diet drugs, over-functioning of the thyroid gland (hyperthyroidism), anemia , deep breathing, low blood sugar, drugs (thyroid hormones, asthma, hypertension, flu, depression, some of the rhythm-regulating drugs), heart diseases and heart rhythm disorders are the main causes of palpitation in children.

Tests to be done in children with palpitations

For every child presenting with palpitations, first of all, electrocardiography (ECG) should be taken and heart rhythm should be examined. Especially when the patient reaches the doctor or hospital, the diagnostic value of the ECG to be taken while the palpitation complaint continues is high. Unfortunately, most of the patients are found to be normal even if the ECG is taken, because the palpitation subsides until the ECG is taken. If it is not possible to take an ECG, determining the child’s one-minute heart rate and measuring blood pressure at the time of the event may also help in the diagnosis. In addition, some further examinations can be planned according to the child’s complaint. These can be counted as echocardiography (ECHO), 24-hour Holter ECG monitoring, instant event recorders, exercise ECG (exercise) test and electrophysiological study.

Recommendations and treatments for children with palpitations

These patients should avoid tea, coffee, cola, chocolate, smoking, stress (tension) and insomnia. They should use drugs that have been shown to be associated with palpitations, such as thyroid, asthma, flu and depression drugs, under the supervision of a doctor.

During an attack of palpitations, the child should be calmed down and lie down, deep breathing and straining should be provided. In these patients, unilateral massage of the neck artery (only in older children) or washing the face with ice-cold water can end the palpitation. If the complaint of palpitation continues despite this, the patient should be taken to the nearest health institution and an EKG should be taken as soon as he reaches there. It should not be forgotten that rhythm disorders that cause fainting can result in sudden death. For this reason, children with palpitations should be evaluated by a Pediatric Heart Diseases (Pediatric Cardiology) Specialist. Depending on the type of palpitation, some of these patients are followed without drug treatment, while a single or multiple rhythm-regulating medication may be required for some patients. It is also possible to definitively treat some rhythm disorders that cause palpitations in children with cardiac catheterization and hot or cold burning methods during electrophysiological study.

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