Palpitations (Rhythm Disorders)

  • Arrhythmias (rhythm disorders)

Arrhythmia is an abnormal heart rhythm. Children may be born with rhythm disturbances such as rapid heart beat (tachycardia), slow beat (bradycardia), or irregular beating, or rhythm disturbances may occur at any time. Rhythm disturbances are called arrhythmias. Electrocardiogram in the diagnosis of arrhythmia (ECG), 24 hours ECG (Holter),exercise test (exertion test), electrophysiological study methods are used.

  • What are the causes of arrhythmia?

The majority of arrhythmias are seen in children with structurally normal hearts. However, arrhythmias are known to be associated with cardiac abnormalities in some children. Therefore, it should be investigated whether there is a heart abnormality in a child presenting with arrhythmia. In addition, the patient’s use of a drug that may cause arrhythmia, excessive caffeine intake, tobacco and stress factors are questioned.

  • Are there inherited types of arrhythmias?

Certain types of arrhythmias and heart diseases can be inherited and occur much more frequently within the same family. (can be passed from mother, father to child) . It is also known that some gene defects cause certain arrhythmias and heart diseases. If such diseases are encountered, the whole family is screened for this disease and, if necessary, it can be investigated by contacting the center that performs gene defect testing. Long QT syndromes can be given as an example of these diseases.

  • What symptoms do arrhythmias cause?

Complaints or symptoms may be mild or severe. It can cause a rapid heartbeat, chest palpitations, weakness, dizziness, blackouts, fainting, or chest pain.

  • What are normal and abnormal heart rhythms?

Normal sinus rhythm: It is the heart rhythm created by electrical impulses originating from the sinus node in the upper part of the right atrium. While this node generates 70-110 stimuli per minute in older children, the rate increases slightly as the age decreases.
Sinus arrhythmia: Fluctuations in heart rate that occur with breathing. It is more common in younger children. It is considered to be normal.
Sinus tachycardia:A higher than normal heart rate for that age originating from the sinus node.
Sinus bradycardia:A lower than normal heart rate for that age originating from the sinus node.
Supraventricular extrasystole: They are premature contractions originating from the atria. It is common in healthy children. It rarely yields.
Supraventricular tachycardia (SVT):from the upper cavities of the heart (from the ears) caused by a rapid heartbeat attack. It can be as short as seconds, or it can last for days. At this time, the heart rate is usually above 150 beats/min. There are many reasons.
Wolf-Parkinson-White syndrome (WPW):in children SVT It is the most common cause of It occurs due to the presence of an extra muscle band in addition to the normal conduction path between the atria and ventricles. This is a band of muscle that is too small to be seen during echocardiography. However ECG It can be understood from. While it may disappear spontaneously during infancy, it rarely resolves spontaneously after infancy.
AVNRT (AV node cyclic tachycardia): It is more common in adults. It is rarely seen in infants. HUNTING Occurs due to an extra path in the node. It arises and ends very suddenly.
Atrial flutter: It is rare in children. It is caused by an abnormal electrical loop within the atria. It is benign in the neonatal period and usually resolves spontaneously within 1-2 years. It is usually observed in older patients who have undergone surgery for complex cardiac anomalies.
Atrial fibrillation: It is rare in children. Irregularity caused by a large number of irregular electrical impulses originating from the atria. SVT ‘ is There are rarely familial forms. It can also occur after heart surgery.
Ventricular extrasystole (AND S) are the early beats originating from the ventricles. Although it can be seen in children with normal heart, it should be investigated as it may indicate an abnormality.
Ventricular tachycardia: Regular and rapid heartbeats originating from the ventricles. It can be short or long term. It can often be seen together with an underlying heart disease.
Ventricular fibrillation: It is an irregular and very dangerous high-speed heart rhythm originating from the ventricles. In this case, the heart cannot pump blood because it cannot contract adequately.
Heart block:from above your heart (from right ear) The starting electrical impulse passes through certain conduction pathways until it reaches the lower ventricles. In case of a block at any point of these pathways, the electrical impulse from above cannot be transmitted to the lower ventricles. Therefore, the harmony between the auricles and the ventricles is disturbed. In this case, the lower ventricles usually contract at a much slower rate than the upper atria.
sick sinus syndrome: It is the very slowing of the electrical impulses coming out of the sinus node and excessive pauses due to damage to the sinus node due to a certain heart disease or surgery. It can cause abnormally low heart rates.

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