My child has palpitations
Palpitations is an umbrella term describing many symptoms with the term meaning different things to different people.
Children have slender chest walls and can often become aware of their heart beating. The heart beating fast (normally fast) and forcefully can be perceived to be uncomfortable or painful.
Most often this is innocent and not due to a heart rhythm, issue.
Some children can have extra cardiac beats or an irregular heart rhythm (tachycardia (fast) or bradycardia (slow)). An irregular heart rhythm may be clinically important or asymptomatic.
Should I be worried?
A detailed clinical history of the nature, type and frequency of the 'palpitations', associated symptoms and family Hx can often help a padiatric cardiologist stratify the importance of any rhythm, issue if present.
A history of syncope or collapse would prompt more detailed investigation and assessment.
A positive family history of cardiac problems or history of early / unexplained death would raise caution. Formal paediatric cardiac assessment will include top to toe clincal examination & detailed echocardiography to best assess the structure and function of the heart.
12 lead ECG (or electrocardiogram)
This a valuable initial investigation. This test involves placing 12 stickers or electrodes on the chest and analysing how the electrical impulses spread through the heart. It is helpful to look at the heart rhythm
24 Hr holter cardiac monitor
This may be fitted to look at the heart rate and rhythm over a longer period. If there are exercise associated symptoms, a treadmill or bike exercise test may be undertaken, with real-time ECG monitoring to assess the heart under physical stress.
The results of these tests usually provide valuable reassurance or help plan further care.
Formal paediatric cardiac assessment will include top to toe clincal examination & detailed echocardiography to best assess the structure and function of the heart. The confirmation of normal cardiac structure and function in the context of a murmur is the gold standard for confirming that a murmur is ‘innocent’ in nature