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13 years old. Feeling murmur in heart, getting fainting episode and leg congestion. Are they related to puberty?

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My son will be 13 in month. He is always very pale. He is a picky eater so I am sure to make sure that he has supplements for greens. He does eat fruit. He had a check up which showed a tiny rub or noise in his heart. Went to the cardiologist and it was so small that he said it was honestly not even a murmur. I even kept a flow sheet for BP, pulse, O2 and temp.
When we go out or he stands for 15+ minutes, his legs become very dark red. He says he doesn't like being around people in a store. One time he actually had to go outside because he turned as white as a ghost and felt like throwing up or fainting. His doctor said he was at the perfect weight and height, but now he has grown 4 inches since then and not gained an ounce. He also said some kids go through a bad puberty. I have had six children, 5 living, he is my youngest. My other son is 18 and did not go through this at 13 and my three girls, two of them grown have also never gone through this.
Posted Mon, 19 Nov 2012 in Growth and Development in Children
 
 
Answered by Dr. Santosh Kondekar 19 minutes later
Hi,

Thanks for the query.

Though many issues come during puberty and teen age… this does not seem so. Weight may grow little slower this decade, but height gain seems normal.

Regarding the fainting episode and leg congestion…. all this sounds like a syncope-like condition which need evaluation. We need blood pressure, electrocardiogram, cardiac echo and carotid Doppler to be shown normal to rule out a serious issue.

The problems seen in your son needs to be taken very seriously because from your description even 15 minute standing makes him symptomatic.

Murmur may not be related at this moment… heart electric conduction abnormalities may cause such issues though. Please take a cardiologist appointment.

Hope this information suffices. Write back if you have any further query.

Regards
Above answer was peer-reviewed by
 
Follow-up: 13 years old. Feeling murmur in heart, getting fainting episode and leg congestion. Are they related to puberty? 1 hour later
Im not trying to be rude, but you are not understanding that he had 16 different tests at a cardiologist. he had all those tests and he received a clean XXXXXXX of health. His heart is healthy, he only wanted to faint once. what about being pale? his Hemo is 14.3 so he is not anemic. BP is always around 110/75 or a little lower. O2 levels are at a 95% consistently. He says he feels weird around people and starts to feel closed in but yet he loves small places at home. Very happy as a child, never wanted for anything, loved camping, fishing and all that. Feels safe at home as I do. I have taken him to the doctor and they said all is normal. Now what?
 
 
Answered by Dr. Santosh Kondekar 3 hours later
Dear parent, here are your concerns addressed:

I’m not trying to be rude,
=== A good doctor never gets annoyed because parents are not supposed to be aware of details, medical enormous possibilities and uncertainties and lack of precisive tests in diagnosing most cases. So, being rude is welcome.


but you are not understanding that he had 16 different tests at a cardiologist.
=== Its good that the child is worked up well, but really I do not know exactly what those 16 tests were; and also the time frame when they were done.

he had all those tests and he received a clean XXXXXXX of health.
=== There are many conditions/issues which even so called extended complete body check or extended cardiology profile etc will miss. The tests if are not directed to the situation will not mean much. Such sets of normal test will only mean that he does not seem to be at any immediate risk to life.

His heart is healthy, he only wanted to faint once.
=== May be I misunderstood that he only wanted to faint once. With cardiac back ground I perceived this case as a fainting disorder. These misunderstandings do come in online consultations and that's why are the follow-up queries.


what about being pale? his Hemo is 14.3 so he is not anemic.
== Paleness is not always due to anemia. Some children may have paleness due to panic, anxiety, complexion, syncope and reduced blood sugar or blood volumes like say dehydration. Felt paleness may not mean much if an expert has already certified that the child is not pale on medical grounds. It’s good that he is not anemic too.

BP is always around 110/75 or a little lower. O2 levels are at a 95% consistently.
=== good BP may rule out syncope like conditions; but I would recommend your doctor to check BP immediately after getting up from a lying down posture. This may help doctor understand the diagnose and treat a condition called postural syncope.

He says he feels weird around people and starts to feel closed in but yet he loves small places at home.
=== Do you feel; he has some disorder of feelings? he may seem a bit introvert or claustrophobic. Medical science can give a different name to every condition. Does he get paranoid even by chance?
Feeling related issues are better tackled with psychologist; but some conditions like vertigo may exactly mimic these issues and they will respond promptly to antihistaminic medicines.

Very happy as a child, never wanted for anything, loved camping, fishing and all that. Feels safe at home as I do.
== Good that he takes interests in outdoor activities. How does he behave in groups? Does he feel insecure outside home?


I have taken him to the doctor and they said all is normal. Now what?
=== when specialists have said all seems normal... we need to trust them and try to understand how all this can be normal. As he seems to be very fair.... on standing, a good amount of blood gravitates along legs and that may make you see legs going red on standing... normal. As fainting episode was only once; we should attribute it to vertigo or syncope or postural or hypoglycemic or a panic attack or a phobia attack or even a seizure may mimic fainting at times. Enormous possibilities and a test are not available for every one of these conditions to diagnose for sure. Here the clinician's acumen, a good talk with child and some soft clinical signs by precipitating such episodes ... will surely help reach a conclusion... It may be any of these and/ or all is surely normal so that parents should relax calling it as normal variant.


I hope this makes you feel a bit relaxed. You may discuss with your doctor, with a print out of this advice too.

Feel free to be arrogant ... I can help you understand these situations.

Thanks again for replying kindly.
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