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Child complaining for fast heart beat. Should I consult a specialist?

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Cardiologist, Interventional
Practicing since : 1998
Answered : 424 Questions
My son is 4 (turning 5 in February). Is of normal height and weight, and very active with sports. He has been complaining for over a year now of "his heart beating fast XXXXXXX He says he can feel it up into his "windpipe" which to him is his throat/neck. The episodes are very sporadic and seem to only last a few seconds. They will sometimes occur once or twice in a day, and sometimes not for severals weeks. He comes to us and tells us when they occur. They seem to occur during both activity and rest. We have not noticed any other symptoms, and he seems completely normal after they occur.

Today, he had two episodes (hadn't had one in several weeks) in which my wife was watching him and he was just sitting there. My wife said he looked sick for 2-3 seconds, then back to normal, however, he did tell her he felt his heart beating fast. We will be booking an appointment with his physician. What are your thoughts? Potential causes? I'm assuming they'll want a 12-lead, 24-huor monitor to catch one of these episodes, echo?
Posted Thu, 24 Jan 2013 in Hypertension and Heart Disease
Answered by Dr. Prabhakar C Koregol 2 hours later
Yes, more or less I would agree with your thoughts. But many times, what we have seen, when a child of these complains of fast heart beat, it generally is not fast heartbeat and they have wrongly described it so.

But considering his symptoms, we need to look at carefully for arrhythmia but at his age, it's likely to be other diagnosis like breath-holding spells or absent seizure or it could be nothing else.

Yes, his physician may order ECG and Holter, if nothing abnormal noticed on clinical exam. If something abnormal, then further tests will be guided by the abnormality found.

Let me know if you need clarifications.

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Follow-up: Child complaining for fast heart beat. Should I consult a specialist? 41 minutes later
My thoughts are to me a 4-year old may not have a concept of his heart beating fast.

I suspect an arrhythmia, if so, what would cause it? Particularly because it only seems to last a few seconds and he is completely normal afterwards.
Answered by Dr. Prabhakar C Koregol 8 hours later

Thanks for the follow up.

Generally arrhythmia in children would be related to congenital heart disease or surgery for it. Other than that it would be related to electrolyte and metabolic problem, which doesn't look likely in your child.

Most arrhythmia behave the way you describe. Once normal rhythm comes, chid can be completely normal.

Hope this clarifies.

Above answer was peer-reviewed by
Follow-up: Child complaining for fast heart beat. Should I consult a specialist? 13 hours later
Ok, we are going to have it investigate it further, however, it doesn't sound like you are very concerned about it?
Answered by Dr. Prabhakar C Koregol 28 minutes later
Yes, that's right. But I would definitely suggest getting it investigated.

Once investigated, keep me informed. We can discuss further.

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