Heart Palpitations in Children

What Are Heart Palpitations?

Heart palpitations, the uncomfortable awareness of heartbeats, are a common complaint.  

People vary a lot in their ability to feel their heartbeat. Some people are entirely unaware of it, even if it's very irregular. Others notice unusual beats in a 24-hour period. Your child's doctor must determine when palpitations are a threat to your child's health and when to treat a problem. 

What Are Symptoms of Heart Palpitations? 

For no apparent reason, one may feel a short burst of rapid heartbeats. At times one may feel that the heart skipped a beat or two, or there may be awareness of having a very slow heartbeat. 

What Causes Heart Palpitations?

Infrequent palpitations or skipped heart beats can be from an early heartbeat that starts in the lower chambers of the heart called premature ventricular contractions. In the upper chambers, they are called premature atrial contractions. Both may be findings in normal people. Sometimes, there is no evidence of early heartbeats, and these are just sensations you can feel.

Heart palpitations may be caused by a variety of factors, including:  

  • Exercise 
  • Emotional upsets or stress 
  • Nicotine 
  • Coffee
  • Drugs
  • Electrolyte imbalance 

If they are frequent, they may be associated with underlying heart disease such as muscle disease of the heart (called cardiomyopathy), tumors, or inflammation of the heart (myocarditis). 

How Are Heart Palpitations Diagnosed?

Doctors can help determine if the palpitations are dangerous. They can also help determine if the unusual heartbeats are starting in the upper or lower chambers of the heart. This is usually seen on an electrocardiogram, which looks at the electrical activity of the heart.

Unfortunately, most palpitations occur when a doctor is not around. However, there is a test that can record your child's heart's electrocardiogram for 24 to 48 hours or even longer. This test is called ambulatory electrocardiographic monitoring (AEM), or Holter monitoring. AEM continuously records the activity of your/your child's heart on a tape cassette. Your child will place marking signals on a tape by pushing a button on the recorder when you/your child feel palpitations. Later, your child's doctor can review the tape and identify the type of palpitation and where it came from in your child's heart.

Other types of tests called event recorders are worn for several weeks and only record the rhythm for a short period after a button is pressed. This recording is then sent over the phone to the cardiologist's office for interpretation. This allows the detection of abnormal heart rhythms that do not occur very often or do not last long. 

Some patients have frequent or prolonged runs of palpitations, called arrythmias. Most palpitations are just nuisances and interfere with comfortable living, but when they happen in runs some are potentially dangerous. Some examples of arrythmias include supraventricular tachycardia (SVT) that comes from the upper chambers of the heart or ventricular tachycardia (VT) that comes from the lower chambers of the heart. The latter may sometimes be more concerning in adults as they can rapidly change into a more life-threatening rhythm abnormality such as ventricular fibrillation which may cause loss of consciousness and sudden death.

How Are Heart Palpitations Treated?

Reducing or eliminating the caffeine in your child's diet and reducing stress can help to lessen or stop palpitations. Many people feel so relieved after they hear palpitations are nothing to worry about that they no longer feel frightened when the palpitations occur. 

If your child's palpitations are not serious, your child's doctor may decide not to treat them. If your child does need or want treatment, the decision of how to treat the palpitations is based on several factors. The type of palpitations, the potential seriousness, the side effects of drug treatments, and your concerns will be taken into account. 

Most palpitations that require treatment use medications. Some arrythmias may not respond well to long-term drug treatment. If drug treatment fails, a treatment called ablation may be used. Radiofrequency ablation uses heat in the form of radiofrequency waves to burn off a tiny portion of your heart muscle. This usually permanently stops the palpitations/arrythmias. If drug and ablation treatment fail for the more serious arrythmias, sometimes devices are implanted in the heart may be placed to pace the heart out of the abnormal heart rhythm. 

Risks of Treatment

Unwanted side effects from the drugs are the most common problem. Sometimes side effects prevent the use of a drug. Ablation treatment is not always successful and may need to be repeated

What are the Long-Term Effects of Heart Palpitations?  

The long-term effects of heart palpitations depend on the underlying cause. In many cases, especially if the palpitations are occasional and not accompanied by other symptoms, there may be no long-term effects at all.  

If a child is experiencing frequent heart palpitations, it's important to see a doctor to determine the underlying cause and discuss any potential risks. Early diagnosis and treatment can help prevent complications. 

Heart Center Family Resource Guide

To help prepare families for their care with Lurie Children's Heart Center, we have compiled a list of resources about treatment and recovery. Learn how to get ready for an inpatient stay or outpatient visit, and read about our support services for patients and families.

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