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Heart Disease (Expert Forum)
12 year old daughter with AVNRT
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12 year old daughter with AVNRT
by oatbucket, Jul 04, 2007 12:00AM
My 12 year old daughter was recently diagnosed with AVNRT. The Pediatric Cardiologist was very reassuring in telling us this condition is not life threatening.But even though he told us that, she (and I) still get very afraid when she has an "episode". We've noticed that her episodes usually happen while she's riding her horse. They last no longer than 5 minutes (thank goodness) and seem to go away when she does the bearing down maneuver. She's had about 5 of them within the last 3 months, and 4 were while she was riding. I hope and pray that she doesn't have to stop riding because that is her passion. Here are my questions:
1.) her doctor said she was born with this condition so why did the symptoms just start showing up within the last year?
2.) can she have more than one "episode" a day? (rapid beats, event monitor caught one at 250 bpm)(that's the only one she had while she had the monitor. 3.) does stress REALLY aggrevate or bring the episodes on? 5.) if the bearing down maneuver or throwing cold water in her face etc, doesn't work, does the racing heart go back to normal by itself? 6.) is it possible for this condition to go away by itself or is it something she will always have? I know I'm asking tons of questions (and believe me, if I could think of more, I'd ask them here) but we just want to get all of the information we can about this as it's so new and scary. Any words of advice and wisdom would be greatly, greatly appreciated.
1.) her doctor said she was born with this condition so why did the symptoms just start showing up within the last year?
2.) can she have more than one "episode" a day? (rapid beats, event monitor caught one at 250 bpm)(that's the only one she had while she had the monitor. 3.) does stress REALLY aggrevate or bring the episodes on? 5.) if the bearing down maneuver or throwing cold water in her face etc, doesn't work, does the racing heart go back to normal by itself? 6.) is it possible for this condition to go away by itself or is it something she will always have? I know I'm asking tons of questions (and believe me, if I could think of more, I'd ask them here) but we just want to get all of the information we can about this as it's so new and scary. Any words of advice and wisdom would be greatly, greatly appreciated.
Doctor's Answer
by CCF-M.D.-CA, Jul 05, 2007 12:00AM
AVNRT simply means that her AV node ( the area of the heart responsible for slowing down the impulses from the top chamber of the heart) has at least two separate pathways: one a fast conducting normal pathway and a second slow conducting patways. Because of the differences in these two pathways an extra beat can cause the system to short circuit the AV node and conduct very rapidly. Although I am not a pediactric cardiologist, we generally ablate the second slow pathway in the AV node very frequently for this reason in adults. People are generally born with this physiology, but sometimes it doesn't manifest itself until later in life. Sometimes people have had it all their life but didn't know it. So the answers are:
1) Yes she was born with it but just because you have the substrate for the arrythmia it doesn't mean you will have it at all. Other factors such as increased atrial or ventricular beast (APCs or PVCs,) low vagal tone can trigger and perpetuate the arhythmia. 2) Yes she can have more than one events in one day. 3) I don't know about stress but increased cathecolachine levels (running , exercising, etc) can trigger AVNRT 5) It may, and it depends on the electrical characteristics of the two pathways,
6) It is very unlikely to go away by itself. And this is why we generally ablate the second AV nodal pathway.
1) Yes she was born with it but just because you have the substrate for the arrythmia it doesn't mean you will have it at all. Other factors such as increased atrial or ventricular beast (APCs or PVCs,) low vagal tone can trigger and perpetuate the arhythmia. 2) Yes she can have more than one events in one day. 3) I don't know about stress but increased cathecolachine levels (running , exercising, etc) can trigger AVNRT 5) It may, and it depends on the electrical characteristics of the two pathways,
6) It is very unlikely to go away by itself. And this is why we generally ablate the second AV nodal pathway.
Did the doctor say your daughter have wpw or an accessory pathway? I might confuse with AVNRT and SVT. Is she on any medication? Wait for the CCF doctor comment. I hope they'll give you an answer shortly.