My son at 14 went in for his physical today and got denied to play baseball that he's been playing since 4. His blood pressure was high. Top number was 148 and low number ranged from 60 to 89 , tested 3 times. Doc listened to heart and heard a slight murmur. He then did an EEG and it came back unconfirmed. His vent was 93 bpm, rr interval was 640 ms, pr interval was 126 ms, qrs duration was 90 ms, qt interval was 330 ms, qtc interval was 387 ms, qt dispersion was 72 ms and prt axis was 123 52 3. It says sinus rhythm and extensive t wave changes. His notes say premature chd and EKG st changes with suggestion of lvh noted. He's 6'6" & 210 lbs. we have a long history of heart problems. His grandma passed away last yr from a severe heart attack and severe stroke. He sees a cardiologist on Tuesday but I just wanted to hear from others. Does the results seem that he does have heart problems and reason for concern?
RR interval looks in normal range.
PR interval looks in normal range.
QRS interval looks in normal range.
QT interval looks in normal range.
QTc variant looks in normal range.
I think their main concerns are the T wave and ST wave changes plus the mild hypertension (high blood pressure). More tests are required, but flat T waves and changes in ST can be normal in some people. Has he recently had an infection? it could be due to Anemia, or electrolyte imbalance. It could be down to a number of things, but I would have to rule out ischemia due to heart disease at his age.
As someone who was born with a bicuspid aortic valve (BAV), I can tell you that the high blood pressure, the murmur, and the emergence of symptoms in adolescence are consistent with BAV. I'm not saying that BAV is what your son has. I'm saying that it's something to rule out.
BAV is the most common congenital heart defect, and it often is not evident at birth. Typically, it starts to cause symptoms later in life, anywhere from childhood to middle age. Mine was diagnosed at age 49.
An echocardiogram is the test that should catch a BAV; unfortunately, there are a substantial number of false negatives for BAV on an initial echocardiogram. If the echo shows a BAV present, then your son has a BAV. If it does not show a BAV, then he probably doesn't have it, but there's still a possibility that he does and that it might show up on a later echo.
Lvh means left ventricle hypertophy, which -- if confirmed -- can result from hypertension that has been going on for a long time. When BAV is present, hypertension is the body's way of trying to compensate for a defective valve, and the lvh is a consequence of sustained hypertension.
In fact, I don't know what is going on with your son's heart, but something is. The good news is that you've gotten an early warning, so he can get care before anything bad happens. If it is a BAV, he will have to be followed by a cardiologist from now on, but he should be able to play baseball and have a normal life.
In my opinion, a pediatric cardiologist or a cardiologist who specializes in congenital heart defects is your best bet. If this upcoming appointment is scheduled with a "general" cardiologist, then fine. You have an appointment scheduled for this Tuesday, and it's completely understandable that you wouldn't want to postpone. Let this doctor that your son is seeing on Tuesday do his workup, which hopefully will include an echocardiogram, and maybe you will get the answers you need. If not, that's when you can think about moving on to a subspecialist. I wouldn't stop investigating until I got some solid answers.
I think there's a good possibiltiy that your son has some kind of condition that is going to require further monitoring, but FWIW I also think it's unlikely he has anything that is going to be life-threatening in the short run. Good luck, and please let us know what you find out.
At 14 your son should be seen by a pediatric cardiologist NOT an adult cardiologist because adult cardiologists do not really know that much about Congenital Heart Diseases (CHD). A pediatric cardiologist first studies cardiology and then he goes onto a secondary education in pediatric cardiology which the adult cardiologists do not study. HBP can be caused by a lot of things from heart issues to "White Coat Syndrome". Many people have a problem keeping their BP down when walking into the doctor's office. Your son's blood pressure could be a result of the fears he sees you going through. Now, having said all of that, my daughter was diagnosed with LVH (Left Ventricular Hypertrophy or HCM for short) when she was six years old. She actually had hypertrophy, or thickening, of both of her ventricles so she was said to have Concentric Hypertrophy. Her EKG S-T segments were slurred downward and her and T waves were severely inverted. They found a murmur in her for the first time when she was six; the murmur heard is very rare and very specific. IF your son has a true form of HCM and I am not saying he does, sports are probably out of the question as far as basketball and football. HCM is often times genetic in nature and runs in families, but it can be sporadic as well, although much rarer. If this is HCM, and again, I am NOT saying he has this, ischemia is a problem because the thickened walls lose their blood supply. His grandmother passing away from a heart attack would not be related to thise she probably had Coronary Artery Disease as you say she died from a heart attack. That's a totally different issue unless his grandmother died at a very young age from an arrhythmia issue where her arteries were clear from plague build-up which is the real reason for a heart attack to take place. Your son at 14 is very tall for his age. My own grandson is over 6", he was 13 at that point. Sometimes Marfan's Syndrome can result with hieght like that and I'm sure a pediatric cardiologist will be considering that point as well. Good Luck on Tuesday! Take care. (Also on a side note: there is a Forum here on MedHelp for parents and families dealing with CHD and their children. It is a support forum only; it is not the Expert Forum. It is called Pediatric Cardiology Forum)
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