Re: sinus tachycardia

Posted By CCF CARDIO MD - DLB on April 16, 1998 at 21:47:27:

In Reply to: sinus tachycardia posted by Chris on April 16, 1998 at 08:58:43:






I posted before regarding my daughters tachycardia.  She just turned 13 not
too long ago and recently I found out that she's been snorting ritalin.  She
been doing this for about 2 months now.  Since she stopped it (and was very
happy too) she's been back to her normal self, smiling and laughing and just
plain happy again.  I'm really happy over that.  
She still has sinus tachycardia.  She tried to ride a bike last week to the
store but nearly passed out off the bike.  She stopped and rested and then
returned home.  She came in the house and layed down on the floor.  She
grabbed the event monitor that we had packed and ready to send back to the
cardiologist and put it on.  Her heart rate at that time (approx after 4 mins
of rest) was running anywhere between 150-230.. mostly around the 220 range.
The cardiologist said it was sinus tachycardia and nothing else.  He said
it's ok.  
I don't understand.. a 13 year old gets so exhausted riding her bike about
1/2 mile and nearly passes out.  Still running in tachycardia after 4 minutes
of rest and the cardiologist thinks it's ok.  She's not overweight and doesn't
look out of shape.  He said we could give her something for her tachycardia
but it may do more harm than good.  I'd prefer not to if it's not needed.
This cardiologist is for adults.  He said previously that she has a mild
holo-systolic MVP with thickened and elongated valves.  Also she has trace
tricuspid, pulmonic and mitral regurgitation.  Her left ventricle is 5.4CM
in diameter but I was told that's ok.
Can you explain the cardiologists reasoning on why he thinks the sinus
tachycardia is ok?  Would you tell your patients this was ok too?  Do you
suppose she just needs to get out and excersise more?  She won't do drugs
again.. I told her her heart is going bad because of the drugs and may or
may not go back to normal but it shouldn't get worse if she stops.  She's
very concerned over that and I feel she will never touch another drug again!!
But in the meantime, I'm still concerned.
Thanks
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Dear Chris:
Sinus tachycardia does not usually need to be treated.  It is usually secondary to some other condition, such as hyperthyroidism, anemia, or being out of shape.  Occasionally, certain arrhythmias (heart rate problems) masquerade as sinus tachycardia, but are in fact due to abnormal electrical connections in the heart.  These can be tricky to diagnose.  My general preference is that thirteen year olds be seen by a pediatric cardiologist.  An adult cardiologist can handle many heart problems in teenagers, but a pediatric cardiologist, with their training in general pediatrics, is better at treating the whole patient, including issues such as possible drug abuse.

If you wish for your daughter to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a pediatric cardiologist.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.