irregular heart beat in 13 year old

[jkf]

Dear Doctor,

Are PVC's (singles and couplets) common in teenagers?  My daughter will be 14 in April.  Last night she was sitting with me on the couch and she said her heart was jumping.  I felt her pulse and it was throwing out 3-4 PVC's in a row, then a pause then 2 in a row, then a pause, etc. for about 20 seconds. It was scary because it was more than just one extra beat at a time. They were in couplets and triplets. I had her sit up (because when mine does this, if I change my position they often go away) and they went away. She was not dizzy, short of breath or weak during the episode.   She said she feels this every once in a while.  She is very active in dance and water polo.  I called her doctor.  He told me not to worry, however we could do a stress test for peace of mind.  We did an echo on her 4 years ago and it was normal.  What do you think?  Should I worry?

[CCF-M.D.-RCJ]

jkf,

Thanks for your questions.

I am not a pediatric cardiologist, so I can't comment on the frequency of PVCs in teenagers.  However, I had them as a teenager, and I'm still alive ...

We'll have to assume that they were PVCs, but we certainly can't be sure without some monitoring.  But let's assume that they were for this discussion.  Also, why did your daughter have an echo at age 10?  That is uncommonly needed in an otherwise healthy 10 year old.

If she were my daughter, the things that would worry me about PVCs would be:
(1) Family history of sudden death or Hypertrophic Cardiomyopathy
(2) exercise intolerance or failure to keep up with her peers
(3) severe symptoms from the PVCs
(4) history of passing out
(5) history of congenital heart disease such as tetralogy of fallot
There may be other things that I should list, but those are the ones that first come to mind.

If you have PVCs and have done fine with them, then it is quite possible that your daughter has inherited this tendency and will also do fine.  I can't reassure you more without seeing your daughter, especially in the light of the information that she has had an echo in the past for an undefined reason.

Hope that helps.

[jkf]

Because of my history with "funky" beats, her doctor wanted to do the echo.  Just to make sure her heart was structurally fine.  Probably in case something like this came up.  He did tell me last night that we can run the other tests but I shouldn't worry too much because her heart is structurally okay.
Thanks for the response.  As far as items 1-5, I can answer no to all of them.