heart

[Tana_R]

My daughter is 10 years old.  She has been complaining of chest pains that also lead into the left side of her neck (sometimes severe).  We had EKG done, showed irregular pattern.  She wore a portable monitor for 24hrs. now family doctor says the report shows a varying heart rate.  What does that mean?  Sounds like an umbrella term, and should I get a second opinion to see what's really going on?

[grendslori]

How did the echo go? Generally speaking chest pain in children is very common and rarely ever caused by heart disease. Varying heart rates usually mean there is a Sinus Arrythmia going on which is normal because it is in response to breathing. While I have a respect for what some of the posters have written on here, I would have to disagree with some of the things said. If a child's heart rate is 180 during sleep, he could be having a bad dream; it is far more important to know if the rate of 180 started and stopped on a dime. If that is happening, the cause is the electrical impulse "jumping over' to a bypass tract that shouldn't be there in the first place. I would never consider teaching a 10 year old to take her own pulse as children of that age (as well as teens) can become obsessed with their hearts and things can really become out of control. Usually if children have true heart related chest pain, for it to have reached that point, they would have to have a severe form of cardiac disease or structure issues. The chances of you not being aware of that are actually pretty slim. You may not be aware of actual heart problems, but your child's daily living would be altered. Most CHD children start to limit their activities if they are having chest pain; they can't or don't want to try and keep up with their peers. They would tend to tire more easily then their peers as well. This is only my humble opinion, take it for what it is coming from a mother who has been there and lived through it.

[ka1218]

Good luck!

[Tana_R]

Thank you for your comments, you have both had helpful things to say.  I am taking her to Cincinnati Children's Hospital for an echo 2-D doppler tomorrow and see what they have to say.  

[MichelleP_3811]

This is not the expert forum so you may want to post in that forum for some professional advice though there is a fee to do so, so you are aware. I would say definitely go back and follow up with your doctor or find another.  Severe chest pain should never go unchecked.  Irregular rhythm can mean a few things, it could mean she is have extra beats in the atria called pacs or the ventricles called pvcs or should could have sinus arrhythmia where the heart changes rate from slow to fast with the breathing.  We all have it a little maybe a 10 beat difference but in children the difference can be much more pronounced.  In general doctors do not pay much attention to it unless the heart rate is dipping too low.  So what did the doctor say exactly?  Did he say she is fine or did he recommend any further tests?  I would definitely question him about the severe pain.  If he cannot see a cause in the tests he has done what other tests can he perform to check the health of your daughter's heart.  I will say pvcs can hurt even though they are harmless in isolated quantities but it is also important to have the heart fully evaluated to ensure there isn't more going on than just benign ectopic beats.  Well best of luck getting this  figured out.  Please do keep us posted.

[tom_h]

You were given a very broad diagnosis.  Everybody's heart varies in rate depending on what they were doing; sleeping, exercising, sitting at a desk.  I think a missing piece of data, is what was she doing at the time of these variances in heart rate. If the recorder measured 180bpm at 03:00, mostly likely this was during a period of sleep, and something would definitely be wrong.  Did your daughter report anything during that period.

I hate 24hr. Holters.  They look at such a brief period, and if nothing occurs during that period, doctors have a tendency to blow you off.  A 30 day monitor stands a much better chance of capturing a cardiac anomaly.  In the meantime, get your daughter to "listen" more closely to her heart if she thinks something is wrong.  In particular, teach her how to palpate her neck or wrist, and note the rate, how long it lasts,  Is her heartbeat steady, of jumbled, is it skipping.  This data is very helpful to a physician in trying to diagnose something.  Hope you get to the bottom it.