I have an active 13 year old daughter that has recently starting having episodes of rapid heart rate (120-130) with some associated chest discomfort. Frequency is anywhere from 0 to three times per day. These episodes usually last up to a couple minutes and are not related to any particular type of activity - they occur when she is resting or moving around. She has been seen by a pediatrician. A chest x-ray showed nothing and an 24 hour halter monitor only showed a couple instances tachycardia (which she had noted in her log) but otherwise no signs of any arrhythmia. The discomfort she describes as mild chest pain, located just slightly left of the sternum. Basically when I feel her pulse and listen to her heart one would think she had sprinted the 100 yard dash. She has felt slightly lightheaded on a few occasions - but also anxious at the same so those two might go related. Otherwise she feels fine, not tired, exhausted, etc...
The pediatrician concluded that things are likely okay but could offer no explanation as to the cause. He did offer to refer to us a pediatric cardiologist if we wanted.
She is a freshmen in high school and has had some difficulties with friends and a couple of her classes, so I say she has some stress from that. She has been off for the Christmas break for a week now and has still a three to four episodes.
Should we let this ride for a few months before trying and further diagnostics?
From the description that you have given, I wouldn't be too concerned. It is very common for teens to have faster heart rates at times. They often times refer to having chest pain which is actually the feeling of the heart beating. There are only a few types of severe forms of congenital/aquired forms of heart disease in the young that cause true heart related chest pain. Chest pain is caused by a lack of bloodflow to the heart walls. in other words there is usually a structural problem going on with the heart. An eccho would show that. A heart rate of 120-130 really isn't that bad; it can easily raise to that rate from any type of panic or stress or anxiety. A dream can be a cause. A heart rate that JUMPS from say 80 to 160, on a dime and returns back to normal (80) on a dime should be investigated further as that is usually the sign of an extra electrical pathway such as WPW.
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