Pediatric Heart Expert Forum
16 yr old abnormal EKG after fainting
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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16 yr old abnormal EKG after fainting

Last week my daughter who is an accomlished Cross country/Track Athlete was on a run in 86 degree heat. She has never been ill or has had any problems ever in the past with her heart or anything else.  She has a resting heart rate of 45-50 and was in perfect physical condition.  She became ill, weak and threw up.  She may have fainted (doesn't really know), and her hands and feet became swollen. She was taken to the hospital and admitted.  I was thinking she was dehydrated and they would send her home. They performed a Cat Scan, EKG and Echo.  The EKG showed abnormal T waves, although the echo was normal.  She saw a pediatric cardiologist yesterday who also perfomed a Ekg, which now was normal.

He mentioned the possibility of her having and "athletic heart".  He wants to do a treadmill stress test.  This is now scheduled for 2 weeks from now. I definitely want her health put first, but am concerned with the time frame.  Is this test necessary and what else should I be concerned with?  
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Dear Jamcookie,

Without evaluating her or seeing her ECG, I cannot tell you what the significance of this is.  The history certainly sounds as if it may be dehydration-related.  And, it very well could be that the ECG that was performed had the leads put in the wrong place.  Or, it could suggest something else wrong, although I would need more information to be able to say.  I am not sure what the cardiologist means by an athletic heart in this case.  Typically, "athlete's heart" means a thickened heart that is due to significant exercise, especially isometric.  I do not believe that this is seen as frequently in long-distance runners.  It is reversible by having 6 months of non-exercise.  However, with a normal echo, this doesn't sound like she has this.  Therefore, an exercise stress test sounds like an appropriate evaluation at this point, but she may require more, depending on these results.  
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Jeffrey R Boris, M.D.Blank
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