Pediatric Heart Expert Forum
Abnormal EKG
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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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Abnormal EKG

My 12 year old daughter has had episodes of dizziness since October, Dr. felt that her sodium may be a little low and to increase salty food and sport drink intake, she had orthostatic BP's in October. Last spring she started to have some shortness of breath and coughing spells in gym and was started on inhaler for possible exercise induced asthma. Then last Thursday I wasthe ekg showed possible right venticular hypertrophy and  called by school nurse for chest pain, shortness of breath, and dizziness.  I took her to the doctor and she was treated for an ear infection which the Dr felt could be responsible for the dizziness.  The chest pain has continued non stop and is not relieved with antiinflammatories, heat, or antacids, and has even brought my daughter to tears.  A chest xray and ekg were done Wednesday.  The chest xray was normal and the ekg showed possible right ventricular hypertrophy and borderline prolonged QT segment.  The ped does not seem concerned and says she can continue with all her normal activities, including volleyball until she sees cardiologist in one month.  I am concerned for my daughter, should I push for her to be seen by cardiologist sooner?
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773637_tn?1327450515
Dear Allison,

There seems like there are several things going on here.  The dizziness is most likely not related to her heart, although without evaluating her, I cannot say for sure.  The ECG findings of right ventricular hypertrophy and borderline prolonged QT segment need to be confirmed by a pediatric cardiologist.  Often the ECG computer overreads these findings when they are actually normal.  The corrected QT (QTc) should be manually measured AT LEAST by your pediatrician to ensure that it is within normal limits.  So far, the symptoms that you list do not suggest anything associated with prolonged QTc, though.  Finally, the majority of chest pain in children and adolescents is non-cardiac in nature.  Your pediatrician should be able to tell whether the chest pain in cardiac, or not.  If you are concerned about her symptoms and the pediatrician cannot tell whether they are normal or not, then it is not unreasonable to try to be seen sooner by the cardiologist.
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The Children’s Hospital of Philadelphia
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