Pediatric Heart Expert Forum
Bigeminy
About This Forum:

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.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Bigeminy

my son's pediatrician picked up an arrythmia like 3 years ago during a routine check-up.
He is 8 years old now and is in constant bigeminy with occasional couplets and triplets... all ventricular. . He rarely has symtpmos. He goes every year, once a year, to the Miami childrens hospital  and gets examined and has an ECG, echocardiogram, 24 hour holter monitor and a  treadmill test. his cardiologist says that when his heart rate goes up the ectopic beats completely go away and so he has clear him to particpate in full physical activity.

My husband has CAD and has had a quadruple bypass and subsequent stent and I have documented coronary artery spasms (induced on a cath) and we are both on multiple cardiac meds. I just however learned I have a missing or very short left main coronary artery... which they are not going to do surgery on me as my pump function is normal... but was wondering if this finding in me could be a clue why my son has an arrythmia...

also am wondering as he gets older and wants to play in more vigourous intramural sports is this truly safe?

I have read on the internet that the #1 cause of sudden death arrythmias occur because of coronary artery anomalies  and now that it seems I have one I am reconcerned about my sons condition which up until now seemed pretty benign


he is not due to go back for his yearly cardiac check-up until August and I'm just wondering... my cardiologist didnt seem to know the answer here..

Related Discussions
773637_tn?1327450515
Dear questions,

You ask some interesting ones!  I think, though, that we have to separate out some of the issues here.  Unfortunately, we don’t always know the reason for benign isolated premature ventricular contractions (PVCs).  However, we do know that, in children, the natural history of these is to remain benign and to not be associated with coronary artery disease, coronary anatomic findings (like yours), or sudden cardiac death.  

When it comes to sudden cardiac death, the most common etiology in adolescents and young adults is actually hypertrophic cardiomyopathy, a genetic abnormality of one of the proteins in the heart that causes the heart muscle to enlarge for no apparent reason.  The second most common reason, though, is from coronary artery anomalies.  However, those abnormalities are not the same as what is seen in adult coronary artery disease, in which there is the formation of plaques and clots in the setting of well known risk factors, including high cholesterol, hypertension, diabetes mellitus, and cigarette smoking.  The coronary abnormalities are anatomic abnormalities in which one coronary artery arises in a steep angulated fashion or in which it travels between the aorta and the main pulmonary artery.  These abnormalities can cause decreased blood flow to the heart muscle that leads to injury or even death of the heart muscle.  However, the difference between this and what your son has is that any arrhythmias, such as PVCs, would likely get worse with exercise, not disappear.  The other factor to keep in mind is that if your son is being seen by a pediatric cardiologist, which I can’t tell by your history, and has had an echocardiogram, then the coronary artery anomalies like I mentioned above are likely to have been looked for.  That said, ask your cardiologist to be sure.  

For our other readers, the incidence of sudden cardiac death is VERY low, at 1 in 200,000, although if it happens to your child, it’s 100%.  That said, there is a greater risk of being hit by a car walking across the street.  Taken together, the risk of the coronary artery anomalies mentioned above are an even smaller fraction.  Meanwhile, the risk of death by coronary artery disease is much greater, and the pediatric population today is at a much greater risk than ever.  Therefore, it is important to continue to reduce the risk in things that we can control, such as stopping smoking (or not starting in the first place), and controlling diabetes, blood pressure, and cholesterol levels.  These last three can be controlled by in our pediatric population by reducing obesity or overweight with exercise, dietary, and other lifestyle measures and, if needed, appropriate medication therapy.
Blank
Continue discussion Blank
This Forum's Experts
773637_tn?1327450515
Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
Blank
Request an Appointment
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank