My almost 11 yo son has had a palpably irregular pulse for at least 4 years. When I initially asked the pediatrician about it, she sent him for an EKG. The EKG was supposedly read by a pediatric cardiologist and the irregular pulse was deemed benign. About a year ago I asked our new pediatrician about it. He felt his pulse and said that it was irregular but was nothing to worry about.
Last night at around 11:30 p.m. my son told me that he had felt weird. When I questioned him he indicated that he had been anxious about something and that he was tired. I have a fingertip pulse ox and his pulse was in the high 50's/low 60's. He went to bed and I checked his heart rate several times during the night. His o2 ran from 95-97 and heart rate was from 52-61 every time I checked.
Today after getting up his numbers seem more normal. Does this sound like something I should get looked at? Long QT or heart block....
The most common reason for an irregular heart rate in a child is what is a normal finding called respiratory variation (or sinus arrhythmia, if reading it on an ECG). The heart rate increases with inspiration and decreases with expiration. Without evaluating your son, I cannot say if he has this or something more concerning. I can say that his nighttime heart rate readings suggest that he does have increased vagus nerve tone, which can slow down the heart rate. This can be more associated with respiratory variation, as well. As long as he has adequate blood flow to his brain and kidneys, I am not so concerned with the actual heart rate being in the 50's-60's. This is not likely to be long QT syndrome. Heart block is probably also of low likelihood here. I would check in with the pediatrician first and see if the ECG was read as sinus arrhythmia. If there are early beats (premature atrial or ventricular contractions), then it may be more appropriate to be seen by a pediatric cardiologist for this.
Thank you for your response. I did take him to his pediatrician who recommended he see a Pediatric Cardiologist to be on the safe side. The Cardiologist did an EKG and an Echo. He diagnosed sinus arrhythmia and said that everything else looked normal.
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