Pediatric Heart Expert Forum
Nighttime PVC's
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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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Nighttime PVC's

I am concerned about my 5 year old grandson.   He is very healthy, but has PVC's (I have listened with a stethoscope and am an RN) at night, when sleeping.   Basically no other symptoms.  He saw his pediatrician, who put him through the paces (run, jump, etc.) and she never found anything wrong.   He hasn't had a Holter monitor, or anything.   One time, when playing soccer, he was kind of holding his chest, but no other symptoms.  Could have been muscular.
Can this be a normal thing in children?   He is normal weight, 8 pounds at birth, full-term.
The pediatrician says only to worry if he has symptoms.
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773637_tn?1327450515
Dear DJ,

At this point, it is hard to say without him having any specific documentation of his rhythm, exactly what his rhythm abnormality is.  It also could certainly be respiratory variation, in which the heart rate speeds up with inspiration and slows down with expiration.  So, the first thing that I would recommend is actually documenting what the rhythm is.  If he does have early beats (premature atrial or ventricular contractions), it would make sense for him to be evaluated by a pediatric cardiologist.  That evaluation would likely include a 24 hour Holter monitor as well as an echocardiogram; in an older child, it might also include an exercise stress test.  These tests show how frequently the early beats are happening, if there are any structural reasons for the early beats (like tumors, etc.), and if it worsens with exercise, respectively.  Of note, if it does suppress with activity, we consider this to be benign, so that would be a good thing.
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773637_tn?1327450515
Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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