PACs in newborn

After my daughter was born, it was noted that she was having PAC's.  We took her to a cardiologist when she was  2 1/2 weeks old for a little reassurance that it was "common."  However, the cardiologist was rather rude about the fact that we were even there.  He did an EKG, that showed a normal sinus rhythm, and sent us home with the feeling that we should never have been concerned about her heart.  I haven't noticed the PAC's when listening to her since, however, she does have some other symptoms that I am wondering about.  Her legs and feet turn purple at times...this does not seem to correspond with them being cold or dependent.  She also will have a cool, clammy forehead when she eats or is crying.  This does not happen every time, but quite frequently.  Are these things that I should be concerned about since she was noted to have PAC's early on?  Would an ECHO be a good idea for her to have?  

[Marie M Gleason, M.D.]

Premature atrial contractions are very common in newborns and are generally benign.  They usually go away by themselves and require no intervention.  If your child has been seen by a cardiologist, had a physical exam by them, and the ECG was normal, then the chance of an underlying congenital heart defect is small.  The acrocyanosis (blueness, coolness) of the lower extremities is common in babies and relates to vasomotor instability in young children.  A clammy forhead with crying or eating is non-specific, and if your child is not breathing quickly, is feeding normally and gaining weight, then likely all is well.  If you have further concerns, please discuss them in more detail with your pediatrician and they can decide if further testing is warranted.