Pediatric Heart Expert Forum
Sinus Tachycardia in a 5 yr old male
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Sinus Tachycardia in a 5 yr old male

Our son has been diagnosed with sinus tachycardia twice now.  The first time was about 10 months ago, he went nonresponsive and had a heart rate of 145-197 bpm while at the hospital.  He also had a small infection (no antibiotics required), 10% dehydrated, a temp of 103 degrees, and a blood sugar level of 125 (he is not diabetic).  Recently he came down with hand foot and mouth, his fever was about 102 degrees, but his heart rate was between 125-180 bpm.  Both times we have seen a cardiologist and he says everything looks fine (both times he ordered a 24 hr holter moniter).  Our family physician does not feel the same way.  Every time his heart rate gets to 135-140 bpm our family doctor wants us to get in to the ER right away, but the cardiologist feels this is nothing.  So as you can see we are really confused on what to do.  
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It would be impossible to fully comment on your question as there really is not enough information there.  It sounds like your 5 year old had some type of event where he lost consciousness ("he went nonresponsive"). That in and of itself is reason to see a cardiologist.  I don't know what type of work up your child had (ex: was there a normal electrocardiogram?  did the doctor feel that any other tests were needed aside from the holter?)  It is common for children with fever, infections (both viral and bacterial) and dehydration to have a rapid heart rate/ sinus tachycardia.  In fact it is a normal response of the body to a stress.  The abnormal tachycardias (like SVT and VT) are generally faster than the rates you describe. Getting a holter monitor or an event monitor to document the heart rate is helpful, in trying to distinguish between sinus tachycardia and other abnormal rhythms.  If the episodes of tachycardia occurred at times when he was not ill, it would be more worrisome for a primary cardiac problem.  But here it sounds like he was sick both times.  Anyway, if you and your primary doctor are dissatified and feel that more information is needed, then you should pursue a second opinion.
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