Pediatric Heart Expert Forum
Sinus Tachycardia
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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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Sinus Tachycardia

My 5 year old has diagnosed sinus tachycardia.  Her at rest heart rate is 120.  Sleeping its 90.  I was told she would outgrow it but she has not.  When she was 2 she had a Holter, Echo and since an EKG.  All show normal.  Upon illness, (rarely otherwise) she gets asthma like symptoms (since 2 years when she got RSV). She gets Xoponex and Flovent  surrounding these episodes.  Yet she has the ST all the time....  why? What causes this? and what if she doesn't outgrow it?  
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773637_tn?1327450515
Dear I’msure,

Actually, this is not considered sinus tachycardia, in reality.  For a five-year old, the normal heart rate range is between 60 to 130.  So, the real question is whether she is symptomatic with this heart rate, including whether she is able to exercise with other children and keep up with them, whether she is aware of her heart beating “abnormally”, etc.  Without seeing her specific information, I can’t say for sure if her findings are normal.  One other factor that can lead to increased resting heart rate is uncontrolled asthma.  It sounds as if she is taking a rescue medication and a controller medication (Xopenex and Flovent, respectively) during acute exacerbations.  However, she may have low level persistent inflammation in her lungs, which means that she may need to be using her Flovent on a routine basis.  I would discuss this further with your primary care provider, including consideration of measurement of her peak flow rates or pulmonary function testing to assess for uncontrolled mild asthma.
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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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