Tachycardia in children?

[Mom2four85]

I took my youngest daughter (8) to the ER the other night after she fell on our kitchen tile running & playing with socks on. The ER dr said she had a high HR (over 120) and attributed it to being anxious about getting stitches in her forehead - thankfully she didn't.  

At her followup with a new pediatrician, her HR was still high at 97; that's after laying on the table waiting for about an hour.  The dr mentioned this to me asked if her HR was always so high or was she just nervous.  I've noticed her heart beats funky sometimes and not sure if I should push getting an EKG or echo and how reliable ekg's are in children?

The dr did a bloodtest and found she's pretty anemic; she said she looked a bit pale and just wanted to be sure.  I counted her normal daily food iron intake and it was over 20g.

I first started with a racing heart and fainting at age 9...I'm wondering if what I have - Polymorphic VT is genetic and maybe it is in my children - my oldest daughter (24) will be getting a full cardiac workup in Jan (new insurance) and did about the same thing as me and my youngest daughter - except my youngest daughter has not fainted. I've been through 16 months of testing & surgery to find my cause and nothing has been found so far - maybe my doctors have missed something.

I just find it curious it took me over 42 years to be dx with something and my daughter's are prone to arrhythmia's and tachycardia/pvc's also...my son's haven't had any problems

on a side note: both dr's felt 5 lymph nodes or nodules; on her right throat/under her chin side which they thought was strange and did blood tests (I'm trying not to freak out with that since my dad died not long ago of lymphoma) normal except for anemia.

She's 8 years old, 4'5" - 52 lbs and has been petite since birth; she eats well, doesn't snack much and only has soda on special occasions less than once a month on average.

any thoughts are much appreciated

[Mom2four85]

Thank you so much for taking the time to reply.  

[Jeffrey R Boris, M.D.]

Dear Lisa,

You bring up several concerns here.  First, the normal resting heart rate range for an 8 year old is 80 to 130, or so, so a heart rate of 120 is not overly concerning.  However, if she truly is anemic, that can cause the heart rate to go up.  And, if there is anemia, it would be important for her to be evaluated by her primary care provider to look for a cause of her anemia (rather than just presumptively treating it).

Polymorphic ventricular tachycardia can absolutely be genetic, and may have nothing to do with your daughter's heart rate.  It can be caused by several different problems, so considering your specific history, it would be appropriate for your daughter to not only have an ECG (which are as accurate for the 2 1/2 seconds that she holds still!), but also for her to be evaluated by a pediatric cardiologist.  There are some genetic tests available, which may be helpful for you to get; if the test demonstrates an abnormal mutation, your children can then be screened for them.

Without evaluating your daughter, I cannot comment on the lymph nodes that were found.  Finally, as an aside, the heart rate can be elevated in the face of dehydration.  I recommend that she have at least 32 ounces of fluid on a daily basis.