Pediatric Heart Expert Forum
changes in symptoms or not related?
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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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changes in symptoms or not related?

My 8 year old son has aortic stenosis, bicuspid valve, mild, with no regurgitation.  I have the same (although moderate insufficency, mile regurgitation).  His latest check here in France (four months ago)indicated that he is fine with no restrictions on sports and exercise.  The physician explained that the symptoms, while few, may be extreme fatigue episodes (only rarely).  My son has been in extreme fatigue, normally very active, for over one week now.  And today he asked me why his heart races hard in his chest while he is laying down.  He confirmed it occurred three times today.  Are the palpatations a symptom, although I have had them as well and never thought much of it?  What are the studies that correlate the extreme fatigue episodes, and is this true?  What would your advice be on  his current state?
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773637_tn?1327450515
Dear Pattie,

Aortic stenosis (AS), which is obstruction of the aortic valve, can be anywhere from trivial to severe.  Mild AS, as in your son’s case, is not typically associated with any significant obstruction of the heart that would cause fatigue.  However, without talking with him further, I cannot be sure of the etiology of his fast heart rate.  I would make sure that he is drinking adequate fluid on a daily basis (at least 32 ounces for his age), as relative dehydration can cause these symptoms.  However, he could also be having a true arrhythmia, or abnormal fast heart beat.  I would recommend that you follow-up with your cardiologist in France and discuss whether further evaluation would be warranted to see if he has an arrhythmia.  This evaluation may include a Holter monitor, which records the heart beats in 24 hours, OR an event monitor, which records the heart beats only when it is activated (such as in intermittent episodes), OR an exercise-stress test, which could assess whether there are exercise-associated abnormal beats.
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773637_tn?1327450515
Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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