HELP!

[Barb0359]

I am the mother of a 11 year old boy.  He has a very mild case of osteogenesis imperfecta.  For years he would come to me once or twice a year and complain of "his heart beating fast".  I would check his pulse (I am a nurse).  Pulse would be around 170.  Had him seen by a cardioligist at The Hospital for Sick Children in Toronto, Canada.  He had ECG'S Holter Monitor and home recorders to phone patch an episode.  We were never able to catch anything and I was left with the impression from the cardioligist that he was fine and was only "feeling his natural heart rhythm".

We had no action for quite awhile but now it has started up again.  Three to four times a week.  We have him on the phone patch monitor again and have sent in a couple of episodes.  Haven't heard back from them.  Again his heart rate is in the 170's with a resting rhythm of around 80.  The last one he did he had no top on and with the monitor against his chest recording, I could actually see the monitor and his chest bounding.  While I do not want to be told he has a condition, I do feel that something is wrong and feel I need validation.  Any ideas?

A concerned parent!!!!

[Cleveland Clinic]

The reason why i think he should have an ablation instead of medications is because he is so your and would be subject to side effects which could affect his quality of life.  The ablation, on the other hand, would cure him right away.

[Cleveland Clinic]

Supraventricular tachycardias are common in kids.  This is probably what your son has.  I would definitely make sure that the doctor got those recordings.  Prognosis is very good with these arrhythmias.  Most can be treated medically, but in your kid, it would be probably best to have an ablation procedure which is commonly performed, very safe and 99% effective in completely curing most of these arrhythmias.  The other important thing is that these arrhythmias, even when they occur are typically benign and won't hurt your child.  If they ever last for quite some time, you should have him cough, bear down or put his face in cold water.

[prickles]

How often are these episodes happening now? I agree, it's worth asking him to cough etc, as Cleveland Clinic suggested. If doing that makes the symptoms stop then that information can help aid a diagnosis. Also look out for correlation. Is your son always tired when these episodes occur? Has he just eaten? Has he had a lot of calcium today? Has he had caffeine or energy drinks (e.g. red bull)? Has he been anywhere smoky? (Cigarette smoke can trigger episodes of tachycardia - little-known fact!)

In the ablation surgery mentioned above the surgeons will try to induce the tachycardia by injecting various substances that will affect the heart. It can be wonderful for some people because the tachycardia is triggered and then the origin of the electrical misfirings is identified and ablated. However, they may not be able to stimulate the heart in such a way to trigger the tachycardia, in which case the problem will not be fixed. And if the origin of the problem is close to the AV node in the heart then the risk of your son needing a pacemaker after the ablation would be too great so the surgeons would not do the ablation. (The AV node is the natural pacemaker, so if it is ablated then an artificial pacemaker must be inserted)

On the other hand, it could be a case of Inappropriate Sinus Tachycardia, which cannot be treated other than with beta blockers to slow the heart. & unless your son's symptoms are not occuring several times a day, doctors are unlikely to prescribe anything. Beta blockers won't always help anyway, because they just slow the heart, so irregular heart beats can still occur, they just occur at a slower rate! & there are of course side-effects to consider.

I hope you find a helpful solution. Let us know if you do!

Best wishes