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irregular heart rate in 4-year-old

  : A couple of months ago, while watching my 4-year-old (almost 5) son
  : sleep, I noticed something that I thought seemed odd.  His pulse rate
  : (which was visible, due to his being asleep) kept changing.  It would go
  : faster when he inhaled and then slow down when he exhaled; the rhythm
  : would remain regular except for the slowing and speeding up (which was
  : not a very wide variation, but definitely noticeable and consistent).  I
  : tried to ignore it, because he is a very active and healthy little boy
  : with no signs to indicate that there might be anything wrong.  A few times
  : since then, I have also noticed the same thing, so I know that it was not
  : just a one-time thing.
  : My questions:
  : Is this change in heart rate normal for a child of his age?  Is he likely
  : to outgrow it?  Should I be concerned?  
  : Both of my children (I also have a 7-year-old daughter) were "breath-
  : holders" when younger.  That is, when very upset, they would begin to
  : cry but then be unable to catch their breath, then would turn blue and
  : pass out.  Both outgrew this at about age 4 (my son stopped this past
  : spring).  I have found that this is considered to be harmless and
  : hereditary (my husband also did the same thing as a child).  Could the
  : heart rate irregularity be some kind of residual part of this that will
  : go away as my son gets older?  I have no idea if the two are even related,
  : but the possibility occurred to me.
  : I would like to be able to just ignore this, since he is active and
  : healthy, but since this is my child, I need some assurance for my own
  : peace of mind.
  : Thank you for any information you can provide.
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238668 tn?1232735930
Dear Kristine,
Thank you for your question.  You deserve an A for your observational skills.  You have witnessed what was first noticed several thousand years ago by the Chinese and is now referred to by modern science as Heart rate (or heart period) variability (HRV).  This is a normal response of the heart to the respiratory and nervous system control.  As you noticed it is usually increased during sleep.  It is also higher in children than in adults.  You can however do a simple experiment on yourself and see the effects of HRV.  Find your pulse and take a slow deep breath in and out.  Watch what happens to your heart rate.   A robust HRV is actually an indicator of good health.  It may be increased by regular exercise and is decreased by smoking.  Hope this allays your fears and answers your question.  

Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist.

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