My Child..Help Please

[Father2012]

We found out accidentally in February 2012 that our daughter has 2:1 (secondary degree) heartblock. She was 5+ years old at that time and is now 7+. She did not have any symptoms until recently. She has 2:1 block but occasionally she gets 1:1 (normal beat) conduction.

One week ago she complained of having pain on the left hand side of the chest area. We took her to A & E and after examining her and checking her heart beat (ECG) they told us that she had pulled a muscle and sent her home.

Her pain got better and she went to school over the last two days. Tonight before she went to bed she cried but said that she was not having any pain.  We are not sure what's going on with her...
She is active and bright most of the time...we noticed that whenever she stays at home and is not active she seems to be getting these problems. Her teacher told us that she is active and playing normally when at school.
Since 2012 she was seen by a cardiologist every six months. Two months ago her cardiologist did 24 hour tape and exercise test. The doctor told us that she is stable and whenever she needs her heart can do 1:1 conduction (normal beat) and when she did the exercise test her heartbeat went up to 180/min and she said they don't need to see her until 2015.
Her heartbeat has always been in the range of 45 to 55 per minute and it is still the same. We don't understand what's going on with her now...We are hoping that she wouldn't need a pacemaker until she reaches her 20's ..30's ...we are very worried about her...please advise us if you had/have similar experience...

[MichelleP_3811]

I personally don't know much about heart block but it sounds like based on the tests that her heart is doing OK despite the block.  This said, there is nothing wrong with getting a second opinion or taking her back in if new symptoms arise.  But in general it sounds like she may be fine for now.  You know I will note here though it wasn't likely caught by the doctors yet but your daughter could have pvcs on top of the block.  These are extra heart beats in the lower chambers of the heart.  They are sometimes a safety mechanism by the heart to ensure the blood is moving along well.  They can also arise in a healthy heart for seemingly no reason.  But having them myself they can sometimes cause transient chest pain but it doesn't last.  So it is possibly due to the block your daughter may have an extra beat from time to time to compensate.  But again, she has had some good tests that show her heart is generally working fine in conjunction with the block though if she hasn't had an echo you may want to ask for one just to make sure all the appropriate tests have been done.  But from the looks of it she may not need worry about her heart for some time.  But again, keep an eye on things, seek a second opinion if you feel it wise, and don't hesitate to go back if things change.  Take care and best wishes to you and your daughter.  Hopefully someone with heart block experience can jump on and give you feedback.

[MichelleP_3811]

I should stress, pvcs unless the heart is pretty diseased in general they are very benign and in your daughter's case may be a good thing.  But it might be something you want to discuss with her doctor as to a possible source of the pain and what it means for her specifically if she possibly has them.  Doctors aren't always forthcoming about someone having them because they are pretty benign and for the most part when people hear about them they wind up worrying when they need not but it might be worth discussing so you know if this is the case with your daughter.

[achillea]

Everything I've read about this grade of heart block agrees with Michelle's statements.  Your daughter's heart has been checked out quite thoroughly and is being re-checked quite frequently, and her prognosis looks good.

However, at seven years, she is now old enough to understand the idea that something is wrong with her heart and worry about it.  She also at the classic age to begin to grapple with the concept of death.  Since her recent symptoms are worse when she is at home and not busy, and since her symptoms are less when she is occupied and active, I have to wonder if she might not simply be frightened at this point, especially since she does not know how hearts work.

Does your health care system provide psychological counseling for children?  If so, a couple of visits with a therapist might help to sort out whether or not there is a significant psychological component to her symptoms.

[Father2012]

Her pain has gone and she is back to normal...She is very active as usual..

...We hope she won't need a PM until she reach in her 30's,50's...Since she can conduct 1:1
whenever she wants she might not need a PM for life...If she need a PM in her 30's or 40's that time getting a PM won't be a big deal..we already hearing about leadless PM...Bio PM etc..

..Some times she complains that she feels like vormiting. ..she might have acid problems..we are planing to talk to her GP to look at this possibility...

Our daughter is very active and constantly moving..for the last Christmas we bought a 3 wheel scooter for her...most of the time she carries this scooter in her shoulder..we know she should not carry heavy things but she never listen to us...She is thin but strong...I have hidden her scooter...Now she is not having any pain but she keep asking for the scooter...

We don't want her to have a PM unnecessary but we are monitoring very carefully...Again thank you all for your comments...