increased heart rate in teen son

[gleas0515]

my healthy,fit 15 year old has had a few occurences where his heart was racing. once he was just throwing the football on the sidelines,once was during agame, and most recently during and after his wrestling match. during the first two episodes his heart rate came back down by simply resting. the last occurence began about half way through his six minute wrestling match . half way through he felt his heart start racing and some pressure in the center of his chest(same symptoms in the other episodes),he took a time out but the symptoms remained and he finished his match.he attempted to bring his heart rate down by bearing down with no success.after approximately 25 minutes we went to the emergency medical center,when we arrived his heart rate was 192 bpm.the staff on hand instructed him to bear down and this time his heart rate immediately began to drop and eventually return to 80-90bpm.he has had 3 ekgs,1 ecg, and wore a 24hr holter monitor.the results have all come back normal. i dont know what my next step should be and also i have pulled him out of wrestling for now. he has his state qualifier tournament in 7 days and i dont want to keep him out of this if he is safe to participate.his dr. has not restricted him from participation but, being an extremely concerned parent i do not want to put his safety at risk either. please advise me of what my next step should be and also please share your opinion with me about continuing to participate in wrestling. thank you for your time.

[gleas0515]

it may not be called an ecg,it was an echocardiogram, i believe. the best way i can describe it is a sonogram of his heart. thank you for your input.

[Jerry_NJ]

You indeed have a hard question...

For a 15 year old the rule of thumb for maximum aerobic rate is in the range of 190, so his 192 was not in itself threading.  However, as it was that high when you go to ER, one wonders how the maximum rate was.  It may have been the same, just "stuck" there.

I read you post to say the holter monitor didn't discover any problem.  You also mention his HR returning to 80-90, at rest I assume.  That strikes me as a bit high, but not threatening.  I may be off on this one, a teen's rate may be a little higher.  I'd expect an adult up through middle age who is physically active to have a HR more like 60-70.   Not looking for trouble here, just reacting to the data you provided.

You mention 3 ekg and 1 ecg.  The usage I'm familiar with ekg = ecg, just phonetic variations/abbreviations for electro-cardiogram.  Are you telling us about two different types of tests?  

Given you have a doctor's release for athletic involvement, I can only assume it is fine, but I'd "extract" an agreement from you son that he tells all, doesn't hide anything from you if you agree to let him engage in the tournament.  

I expect a tournament will have at least a paramedic or doctor on hand to handle emergencies.  This I do not know, you may want to check for your own comfort.  In any case, emergency help should be available simply because there will be lots of people around, some who know first aid, including defibrillator...the tournament must have a defibrillator, again something to check on if you like.  I'm not trying to raise fears, rather I'm saying whatever risk is being faced, that risk exists 24/7 and given the doctor's approval I'd lean toward going with the participation.   A successful match will also help calibrate your fears.