My six-year-old son came to me several times throughout the day telling me to feel his heart because it was pounding. You barely had to put your hand on his chest to feel it. Each time he had been doing some minimal activity, but is normally very active and plays soccer and does gymnastics. If it has happened before, this is the first time he has brought it to my attention. Should we be concerned?
As pediatric cardiologists, we see pounding mean one of two things: the heart is beating hard or it is beating fast. Typically, children don’t complain about their heart beating abnormally. So, we can see these complaints of the heart beating hard if there is stress or if the child doesn’t drink enough fluid during the day. It can also happen in the face of an arrhythmia (abnormal heart rhythm). Beating fast at rest is often an arrhythmia, although it can also be dehydration, as above. I find that adolescents tend to have more of the dehydration, but younger kids can have an arrhythmia as the cause of this sensation. If it is occurring more frequently, lasting at least 20 minutes, or giving him other symptoms, such as shortness of breath, chest pain, or passing out, he should definitely be seen by a local emergency department. It would also be helpful to measure a pulse rate or a heart rate. If it is greater than 180 beats per minute at rest, this is probably more consistent with an arrhythmia. An easy way to measure a pulse rate is to count the number of pulsations in 6 seconds and multiply by 10
In the meantime, do make sure he is adequately hydrated—skim milk or water is best. We try to limit the juices and sodas (and chips, too!) because of the extra calories.
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