Palpitations including SVT
Cardiac reasons for palpitations include problems with the heart rhythm, known as arrhythmia. The commonest cardiac cause for palpitations in babies, children and teenagers is SVT (supraventricular tachycardia). Ectopic beats arise abnormally, not from the normal pacemaker of the heart.
Symptoms
Children may complain of feeling their fast heart rate or an irregular heartbeat. Some complain of feeling "hard", "banging", "thumping" or "throbbing" heart beats. Younger children may complain non-specifically of their chest hurting.
Parents may notice that they can see their child's heart pulsation in the chest or the neck. If they place their hand on their child's chest they may be able to feel it beating quickly or irregularly.
Diagnosis
A detailed clinical history and examination will be performed. In most cases the clinical examination will be normal.
An ECG will be performed to look for patterns like WPW. An echocardiogram will assess heart structure and function. The rhythm over a longer period can be assessed with a 24 hour ECG or an event monitor. An exercise test may also be recommended.
Treatment
If your child is having a palpitation associated with feeling faint or dizzy, urgently take them to the hospital.
For an acute attack of SVT, there are various manoeuvres you can try to slow the heart rate:
1. Putting something cold (like a packet of frozen peas) on your child's back to give a sudden shock, which sends nerve impulses to the heart to slow down.
2. Helping your child to do a handstand.
3. Ask your child to puff out their cheeks and hold their breath while pinching their nose and straining.
4. Encouraging young children to blow as hard as they can into a straw, bubbles, a balloon or a windmill.
Prevention of Palpitations
SVT attacks are prevented with oral medication, often a beta blocker. Older children with recurrent SVT can be treated with a curative radiofrequency ablation keyhole procedure. Dr Naqvi works with world-leading electrophysiologists for these treatments.
Prognosis
The outlook for children with palpitations is usually very good. Many children with SVT outgrow it, particularly those affected in the first year of life.
Dr Naqvi says: "Having palpitations early in life does not stop children doing well in sports or from having a happy full life. I know some who are successful athletes and others who are academic high achievers."
