Limarenko M.P., Iskovich D.V. Roemheld syndrome in children: a modern view of an old problem / University Clinic. 2021, No. 2 (35). pp. 122-126.

Your volleyball > Articles > Tachycardia in children

Attentive parents sometimes observe a rapid heartbeat in children. If tachycardia occurs after physical or emotional stress and the condition quickly returns to normal, then there is no cause for concern. In all other cases, this phenomenon is an alarming signal.

Tachycardia in children is a common heart rhythm disorder. We can talk about pathology if the heart rate increases by 20-30 beats per minute.

Symptoms

Symptoms of pathology in a child may initially be vague, so parents do not pay attention to the problem, assuming completely different diseases. It is especially difficult to suspect tachycardia in a baby: if the heart rhythm is disturbed, newborn babies begin to behave restlessly, become capricious, and their sleep and appetite worsen. Agree, for a mother who does not have a medical education, the first thoughts when experiencing such symptoms are a tummy ache, a tooth cutting, or a “jinx.” Only a highly specialized doctor can identify the true cause of deterioration in well-being.

In older children, the symptoms of tachycardia depend on the degree of the disease: the stronger the tachycardia, the brighter and more dangerous the signs. Children with tachycardia experience:

• increased heart rate, shortness of breath;
• loss of strength, lethargy, decreased blood pressure;
• dizziness;
• nausea, vomiting;
• chest pain, suffocation;
• increased sweating, pale skin;
• sudden darkening of the eyes, loss of consciousness;
• bulging veins in the neck;
• emergence of fear of death.

The symptoms of tachycardia are practically no different from the signs of other childhood pathologies, so it is impossible to independently diagnose the disease.

Causes of tachycardia in childhood

Tachycardia can occur due to many reasons. As mentioned above, not all of them lead to pathology. The safe type of tachycardia is sinus, the pathological type is paroxysmal.

Rapid heartbeat in children and adults is a normal reaction to the following conditions:

• increased physical activity - running, squats, jumping, etc.;
• emotional overstrain: fear, excitement, indignation, etc.;
• tobacco and alcohol use;
• increased body temperature;
• sudden changes in room temperature.

If tachycardia is not associated with physical prerequisites, then the reason for its development is pathological disorders in the child’s body:

• decreased blood pressure (for example, with bleeding);
• anemia – decreased hemoglobin level;
• purulent infection;
• dehydration;
• cancer;
• thyroid disease, disruption of the endocrine system (for example, obesity);
• disorders in the cardiovascular system;
• disorders of the central nervous system;
• side effect from taking certain medications;
• increased growth of the body.

Tachycardia is observed with heart murmurs, heart disease and cardiopathy - serious disorders of the development of the heart muscle.

Causes of tachycardia

The causes of increased heart rate are divided into two large groups: cardiac (intracardial), in which the rhythm disturbance occurs due to a problem in the heart, and extracardiac (extracardiac), in which the main problem is outside the heart.

Cardiac causes of tachycardia:

• heart failure;
• myocardial infarction;
• unstable angina;
• anatomical (congenital) heart defects - mitral stenosis, aortic stenosis;
• cardiosclerosis - pathological widespread proliferation of connective tissue in the myocardium;
• cardiomyopathies - a group of diseases in which the heart pathologically expands with thinning or excessive growth of the myocardium;
• inflammatory processes in the heart;
• hypertension - a stable increase in blood pressure;
• anemia is a condition accompanied by a decrease in the level of hemoglobin and red blood cells in the blood;
• hypoxemia - decreased oxygen content in the blood;
• acute vascular insufficiency.

Extracardiac causes:

• heavy physical activity;
• stress;
• pathology of the central or peripheral nervous system;
• mental disorders;
• infectious diseases with fever;
• the effect of medications;
• intoxication with poisons;
• the effects of tobacco, alcohol, coffee and strong tea;
• dehydration, including blood loss;
• pain shock;
• pathology of the endocrine system;
• hypoglycemia - decreased blood glucose levels;
• low blood pressure;
• sedentary lifestyle;
• respiratory failure;
• rapid and significant loss of body weight;
• hypokalemia - decreased potassium levels in the blood;
• injuries.

Tachycardia is not the cause of the disease, but a consequence of another pathology

Features of childhood tachycardia

In most cases, tachycardia in newborns, according to doctors, is a physiological norm and does not cause concern. Many factors can cause an infant's heart rate to increase, such as overheating or nervous tension (being examined by a doctor or being scared). If there are no other abnormalities (anemia, disruption of the nervous system, etc.), then the baby does not need treatment.

The older the child gets, the more serious the course of this disease, so if the heart rate increases in older children, parents should be especially vigilant. Tachycardia may indicate rapid development of the body, which is not provided with the necessary conditions - nutrients, oxygen, sufficient blood supply, etc. The background for the development of tachycardia in children may be:

• increased nervous excitability, overstrain;
• severe emotional stress (problems at school, excessive demands from parents);
• lack of oxygen (hypoxia);
• bad habits of parents (smoking, alcoholism);
• frequent and sudden changes in body position (from horizontal to vertical and vice versa).

Medical care for supraventricular tachycardia in a child

Supraventricular tachycardia in children is a common heart rhythm pathology. It manifests itself as short attacks of palpitations, but sometimes can last for hours or even days, although the child has never suffered from organic diseases before.

Parents should not panic and try to independently relieve an attack of tachycardia in their child in every possible way. Only a pediatric cardiologist can determine how to treat cardiac tachycardia in children. In most cases, it is enough to eliminate the causes that cause such attacks:

• physical stress;
• emotional disorders (due to stress at school, conflicts with parents, first love);
• vegetative disorders.

Medical care for supraventricular tachycardia in a child is not only about medications. In order to relieve an attack, the child must be taught to hold his breath and strain (these are the so-called vaginal reflexes that counteract heartbeat attacks).

Related services: Cardiac Check-up Diagnosis of heart rhythm disorders by ECG monitoring

Heart rate norms in children

Attention: exceeding the norm by 20-30 beats per minute. - a reason to contact a cardiologist!

What tachycardias are most common in children?

In a child, palpitations are divided into two main types:

• sinus;
• paroxysmal.

The first type occurs most often and, as a rule, against the background of a healthy heart.

Paroxysmal tachycardia is a whole group of diseases characterized by:

• sudden onset;
• high heart rate;
• spontaneous restoration of normal heart rhythm;
• preservation of the normal sequence of cardiac complexes on the ECG;
• short duration of the attack, from a few seconds to several days.

Frequency of occurrence in the pediatric population: 1 in 25,000 people, which is an average of 15% of all arrhythmias. Paroxysmal tachycardia is divided into the following forms:

• atrial;
• ventricular;
• atrioventricular.

Pathology develops as a consequence of such factors:

• congenital or acquired during childbirth pathology of the central nervous system;
• unfavorable family and social situation;
• congenital malformations of the child’s heart;
• cardiac surgery;
• some infectious pathologies;
• installation of a catheter in the heart cavity;
• heart trauma (closed);
• angiocardiography.

Another attack can be triggered by:

• mental stress;
• physical overload;
• hyperthermia;
• stress.

A child with paroxysmal tachycardia presents the following complaints:

• palpitations starting with a “push” behind the sternum;
• pain in the area of ​​the heart and in the pit of the stomach;
• feeling of lack of air;
• dizziness;
• headaches;
• insomnia;
• weakness;
• nausea;
• fear.

As for changes on the ECG, they differ depending on the form of the disease and are indicated in the table below:

This disease can be life-threatening for the child and requires emergency treatment.

Sinus tachyarrhythmia in a child

This type occurs due to increased functioning of the sinus node. This condition can be provoked by a number of irritants:

• stress;
• dehydration;
• shock states;
• physical activity;
• an increase in the concentration of calcium ions in the blood;
• consumption of large doses of stimulants (tea, coffee);
• taking medications (caffeine, antidepressants, antiallergic drugs, theophylline and some others).

The main external distinctive signs of sinus tachyarrhythmia are:

• short duration;
• no significant discomfort;
• normalization of heart rate after removal of the influence of the irritating factor.

Tachycardia, which persists for a long time, can develop under the influence of various pathological conditions associated with both heart problems and diseases of other organs - anemia, respiratory failure, etc. In this case, an increase in heart rate is accompanied by certain complaints of moderate intensity: palpitations, sensation lack of air.

Sinus tachyarrhythmia is a condition characterized by a heart rate that exceeds the child’s age norm. It is based on the acceleration of the production of electrical impulses by the first-order pacemaker, the sinus node. In the absence of other symptoms, in addition to an increase in heart rate, sinus tachycardia is considered a normal variant.

With a significant acceleration of the heart, the child experiences the following symptoms:

• fatigue and weakness inappropriate for physical activity;
• emotional arousal;
• change in skin color;
• dizziness;
• heartbeat;
• moodiness;
• fussiness and so on.

Sinus tachycardia in most cases resolves spontaneously immediately after the influence of the provoking factor ceases.

To make a diagnosis of sinus tachycardia, the following methods are used:

• taking anamnesis;
• physical examination;
• types of ECG (regular, stress test, high resolution, Holter monitoring);
• electrophysiological study.

Differential diagnosis with other rhythm disturbances is of great importance. Sinus tachycardia of all arrhythmias has the most favorable prognosis.

Treatment

Depending on the cause of tachycardia, the specialist determines the tactics of its treatment. If physiological preconditions became the provocateur, after eliminating which the heartbeat returned to normal, there is no need for treatment.

If treatment is required, a set of measures is prescribed, including drug therapy and alternative medicine.

Drug treatment

Antiarrhythmic drugs are used to restore normal heart rhythm and control the contraction rate. They can be taken either orally or by injection.

The choice of drug depends on a number of factors:

• type of tachycardia;
• accompanying illnesses;
• side effects of the chosen drug;
• the child's response to therapy.

If sinus tachycardia is of neurogenic origin, sedatives are selected for school-age children - seduxen, luminal or others at the discretion of the doctor. Up to 7 years of age, only homeopathic remedies are recommended.

If tachycardia is caused by heart problems, the cardiologist will prescribe cardiac glycosides that normalize heart rhythm. Additionally, traditional methods of treatment can be used.

Causes of tachycardia in children

Do not forget that even normally, the heart rate (HR) of a child is significantly higher than that of an adult. This is due to a more active metabolism, leading to increased oxygen consumption by the cells of a growing organism. Heart rate norms for children of different ages are indicated in the table below:

The causes of tachycardia in children can be both physiological and pathological; associated with heart disease or resulting from other ailments.

With a healthy cardiovascular system, an increase in heart rate can be triggered by the following factors:

• hyperthermia due to acute respiratory viral infections or other infectious diseases;
• high ambient temperature;
• increased physical activity;
• emotional overexcitation;
• thyroid diseases;
• vegetative-vascular dystonia;
• overweight;
• pheochromocytoma;
• dehydration;
• anemia.

As for heart diseases, tachycardia in children is most often observed with congenital heart defects, myocarditis, and certain types of conduction disorders. Depending on the age of the child, one or another reason comes first.

In infants

Babies in the first months of life are most often exposed to attacks of tachycardia under the influence of the following factors:

• external mechanical influences, such as inspections or changing;
• cardiovascular failure;
• congenital developmental anomalies;
• perinatal encephalopathy;
• respiratory failure;
• acute asphyxia;
• hypoglycemia;
• anemia.

Naturally, a baby is not immune from the development of infectious diseases and, first of all, colds.

For schoolchildren

The reasons why tachycardia may develop in a child who has begun to attend school differ from those in an infant. By this time, congenital developmental anomalies partially lose their positions, since they have been cured, stabilized, or have already led to a sadder result, but continue to remain in first place. The frequency of acute asphyxia is also noticeably reduced. The main reasons for high heart rate in schoolchildren are:

• autonomic disorders due to increased stress, both psychological and physical;
• thyroid dysfunction;
• hyperthermia of various origins;
• organic heart pathologies;
• excessive physical activity;
• electrolyte dysfunctions;
• neoplasms.

The task of parents of schoolchildren who want to reduce the likelihood of tachycardia in their children is to normalize the regime, minimize physical and psychological stress on the child, undergo regular medical examinations and fight against infectious pathologies that can cause inflammation of the membranes of the heart.

All carious teeth need to be cured, and if a child has a sore throat or already feels discomfort in the heart due to an elevated temperature, then no exam or new topic should be a reason to postpone a visit to the doctor.

In teenagers

Adolescence is characterized by a significant increase in the development of risks for the cardiovascular system. This time marks the beginning of increased body growth, puberty with a characteristic surge of emotions, and the first experiments with the use of psychoactive substances.

Let's figure out what reasons cause rapid heartbeat in a teenager.

Their list is as follows:

• chronic infections (caries, frequent sore throats) that provoke inflammation of heart tissue;
• imbalance in growth rate between the heart (lags behind) and the rest of the body (leads);
• general passion for tonic low-alcohol drinks;
• “small heart” against the background of an underdeveloped musculoskeletal system;
• vegetative-vascular manifestations;
• electrolyte imbalance;
• tumors.

From this list, parents, even without contacting doctors, can cope with a good third of the reasons.

Boys and girls should be taught the negative effects of drinks containing caffeine and other stimulants. If he or she really wants alcohol before a disco, let him or her drink wine or vodka rather than Red Bull or Jaguar.

Treatment with folk remedies

Alternative medicine can significantly help in the fight against tachycardia, but folk remedies cannot replace drug treatment. Before using any method, you must consult your doctor.

Treatment of tachycardia using traditional medicine involves the following effects:

• general calming effect;
• sleep stabilization;
• normalization of the nervous system;
• decreased myocardial excitability;
• activation of general regulatory processes in the body to protect it.

There are a huge number of recipes with medicinal plants: hawthorn, valerian, chicory, lemon balm, motherwort, honey, etc. The following recipes are most effective:

Calming collection No. 1. Pour a pinch of calendula flowers and motherwort herb into 1 glass of boiling water, leave for 2 hours, strain and drink warm after lunch.

Calming collection No. 2. Pour a tablespoon of dried white willow flowers into a glass of boiling water and leave for 1 hour. Then strain and divide into 6 portions.

Calming collection No. 3. Add a tablespoon of lemon balm to a glass of hot water and steep like regular tea. Drink the drink up to three times a day.

At the pharmacy you can buy ready-made tinctures of hawthorn, motherwort, and valerian. They should be taken 10-15 drops 3 times a day or if your heart rate increases.

Prevention

The following preventive measures will help reduce the risk of tachycardia and the likelihood of complications after it:

• proper nutrition, following a healthy diet (more fruits, grains, vegetables);
• limited consumption of caffeine, which is found in tea and chocolate;
• prevent your child from gaining excess weight;
• avoiding stress and emotional turmoil;
• playing sports without excessive stress;
• proper daily routine, including proper sleep and rest;
• taking sedatives and vitamins for the heart (if necessary);
• control over blood cholesterol levels;
• regular visits to the doctor.

Recovery prognosis

As a rule, experts give a favorable prognosis for recovery for children with any type of tachycardia. Effective treatment in almost every case will return the child to a normal lifestyle without restrictions.

In adolescents, tachycardia will most likely persist for the rest of their lives, and therefore they will not stop taking medications. In addition, adherence to the recommended diet and exercise will always have to accompany it, otherwise even slight excess weight will put a strain on the heart and provoke the development of various diseases.

Author : Alexander Kulakov

Certified physician. Graduated from the Moscow Medical School. Clara Zetkin, Moscow Medical and Dental Institute named after. Evdokimov. Author med. content of the site tvou-voleyball.ru