Sinus tachycardia in a child: symptoms and treatment

Tachycardia in children is no less common than in adults. And if in one case the pathology is caused by the influence of physiological factors (temperature changes, emotional experiences, etc.) and therefore does not pose a serious threat to the child’s health, then in another case tachycardia may be a symptom of a serious illness. Therefore, it is important to distinguish between when the symptoms of a rapid heartbeat are not dangerous and are normal, and when they require urgent medical attention. What is tachycardia and how does it manifest? What are the causes of the disease and what to do if the diagnosis is confirmed?

Why do children's heart rates increase?

The term “tachycardia” in children refers to a variant of arrhythmia, the main manifestation of which is considered to be an increase in heart rate of more than 90 beats per minute.
The increased rhythm is associated with the anatomical features of the body. Catecholamines play the role of specific stimulants of myocardial activity. Negatively affect cardiomyocytes and disrupt electrolyte metabolism.

Dysfunction in the functioning of the heart appears when nervous excitability changes.

The myocardium contains a large group of cells that act as pacemakers. They operate at a frequency of 60-80 per minute. When the work of the nervous system increases, a signal is given that travels further along the conduction pathways of the heart.

Pacemakers (drivers) stimulate cardiomyocytes to do more work. This condition may be physiological, and after a short period of time, heart function returns to normal. Normally, sinus rhythm is maintained.

This does not happen under the influence of organic pathology. Already at an early age, arrhythmia appears, the main symptom of which is tachycardia in a child.

First aid during an attack

If an attack suddenly begins, you need to call an ambulance and take the following measures:

1. Induce vomiting.
2. Massage the surface of the abdominal cavity.
3. Press on the eyeballs for several minutes.

Thanks to these actions, the heart rate decreases slightly.
In the event of an attack in a newborn, it is necessary to provide fresh air and apply a cold compress to the forehead. This will reduce the severity of symptoms. RECOMMENDED: If you experience weakness, dizziness and palpitations at the same time

If tachycardia occurs in a 14-year-old child, it is necessary to give a few drops of Corvalol or Valocordin.

Causes

However, in addition to age-related characteristics, the child may experience attacks of palpitations of a pathological nature.

Causes of tachycardia in children:

• abnormalities in the development of the cardiovascular system;
• endocrine disorders;
• complications after infectious and inflammatory diseases;
• exercise stress;
• stress;
• side effects when taking medications.

There are two types of tachycardia in children: sinus and paroxysmal.

Tachycardia in a child can be of two types: sinus and paroxysmal. Sinus tachycardia is divided into physiological and pathological (extracardiac and cardiac).

Sinus tachycardia

There are physiological and pathological (cardiac, extracardiac) sinus tachycardia.

A child's cardiovascular system is affected by a number of factors. This often leads to increased heart rate. All reasons are divided into several large groups - external and internal. The first includes the following diseases and conditions:

• anemia;
• heart defects;
• myocarditis;
• endocarditis;
• vascular insufficiency (with fainting, shock).

The causes of increased heart rate in children may include the following natural causes:

• emotional and physical stress;
• with hyperthermia;
• when smoking or drinking alcohol (more often such tachycardia in adolescents).

In many cases, tachycardia in children is mild and does not require medical intervention. It is caused by physiological reasons, when eliminated, the heart rate returns to normal.

The main reason for the appearance of sinus tachycardia is the activation of the sinus node, however, an increase in its automaticity can be associated with both non-dangerous physiological conditions and diseases.

Physiological

Is it dangerous

Sinus tachycardia in children and adolescents is not an independent disease, but a symptom . An increased heart rate often indicates diseases - heart failure, left ventricular dysfunction, as well as anemia, hypoglycemia, tumors, diseases of the central nervous system, etc.

This disorder sometimes leads to vegetative-vascular dystonia of the hypertensive type and cardiac pathologies. Therefore, children with sinus tachycardia need observation .

Types of tachycardia

There are several types of tachycardia, and in children it most often occurs in two types - sinus and paroxysmal.

With sinus tachycardia, the rapid heartbeat reaches more than 100 beats per minute, and in some cases up to 200. The location of the sinus node is noted in the atrium, or more precisely in the lateral wall.

Its excitation is carried out due to parasympathetic and sympathetic stimulation, therefore, disturbance of the heart rhythm of this type most often indicates the presence of any disorders and diseases.

Depending on the severity of the violation, the following degrees are distinguished:

1. Heart rate increased by 10-20% - moderate degree.
2. Heartbeat increased by 20-40% - average degree.
3. The heartbeat is increased by 40-60% - severe.

Most often, children develop supraventricular tachycardia. A more dangerous form of the disease, ventricular, is often fatal, but is very rare. According to the nature of the course, several types of tachycardia are distinguished.

Considering the reasons that caused the increase in heart rate, tachycardia in children is divided into types.

Main forms of the disease

Sinus tachycardia

Sinus tachycardia develops against the background of increased activity of the sinus node. This pathological condition is accompanied by an increase in the frequency of cardiac contractions by 10-60%, depending on the degree of complexity of the disease. As a rule, attacks of such tachycardia are temporary, but if it lasts more than 24 hours, it can cause the development of heart failure .

In practice, sinus tachycardia is manifested by the following symptoms:

• dizziness;
• pain in the heart area;
• general weakness and malaise;
• pale skin;
• dyspnea;
• increased sweating.

Paroxysmal tachycardia

This type of rhythm disturbance can be supraventricular and ventricular (ventricular), which depends on the level of damage to the cardiac wiring system. Paroxysms are characterized by an abrupt onset, rapid development of symptoms and their equally unexpected cessation.

Supraventricular tachycardia in children, as a rule, develops as a result of birth injuries, intoxications, complex infectious processes of internal organs, stressful situations, nervous overstrain, as well as heart defects and changes in the myocardium.

young patients experience severe dizziness with fainting conditions that occur at the peak of cardiac pain. Children often complain of nausea, coughing, breathing problems and shortness of breath. Such babies have a sickly appearance, pale skin, sleep poorly and are constantly capricious. Supraventricular tachycardia in newborns is manifested by rare convulsions, refusal to eat and restless sleep.

Ventricular tachycardia is uncommon in children. Ventricular acceleration of the rhythm is diagnosed mainly in older children. Such tachycardia in adolescents can occur while taking cardiac glycosides, after heart surgery, as a result of myocardial inflammation or during a rheumatoid process. During attacks of ventricular acceleration of the rhythm, small patients complain of pain in the chest, palpitations, a feeling of fear of death and general weakness. Heart rate rises to 250 beats per minute.

Atrial fibrillation

Atrial fibrillation is an emergency condition, as it is manifested by ventricular fibrillation (increased heart rate to 200-500 beats per minute) and ventricular flutter (heart rate does not exceed 300-350 per minute). Atrial fibrillation practically does not occur in childhood , but is a very serious process that contributes to cardiac arrest.

Causes of tachycardia in children

When tachycardia appears, the symptoms and treatment in children of different ages will be slightly different. It is taken as the norm during the entire period that an unborn baby is in the womb of a woman. After birth, the rhythm continues to be accelerated compared to adults.

As the child grows, it becomes rarer. By the age of 14, a teenager has a frequency of no higher than 90 beats per minute. Age periods at a certain stage of life are characterized by specific features. They appear simultaneously with tachycardia.

First of all, you should definitely visit a pediatrician, who, if necessary, will refer you to a cardiologist. There you will be asked to undergo an ECG, where the cardiogram will tell you about possible heart rhythm disturbances. Also, if necessary, additional research methods may be prescribed.

Tachycardia should be treated based on the root cause of its occurrence. If it is a disease, therapy is prescribed to eliminate it. In any other cases, you should follow the doctor’s recommendations and establish the correct rhythm of the child’s life.

It is very important that parents closely monitor the child’s condition and contact a cardiologist at the first alarming symptoms. After examining and determining the cause of tachycardia, the doctor will prescribe the necessary treatment.

Most often, it consists of following the correct daily routine and dosing of physical activity. The child should get enough sleep and eat properly. Diet is an important part of the treatment of any type of tachycardia. It is very important to exclude coffee, tea, chocolate, salty and spicy foods from the child’s diet.

Food should be rich in vitamins and minerals. You should also calm the child’s nervous system and protect him from stressful situations.

All these measures are designed to prevent attacks of tachycardia and make them less pronounced. Drug therapy is prescribed to children in rare cases. Most often, in order to alleviate the child’s discomfort during an attack.

On average, a child’s heart beats about 100 times per minute and this is considered normal, but if it beats faster, sinus tachycardia may occur in children. You can tell that a little person is having an attack of cardiac arrhythmia by looking at the pulse - during an attack it is 10-15% higher than normal.

The diagnosis of sinus tachycardia means that the heart muscle contracts more during inhalation than during exhalation.

Children's heart rate is significantly higher than that of an adult. This is due to the body’s high need for oxygen and rapid metabolism. In addition, babies are constantly on the move. But sometimes the heart rate begins to exceed normal. And after the examination, sinus tachycardia is diagnosed in the child. What kind of pathology is this and how to treat it?

Survey

Diagnostics includes the following activities:

• general blood test - determines the composition of the blood and allows you to identify leukemia, anemia, and other dangerous pathologies;
• blood test for thyroid-stimulating hormones - shows deviations in the functioning of the thyroid gland;
• urine test for adrenaline - excludes or confirms the hormonal nature of the symptom;
• ECG, or electrocardiogram - by the frequency and rhythm of heart contractions, changes characteristic of various heart ailments are found;
• Holter ECG (24-hour monitoring) - shows how the heart works under different loads (at rest, movement, sleep);
• bicycle ergometry - study of heart function during physical activity;
• Cardiac echocardiography or ultrasound examination - reveals pathologies of the sinus node;
• electrophysiological study - detects conduction disturbances;
• electroencephalography (EEG) of the brain - detects diseases of the central nervous system.

This is what sinus tachycardia looks like in children on an ECG:

Symptoms and signs in children of different ages

The main symptom of tachycardia is rapid heartbeat, which may be accompanied by dizziness, weakness, and fatigue. In some children, tachycardia occurs without any external manifestations.

If shortness of breath, pain or a feeling of tightness in the chest, darkening of the eyes, or fainting are added to the symptoms described above, then this requires contacting a doctor and examination. Other risk factors include an attack lasting more than 5 minutes and the presence of heart disease.

Symptoms

The symptoms of tachycardia in children do not differ from those observed in adults. However, it should be noted that due to his age, the baby cannot formulate his feelings and causes of anxiety.

Considering that tachycardia can develop at a very early age, even in infants, diagnosis is based not on the complaints of a small patient, but on the results of examination and research.

Parents' tasks:

1. Listen carefully to the child’s complaints (if he can express them).
2. Pay attention to manifestations of tachycardia.

Rapid heartbeat is accompanied by:

• shortness of breath;
• sweating;
• pallor;
• dizziness;
• nausea;
• pain in the chest area.

In most cases, tachycardia in a child is not dangerous. But some of its types can lead to serious complications if this disease is not treated in time. The danger is that young children cannot describe how they feel.

These signs largely coincide with the manifestations of tachycardia in adults. In children, the skin turns pale, there is swelling and pulsation of blood vessels in the neck, and frequent fainting. If parents notice such symptoms in a child, it is necessary to show him to a doctor as soon as possible.

How does the disease manifest itself?

Clinical manifestations of the pathology depend on the severity of the process, duration and the main reason for its onset.

Symptoms of sinus tachycardia may include palpitations, a feeling of heaviness in the chest, and discomfort. In a more pronounced form due to a lack of oxygen to the brain tissue, tachycardia can manifest itself as sleep disturbances, mood swings, drowsiness, and fatigue. It can also manifest itself as a feeling of lack of air, shortness of breath, and dizziness. With organic damage to the myocardium, the frequency of attacks and their duration increases the likelihood of an attack of angina (with atherosclerotic lesions).

In the presence of vascular pathology, convulsions and focal disorders are observed. Due to reduced cardiac output, since the heart cannot pump enough blood to be released into the aorta in a shorter period of time, there is a decrease in diuresis in the child, cold extremities, and a decrease in blood pressure.

With paroxysmal tachycardia, the onset of the attack is sudden, at this moment the child feels a feeling of fear of death, dizziness, general weakness, and nausea. Objectively note:

• Pale skin
• Increased urination
• Excessive sweating
• Loud clapping heart sounds
• Difference in pulse on the carotid and radial arteries
• Swelling of the neck veins

A prolonged course of an attack can lead to acute heart failure and ventricular or atrial fibrillation (depending on the source of the pathological impulse).

Diagnostics

If you suspect a child's cardiac arrhythmia, you should immediately contact a specialist. During the examination, the doctor will be able to detect a rapid heartbeat, after which the child will be referred for additional physical examination. The most informative and popular methods for diagnosing tachycardia include:

• electrocardiography, which records the frequency, rhythm and correctness of cardiac activity, which makes it possible to judge the presence of tachycardia, determine its type and severity;
• electrophysical examination methods that make it possible to detect the nature of the conduction of pulsed waves through the myocardium;
• Ultrasound examination of the heart, during which it is possible to determine the possible cause of the pathological process.

First of all, you should not self-medicate. The group of diseases to which this pathology belongs is dealt with by a cardiologist.

To diagnose the cause of tachycardia, the following research methods are used:

1. ECG
2. Echo-CG
3. Holter monitoring
4. Electrophysiological study (EPS)
5. Other research methods that determine the cause of pathology outside the heart

An ECG will show a rhythm disturbance, a pathological focus, if the sinus node is not the only one that sets the heart rate for its contraction and ejection of blood. This is the first examination method that will lead the doctor to a preliminary diagnosis and determine further research methods to confirm the cause of the disease.

Tachycardia is detected by interviewing parents and examining their child. The information obtained helps to establish the cause of this condition. If necessary, treatment is prescribed. The examination includes the following methods:

• ECG (Electrocardiography).
• Holter monitoring ECG.
• Electrophysiological study (EPS) - transesophageal or intracardiac.
• Load tests.
• MRI.

An ECG image for various forms of tachycardia provides data characteristic of a certain spectrum of diseases. Depending on the pathology and heart rate, therapy is prescribed. It is carried out under the supervision of examination and additional research methods.

In childhood, a sinus variant of tachycardia is most often detected on the cardiogram. It does not exceed 150 beats per minute. The rhythm remains within normal limits, and the P wave remains positive.

The supraventricular form differs from that described above. The contraction frequency can be 250 per minute. QRS remains normal. The P wave may have changes in the form of:

• negative option;
• deformed;
• two-phase.

The electrocardiogram with the ventricular form of tachycardia looks altered. The QRS complex is deformed, and the child’s heart rate remains within the range of 160-210 beats per minute. Dissociation may occur when the ventricles contract in their own rhythm, and the atria in their own.

If the child does not have the paroxysmal variant, then the above symptoms will persist. There are differences in the number of heart contractions. Children are characterized by moderate tachycardia in the range of 110-120 beats per minute.

In addition to the electrocardiographic method, Holter monitoring is used. All data is collected within 24 hours. For this reason, it is carried out only among older children. The results, which are obtained within 24 hours, are assessed by a doctor. Sometimes questions remain in clarifying the form of tachycardia or it is difficult to find its cause.

To resolve controversial issues or confirm the diagnosis, a transesophageal examination is performed. The method allows you to evaluate the lesions that provoked the increased rhythm and caused associated symptoms.

For ventricular and supraventricular forms of tachycardia, stress tests are indicated. A treadmill test or bicycle ergometry is used. They are given to older children.

It is important to consider all possible complications and contraindications. If a child has a ventricular variant, then caution is needed. This is associated with a high risk of developing an attack, which occurs during intense physical activity.

In unclear situations (or to obtain complete information about the condition of the heart), a magnetic resonance imaging (MRI) study is performed. A complete examination allows you to get a clear picture and assess the severity of the pathology.

Only by determining the cause of tachycardia in a child can the correct treatment be prescribed. Therefore, when complaining of an accelerated heartbeat, the doctor refers the patient for examination. Most often, a 24-hour Holter ECG is performed for this purpose. A miniature sensor is placed on the baby's body, which records heartbeat readings throughout the day.

To identify what abnormalities in the heart caused tachycardia, an ECG, MRI, ultrasound of the heart or bicycle ergonometry are done. This allows you to evaluate the work of the heart muscle and the condition of the valves.

Blood tests are also taken from the child. They are designed to determine the level of hemoglobin, as well as the number of red and white blood cells. This will help identify blood disorders, such as anemia, or the presence of infections that may cause the heart to beat faster. They also do an analysis of thyroid hormones to determine whether the cause of tachycardia is a disturbance in its functioning.

In order to identify a possible disease as soon as possible, the doctor will try to find the root cause of the disorder in the functioning of the heart muscle and prescribe a series of diagnostic tests. First of all, this is the collection and analysis of the patient’s medical history in order to determine whether the child has chronic diseases that can affect the heart rhythm.

The doctor also needs to be told about the medications that the little patient is taking. After this, the baby will need to undergo blood tests, this will help to find out if the baby has anemia and whether everything is in order with the hormones.

It will be necessary to make an electrocardiogram of the heart in its normal state and undergo a stress ECG. If the cause is physiological, then treatment for tachycardia may not be required.

The signs of sinus tachycardia in a child are practically no different from the symptoms observed in an adult. This:

• fast pulse compared to normal,
• recurring dizziness,
• fainting,
• darkening of the eyes with sudden movements or changes in body position,
• dyspnea,
• pain in the heart and chest.

When these signs occur frequently, sinus tachycardia may be suspected. But only a doctor can draw conclusions.

To diagnose the disease, an ECG must be performed.

With its help, you can not only establish a diagnosis, but also identify the characteristics of the course of the disease in a particular child. Based on this, treatment can be prescribed.

Before performing an ECG, you need to familiarize the child with the procedure, explain why it is needed, and also make sure that the child does not perform active actions before it. Otherwise, the results may be incorrect. It is necessary to conduct an ECG with a child who is 1 year old or a little older in the presence of parents so that the baby does not worry.

Sinus tachycardia on ECG

The ECG clearly demonstrates the presence of sinus tachycardia, since it shows that the intensity and periodicity of heart contractions are impaired. The teeth and intervals will tell the doctor the specifics of the treatment, as well as the studies that need to be carried out to establish the details of the picture.

This may include tests or examination by doctors of a different specialization, if tachycardia is caused by or accompanied by other diseases.

For children, a rapid heart rate is normal, especially during active activities.

It is easiest to identify sinus tachycardia on an ECG, since this study allows you to accurately count the number of heartbeats, and by changes in complexes and segments, determine whether the tachycardia is really sinus. To clarify the diagnosis, Holter monitoring can also be used, in which the child’s ECG is continuously recorded throughout the day.

To identify cardiac pathologies manifested by tachycardia, the child may be prescribed echocardiography. To exclude non-cardiac pathologies in the baby, you need to take a general blood test, assess the level of thyroid hormones and do an EEG. Among specialized specialists, the child may need to consult an endocrinologist and a neurologist.

Treatment

The treatment tactics for tachycardia in children depend on the root cause that caused the appearance of pathological symptoms. The treatment of rhythm disturbances is carried out by a cardiologist or a pediatrician if we are talking about tachycardia of extracardiac origin.

In practice, the process of eliminating alarming manifestations can be realized with the help of conservative treatment, as well as physiotherapeutic and surgical techniques.

A sudden attack of tachycardia requires first aid, which consists of the following:

• the child must be taken out into the fresh air or ensure its flow into the room by opening the windows;
• A wet, cold compress should be placed on the forehead;
• Call a medical team immediately.

If a child has a sudden attack, the following actions must be taken urgently:

• Take the child out into the fresh air
• Place a damp towel on your forehead
• Call a doctor

Emergency care for paroxysmal tachycardia depends on the location of the source of generation of the pathological impulse. When it is located in the atria, it is necessary to perform movements that reflexively stimulate the activity of the vagus - the vagus nerve.

What to do to trigger the reflex

For children 3-4 years old, you need to do the following movements:

• Valsalva maneuver - close your nose and strain for about 10 seconds
• Massage the carotid artery alternately on each side for 5 seconds

From seven years old:

• Pressing on the root of the tongue
• Drying the body with a cold damp towel
• Slow deep swallowing

Emergency care for the source of the impulse in the ventricles is carried out with medication:

1. 1-1.5 mg/kg lidocaine 1% is slowly administered intravenously. If there is no desired effect, the procedure is repeated at half the dosage.
2. If ineffective, a 2.5% solution of ajmaline (gilurythmal) is administered per 10.0-20.0 ml of a 0.9% NaCl solution at a dose of 1 mg/kg.
3. If the attack continues, a 5% solution of amiodarone in 5% glucose is administered intravenously - 10 ml.
4. Extreme measures are transesophageal pacing.

During complex therapy, you must follow all the doctor’s recommendations.

It is important to follow non-drug therapy - sound, long sleep, reduced physical activity, emotional stability, systematic walks in the fresh air. It is advisable to adhere to a diet rich in magnesium, potassium, and vitamins. Dried fruits and baked potatoes are rich in potassium and magnesium. Remove chocolate, coffee and tea from your diet.

Drug therapy

In most cases, the heart rate accelerates with excitement, physical activity and hormonal changes in adolescence. If there is no organic pathology, then you need to calm down - this is often enough to normalize the condition. According to indications, the child is prescribed medications, or he is sent to a surgical hospital for surgery.

If there is no effect from the therapy, if complications arise or the child’s condition worsens, the child is referred for surgery. During pregnancy in girls under 18 years of age, possible contraindications are clarified.

Non-drug therapy

When tachycardia interferes with the quality of life, then, according to the recommendations of Dr. Komarovsky, you need to use therapeutic methods:

1. Massage of the carotid sinus in the neck in the area of ​​the carotid artery. It should not be performed for a long time, so as not to lead to an excessive slowdown of the heart rate.
2. Short-term straining of the abdominal muscles, lasting 1.5-2 minutes.
3. Covering the face with pieces of ice.
4. Pressing on the eyeballs while lying down.

Methods to combat pathology are quite ambiguous. If there are no symptoms of tachycardia and the baby feels well, then he can easily do without medications.

However, such children are recommended to undergo systematic repeated examinations and visit a cardiologist. If sinus tachycardia of the heart in a child occurs with unpleasant symptoms, then drug therapy is mandatory.

At the same time, children are recommended to take medications developed mainly for adults. That is why doctors prescribe them extremely carefully, choosing the right dosages and treatment regimens.

As a rule, therapy consists of the following groups of drugs:

• sedatives;
• medications involved in hematopoiesis;
• vitamin complexes;
• cardiac glycosides (if the problem is in the heart).

In addition to treating tachycardia in children with medications, it is important to follow a diet and proper regimen.

In order to eliminate abnormal heart rhythm, it is necessary to identify the root cause of tachycardia. After this, you need to eliminate it and try to also remove all those factors that provoke it.

If the cause is stress, you need to try to create a favorable emotional environment around the child. If it is a viral infection or a lack of vitamins, you need to try to consume more vitamins and minerals.

If the cause of heart disease is improper functioning of the myocardium, you will need to take heart medications. You cannot prescribe them to a child on your own, since something that is suitable for an adult can have a negative impact on the child’s body.

It is also unsafe to exceed the dose indicated by the doctor or in the instructions.

Prevention

For normal well-being, the following measures are recommended:

• maintaining a healthy weight - extra pounds put a strain on the heart;
• regular exercise;
• limited consumption of products containing caffeine;
• healthy diet, with a limited amount of fats and fast carbohydrates;
• a calm environment in the educational institution and at home;
• giving up bad habits - smoking, alcohol, which increase the manifestations of tachycardia.

As you can see, the child’s health depends on the attention of the parents and adequate, timely treatment. Therefore, if there are frequent attacks of tachycardia, the child should be shown to a doctor. Then the chances of a full recovery increase.

oserdce.com

The prognosis of the disease is favorable. By treating the root cause, the heart rate stabilizes.

You can support the myocardium by following a diet and moderate physical activity. The child needs to avoid stressful situations and emotional stress in kindergarten or school, not to overheat or get cold, and also strengthen the immune system so as not to catch a viral infection.

At the first complaint of heart pain, parents should take their child to the doctor, and under no circumstances self-medicate.

To prevent heart rate problems in childhood, it is important to teach your baby a healthy lifestyle. To do this, the baby must have an optimal daily routine, moderate physical activity, a balanced, varied diet, and good sleep.

In the next video, a pediatrician will tell you more about childhood tachycardia and give some advice to parents who are faced with this disease.