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Original poster

Childhood Arrrhythmia

51 replies

loopydoo · 15/02/2012 01:33

Hi - before xmas, DS (7yrs) had a terrible pain in his chest quite out of the blue. We were all chatting in the kitchen when he suddenly gripped his chest and throat and said he couldn't breathe.

I was really worried and about to take him to A & E but sat him on the worktop and calmed him down until it stopped.

Since then, he has complained a few times saying "my heart hurts" and so I kept checking his heart whilst he was sleeping. It felt all over the place, mainly as though it was coming out of his chest and really fast. Even though I felt it at rest, it also felt as though it was doing an extra beat; kind of like.........
bum, bum
bum, bum
bum, bum
bum, bum,bum ,bum
bum,bum
(IYSWIM?)

So a few weeks ago I had him checked out with the GP who listened to his heart for a couple of mins and said she thought it was arrhythmia, common in children. She said if he got pains again, to take him back and that she thought the down beats were faster than the up beats (sort of how she worded it Confused.

I'm still owrried he wasn't sent for an ECG - should I take him back or does this sound common?

OP posts:
SydneyS · 15/02/2012 02:13

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Ebb · 15/02/2012 10:31

Go back to a different GP for a second opinion and insist on being refered to a paediatric cardiologist. I'm quite shocked the GP didn't investigate further. My Ds had a murmur picked up at 9mths when he was poorly and the GP told me to bring him back 2wks later. It was still there so he was immediately refered to a cardiologist for an ECG and ECHO and diagnosed with aortic stenosis. I would imagine a heart is the one organ you don't take chances on! Good luck!

Original poster
loopydoo · 15/02/2012 10:41

Thank you - I'm so sorry to hear about your dd Sydneys - that must have been traumatic and still so now.

The GP seemed very unperterbed by it and said there was no murmur - just that the second beat went faster than normal but that it was normal.

The heart is obviously so very intricate and I'm not sure that a GP should be able to tell me not to worry.

I will call the docs this morning.

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Ebb · 15/02/2012 10:44

Sydney your daughter is beautiful.

Original poster
loopydoo · 15/02/2012 11:50

Hi - so I just the GP's and asked the receptionist to tell me what the GP had put in the notes. She said it's sinus arrhythmia.

I said I'd google and get back to her if I wanted to chat to GP about ECG referral.

Trying to see if it's dangerous or normal - seems so far to be more common in children.

The GP wrote to go back if he experienced any more chest pains.

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margoandjerry · 15/02/2012 11:57

Definitely press for more investigations. I've just been told I have sinus arrythmia and another thing (right bundle branch block???). GP was very unconcerned about both, particularly the first. He said it was very common and just the way some people are (something to do with heartbeat fluctuating with breathing) but he's referred me on for a 24 hr ECG anyway. For your son I think further investigations are definitely merited. And Sydney, so sorry about your story - what a terrible thing to happen. I hope you continue to see improvements in your lovely girl.

Original poster
loopydoo · 15/02/2012 12:06

Thanks Margo - I'm going to show DH the info later tonight and then ask the GP for an ECG to set my mind at rest.

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SydneyS · 15/02/2012 20:42

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Original poster
loopydoo · 16/02/2012 09:38

No worries Sydney - I completely understand how often heart probs go undetected so it's made me think that we should say we want an ECG at the very least.

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charliechildnurse · 18/02/2012 18:40

The biggest risk is not being diagnosed. You have warning signs, and you should act upon them to try to get a diagnosis.

How long do these episodes last?
Do they resolve totally spontaniously?
Do they happen after anything specific, eg running or the phone ringing or just sitting and watching TV, or do they happen seemingly randomly?

I had an undiagnosed heart condition (long QT syndome) and I died. Luckily, CPR was effective and I survived, and now have an ICD (implanted defibrilator).

This isn't an excersise to scare you, but it is really important that it's checked out. I would seek advice from a paediatric cardiologist too, because in children who have not yet reached puberty, EGC patterns can overlap and give false positives, because the 'waves' as seen on ECG's can have different inversions which may look like sinister things, when it isn't. Your GP would likely not have had experience for many years in interpretation of ECG's, and therefore I think it needs to be looked at by a specialist. Ask at your surgery if there is a GP with a special interest in cardiology, as they may have more experience at ECG interpretation.

Also, as previously mentioned, there are many, many heart conditions which will not show on an ECG. Long QT Syndrome, for example, doesn't always show on an ECG, and needs different tests, and longer monitoring with a 'holter' monitor which is attached for 24 or 48 hours, or in some cases, 6-8 weeks. It is therefore important that you seek advice from a cardiologist rather than your GP.

It might be worth taking your son to A&E as soon as it happens next time. You can tell him in advance that you will be doing that, so he doesn't get scared. This way, an ECG can be taken during, or straight after the event, helping with diagnosis.

I hope you get this sorted out, sooner rather than later. Good luck!

:)

Original poster
loopydoo · 18/02/2012 19:29

Thank you so much for the info charlie. I'm going to go back to the GP and ask for a referral to someone who specializes in paed cardio. I read about the holter monitor.

As I said to the GP receptionist when she said his notes to go back if he has any more pain "I can't take chances with his heart".

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charliechildnurse · 18/02/2012 19:52

You can't take chances with the ticker, that's for sure!

But I really would consider a trip to A&E next time it occurs, because they may well be able to catch it.

:)

Original poster
loopydoo · 18/02/2012 19:56

The really bad first pains he got, we were all standing in the kitchen chatting when he suddenly gripped his heart area of his chest and then his throat, saying he couldn't breathe.

Wasn't an asthma not being able to breathe but more a strangling can't breathe but he said the pain was in his chest where his heart is.

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charliechildnurse · 18/02/2012 20:12

How long did it last? You say you sat him on the counter and calmed him down. Any idea how long this took? 5 minutes? 20 minutes?

If you don't want to go to A&E (which, I suggest you do!) then make sure you time it, and count how many breaths he takes in a minute (without telling him... you can just count for 30 seconds and double it) and try to find his pulse and see what it feels like.

Is it strong? Is it regular? How fast is it going? (again, count for 30 seconds and double it)

You can hold his wrist for 1 minute and do 30 seconds of respiratory and 30 seconds of pulse. If his pulse is too fast to count, or is irregular he needs to go to hospital straight away.

Original poster
loopydoo · 18/02/2012 22:28

I'd say it was about 5 minutes charlie before he said it stopped hurting painfully. I was on the brink of taking him to A & E but after I calmed him down, didn't see the need.

When it happened, he fell to the ground on his knees - that shocked me the most because at first, I thought he was faking it as it was so dramatic (DH still didn't realise what was happening really until I said he was having trouble).

I felt his chest and it felt as though his heart was beating almost through his chest. His pulse was very fast and felt like it was all over the place.

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Ponders · 18/02/2012 22:32

I was reading only today about \link{http://www.c-r-y.org.uk/\CRY - Cardiac Risk in the Young}

I don't know if it's relevant to what your DS experienced but in your position I would definitely push for investigation

I do hope what he has can be properly diagnosed & fixed

Original poster
loopydoo · 18/02/2012 22:57

Have just been reading up about Papworth hospital (only about an hour away from us)and the diagnostic tests they provide.

I just think the GP will put down my request for further testing; I just don't trust her ability to diagnose a problem. Can I insist on a referral for diagnositc testing?

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SydneyS · 19/02/2012 00:24

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Original poster
loopydoo · 20/02/2012 22:10

Called GP practice today and the GP is going to do a phone app on Wednesday. Slightly worried she'll think I've got Munschausen by Proxy !!!

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SydneyS · 21/02/2012 01:46

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Original poster
loopydoo · 21/02/2012 12:34

Thanks - I will use that line ;)

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Original poster
loopydoo · 22/02/2012 13:25

Well, that didn't go great!

She called me and I asked her for more details about sinus arrhythmia, which she said were completely normal, especially in children.

I asked ( I wanted to be more assertive but wasn't) whether ECGs were routinely done to double check and she said no - she didn't think the surgery had ever done one on children Hmm.

Anyway - she said she would book him for an ECG at the surgery (not what I wanted as it now means, she'll look at it and conclude, rather than cardiologist).

Oh well, it's a start - I can always pay for a private test I guess if not.

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larrygrylls · 22/02/2012 14:14

Loopy,

I am not sure you are entirely getting the message. Various people with either personal or professional experience seem to have advised you to take this VERY seriously. I don't think you should wait for your (incompetent sounding) GP to do an ECG and find not much wrong in order to go the next stage.

If it were my son, I would be threatening to sue if I was not given an urgent referral to a paediatric cardiologist or, if you can afford to go privately, I would be finding the best one in my area and calling his/her secretary, explaining the situation and asking how soon they would be able to see me given the situation.

Original poster
loopydoo · 22/02/2012 15:14

Okay - thanks larry.

Nobody here had said they were a professional - or do you mean what I'd read on websites?

It makes me worry though what does get missed.

It is very hard for some people (I mean me as well) to be assertive with GPs/HPs. Whilst I'm hoping to be one myself soon (midwife), I certainly believe that being supportive and empathetic towards parents is something GP practices need to work on.

However, if she tells me a), b) and c), I feel as though I don't trust her saying "well, I wonder if it might be x), y) and z). Surely she is the trained doctor - yes not cardiologist - but she ensured me it's completely normal. If I was an even less assertive person than I am, how would I have gone if she refused an ECG?

Anyway - will see what ECG shows and then decide whether to take him privately.

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Original poster
loopydoo · 22/02/2012 15:22

Oh other thing was when describing the original chest pain when he was holding his chest, she said she didn't that would be related and in a child that young, not iscemic heart disease

I don't get why she would only think of that (as it's common in older people). She didn't mention anything else it could have been.

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