Bradycardia in children and adolescents 5-15 years old

Bradycardia – heart rate below normal. Children can have many of its root causes, namely:

  • Physiological bradycardia in sports.
  • Congenital or acquired heart defects.
  • Postponed cardiac surgery.
  • Postponed infectious and inflammatory myocardial diseases.
  • Acceptance of certain medications.
  • Activation of some reflex arches (with coughing, vomiting, urination, etc.).
  • Violation of the electrolyte balance of the blood.
  • Thyroid hormone deficiency.
  • Low body temperature.
  • High intracranial pressure.
  • Sleep apnea.

All these causes can affect different parts of the nervous or cardiovascular system. Hormonal or reflex regulation of the activity of the heart muscle is sometimes disturbed. That is why additional symptoms of pathology depend on the root cause.

The rhythm of the heart is regulated by the sinus node. It is located at the confluence of the vena cava in the right atrium. The sinus node is a site of the heart muscle.

It generates impulses that affect the heart rate. Accordingly, it is in this area of ​​the heart that processes that regulate heart rate are born. Violations of the functionality of this element are the cause of the development of bradycardia.

The sinus node is not the only one in this area. Other minor nodes are located here. They also generate impulses. Despite the fact that the pulses created by them have a lower frequency, their work is subordinate to the main, sinus node.

In case of damage to the sinus node, its functions can partially take over additional elements. However, due to the physiological characteristics of the structure of the heart, they are not able to completely replace this node. Because of this, pathology develops. If the sinus node is replaced by the last nodes generating the weakest impulses, pathologies that are incompatible with life arise.

In case of small violations, there is no threat to the life of the patient. But they show that it is necessary to begin to monitor health. The aggravation of bradycardia threatens the development of more serious pathologies that can result in death.

Symptoms

Parents should closely monitor the condition of the baby in order to detect pathology in time. This condition has clear manifestations. A kid with such problems will be weak and lethargic, refuse food, get tired quickly. Many patients suffer from:

  • dizziness;
  • shortness of breath and difficulty breathing;
  • cold, profuse sweating;
  • fainting state;
  • jumps in blood pressure indicators;
  • distraction and impaired concentration of attention;
  • pain in the chest;
  • slow pulsation of arteries.

All these manifestations are associated with impaired function of the heart to supply the body with the necessary amount of blood. Because of this, cells do not receive enough oxygen and nutrients and die.

Bradycardia is dangerous not only by the probability of loss of consciousness, but also by exhaustion of the heart muscle. It can burst, leading to the death of the patient. Timely treatment will help to avoid this.

Symptoms and methods of diagnosis

The main symptom of this condition is a decrease in heart rate. If the child likes the sport and is trained, then slowing the pulse may be a variant of the norm and will not be accompanied by other symptoms.

In other cases, dizziness, fainting, discomfort in the chest area may be present. It is very important not to miss the signs of damage to the brain or thyroid gland.

Bradycardia on an ECG is mainly determined. By cardiogram, you can assess the state of the cardiovascular system. Together with a cardiogram, it is important to conduct an Echo-KG. If these two studies do not give results, then all other organs and systems are examined. First of all, diseases of the endocrine and nervous systems are excluded.

How pathology is diagnosed

The main diagnostic method for detecting bradycardia in children is the Holter electrocardiogram. At the same time, rhythm indicators are monitored throughout the day. This procedure is enough to diagnose mild forms of pathology.

If bradycardia occurred in adolescents, then tests with a load are prescribed. In this case, the child needs to perform certain physical exercises, and the ECG at this time will record changes in the work of the heart.

If a heart defect is suspected, an ultrasound scan or magnetic resonance imaging is additionally performed.

General and biochemical blood tests, radiography and other diagnostic procedures are also prescribed.

Bradycardia in children: what is dangerous, causes, symptoms, treatment, prevention

If bradycardia is not physiological, then it significantly affects the quality of life of the child. Against it, the tolerance of physical activity decreases. Fainting conditions may occur, resulting in personal injury. In the most severe cases, heart failure develops and the work of many organs is disrupted.

The main thing that you can’t do is not to go to the doctor when the child’s pulse rate decreases. The longer this problem remains unresolved, the worse the consequences can be.

Bradycardia in children is a decrease in frequency, determined by calculating the pulse per minute. They are physiological and pathological.

There are many root causes of bradycardia. They can be associated with diseases of the cardiovascular, endocrine or nervous systems, infections or poisoning.

The treatment plan is selected depending on the root cause of bradycardia. If you leave it unattended, deviations in physical development may develop.

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Improper heart function always affects a person’s well-being. Bradycardia is a disease in which there is a slowing of the pulse (a decrease in heart rate). In children, the disease is rare, but requires observation.

Possible causes of pediatric bradycardia:

  • hereditary predisposition;
  • the presence of infectious diseases;
  • rapid growth of the child;
  • diseases of the cardiovascular system.

In newborns

The heart rate in newborns is 120-140 strokes. This value is inconsistent and depends on whether the child was born in a timely manner.

The criterion for sinus bradycardia in an infant is a heart rate of less than 100 per minute for more than 10 s. The manifestly pathological nature of bradycardia is considered with a heart rate of less than 90 in premature infants, and less than 80 in full-term infants.

From 1 year and older

By two years, the pulse will drop to around 124 beats. However, at this age, this indicator is affected by the activity of children, physical activity and other factors, the heart rate can be from 95-155 beats. The norm of the heart rate in children aged 5-6 years is 105 beats.

Deviation from the norm and a sign of the disease is a decrease in heart rate to 80-90 beats per minute.

In schoolchildren, the norm of heart rate is a range from 80-110 beats. The disease in schoolchildren is manifested in the form of a decrease in heart rate to 70 beats per minute.

Adolescents

In children aged 13 to 15 years, the pulse is considered normal if it ranges from 65-95 beats. The heart rate of a teenager over 15 should normally be the same as that of an adult. With bradycardia in adolescents, heart rate decreases to 50-60 beats per minute.

Types and differences

The disease, depending on the reasons, is divided into three types: pathological bradycardia, drug and physiological.

Physiological is quite common in completely healthy people. The reason is physical activity, for example, active training. If the child is involved in football, hockey or martial arts, it is likely that after training, a slow heartbeat from fatigue may be noted.

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Medical bradycardia can manifest itself after the child undergoes a course of treatment with certain drugs. Improper medication can trigger a disease. These drugs include:

  • cardiac glycosides – herbal products that are taken in acute or chronic form of heart failure (Korglikon, Celanide, Digoxin);
  • muscle relaxants – drugs that are used for anesthesia to relax skeletal muscles (Mivakron, Listenon, Arduan);
  • potassium preparations.

It is worth fearing when the disease develops against the background of other ailments, for example, with heart diseases (intracardial bradycardia) or other organs (extracardial).

Symptoms

There are three degrees of the disease: moderate, severe and mild bradycardia. Each degree has its own heart rate and symptoms.

Easy form

This degree is characterized by a decrease in heart rate to 60 beats per minute. Slow heart rhythms can occur in healthy people. The following factors may affect this:

Moderate degree

In this case, the child may not be bothered. The baby’s heart works at a frequency of about 50 beats per minute.

  • fainting;
  • dizziness when lifting from a chair or from a bed;
  • weakness;
  • dyspnea;
  • sleep disturbance;
  • pain in the chest;
  • loss of strength and the inability to perform any physical activity.

With severe bradycardia, fainting and falling often occur. This condition is accompanied by a decrease in heart rate to 40 beats per minute.

Can there be single manifestations? Yes, and this is common enough. For example, if a child is very scared.

Methods of diagnosis

Diagnosis of heart rate reduction in children is carried out according to the following scheme:

  1. Interviewing parents and making a list of complaints.
  2. Conducting an analysis of the history of all transferred infectious diseases and operations.
  3. Mandatory examination of a pediatrician and cardiologist.
  4. Analysis of urine and blood.
  5. Conducting an electrocardiogram.
  6. Ultrasound of the heart.
  7. Test for heart rate deviation.
  8. Determination of the need for treatment.

Attention: the list is not complete, as in some situations additional laboratory tests or consultation of other specialists, for example, a neurologist, is required.

Signs on an ECG

On the ECG, bradycardia is manifested in the form of a decrease in heart rate (an indicator lower than 60 strokes), as well as in the presence of a R.

Often an ECG is performed with various samples (physical activity, orthostatic test). This research method allows you to determine the nature of bradycardia (relative or absolute), and also makes it possible to assess the increase in heart rate.

Treatment

In newborns and infants with detected heart disease and other serious diseases, urgent hospitalization and surgery are required. During attacks, it is not recommended to put the baby to bed, because at rest, heart rate will slow down even more. Sometimes a doctor prescribes:

  • caffeine;
  • theophylline;
  • eleutherococcus extract;
  • ginseng root.

If the symptomatology is pronounced, then hospitalization is required. To alleviate the condition of the patient, it is necessary to control nutrition.

In children who have grown from infancy, mild to moderate treatment of the disease is carried out by strengthening the body (for example, taking the vitamin complex and following a diet).

Nutrition includes walnuts, seafood and fiber-rich vegetables. Your doctor may order an Eleutherococcus.

With a severe form of the disease, hospitalization and always regular examinations by a cardiologist are sometimes required. Perhaps medication.

How to treat adolescents? The treatment often includes plant adaptogens. These include:

  • Schisandra, zamaniha, aralia (potent remedies);
  • Licorice root and strong tea (moderately stimulating);
  • Nettle and kelp have a general tonic effect.

The most famous adaptogen of animal origin is the extract from the horns of maral (pantocrine).

Drug therapy is prescribed by a doctor who can prescribe the following drugs:

  • nootropic drugs (Piracetam, Phenotropil, Biotredin);
  • belladonna preparations (with severe bradycardia), for example, bellataminal;
  • Gutron (with loss of consciousness);
  • a multivitamin complex enriched with minerals.

With secondary bradycardia, which occurs against the background of other diseases, their treatment is recommended. In case of bradycardia on the background of congenital AV blockade, sinus node weakness syndrome, a pacemaker is implanted.

A child with bradycardia is recommended to do swimming, gymnastics and hardening. Exercise is not prohibited, but you need to choose a quiet sport. Engage in weightlifting and exhausting training is contraindicated.

You should carefully monitor teenage children so that they do not develop bad habits (smoking).

The patient’s diet should include seafood, walnuts, strong tea, vegetables and fruits containing high levels of potassium and magnesium. Giving coffee to children is not recommended.

Preventive measures

To prevent the development of the disease, it is required to apply preventive measures immediately after the baby is born:

  • to refuse from bad habits;
  • temper the child (water procedures, walks);
  • monitor nutrition;
  • provide the child with timely adequate treatment for any disease, while refraining from self-medication.

In children, a pathological decrease in heart rate is rare. Physiological does not pose any danger. If there are no serious diseases of the cardiovascular system, no special treatment is required.

Bradycardia in children occurs due to the pathological process in the child’s body. But there are cases of the occurrence of the disease in the normal state of the body. To begin with, we will understand what bradycardia of the heart is. A sign of the disease is a decrease in heart rate, heart rate below the permissible norm.

Causes

There are many reasons why bradycardia occurs:

  • Imbalance in electrolytes as a result of a lack of fiber in food consumed by a child;
  • The child is engaged in professional sports, as a rule, with this there is moderate bradycardia;
  • Past infectious diseases, for example, acute respiratory infections;
  • Congenital heart defect;
  • Excessive, ahead of schedule growth of the body (including the heart).

There are also other causes of the disease, but they are extremely rare and almost never occur in medical practice.

Symptoms

For each age group there is an acceptable threshold for heart rate (pulse).

  • Newborns, less than 120 beats per minute;
  • A child aged 1 to 7 years, less than 70 beats per minute;
  • A child from 7 to 18 years old, less than 62 beats per minute.

The main symptoms of bradycardia are the following symptoms:

  • When heart rate slows, the child loses consciousness;
  • Arterial hypertension develops, entailing unstable blood pressure indicators, to which it is difficult to choose a treatment;
  • Fast fatiguability;
  • Chronic circulatory failure.

Classification

Therapy

With forms of bradycardia that violate the quality of life of the child and worsen his well-being, they resort to treatment with antiarrhythmic drugs. In most cases, the situation is corrected using remedies based on medicinal plants like ginseng root, belladonna, Eleutherococcus extract, belladonna, as well as atropine and ephedrine.

Any drug is selected taking into account the individual characteristics of the body. Therapy is performed to eliminate the underlying disease that caused bradycardia.

For the treatment of mild forms of the disease, with the permission of a doctor, folk remedies can be used, among them:

  • the use of a mixture of walnuts, sesame oil, sugar, poured with hot lemon solution;
  • tightly brewed tea;
  • various seafood;
  • infusions based on pine branches.

It is important to remember that the body of a small child is difficult to tolerate certain substances. Therefore, the use of traditional medicine can provoke an allergic reaction. Parents should carefully monitor the reaction of the baby’s body in order to stop treatment in case of side effects.

With pronounced forms of the disease, it is necessary to urgently hospitalize the patient. If the disease has become chronic, then to normalize the rhythm of the heart, a pacemaker is installed. Thanks to advances in modern medicine, even severe cases of bradycardia in children are successfully treated.

Bradycardia in children is treated with physical activity. This is a fairly successful treatment option in the absence of contraindications.

Is it possible to play sports for children with bradycardia

Sinus bradycardia in children is successfully eliminated by moderate sports. Exhausting workouts that increase the load on the whole body should be abandoned. If you choose the right set of exercises, determine the rational load, encourage positive results, you can significantly improve the physical condition of the child.

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Preventive measures

Classification

  • Sinus bradycardia in children, the following symptoms are typical for it: dizziness, weakness, fear, fear of dying, lack of air. Causes of occurrence: decreased activity of the sinus node of the heart;
  • Not sinus bradycardia in children, the primary symptoms, like sinus. Causes of occurrence: blockade of electrical pulses between the nodes of the heart muscle.

Types of the disease are classified according to the principle of provocation of heart rate reduction:

  • Physiological, caused by playing sports at a professional level or excessive physical activity, a mild form of the disease, treatment is not required, since physiological bradycardia is not dangerous in most cases;
  • Medication occurs due to the use of certain drugs;
  • Pathological, developed due to pathological diseases, is a symptom of other heart diseases, this form of bradycardia is dangerous for humans.

The third classification of the disease has several types, according to the heart rate:

  • Pronounced, the faithful companion of which is arrhythmia, with this type of heart rate drops to less than 40 strokes;
  • Medium, sometimes arrhythmia also occurs, the number of heart beats per minute is less than 60, but more than 40;
  • Mild, arrhythmia completely absent, heart rate from 50 to 60.

To become more familiar with each type of bradycardia, it is worth consulting with your doctor. The specialist will familiarize you with information about the causes, treatment of bradycardia in a child or adult. You can also find out how a disease such as acute respiratory infections can cause more serious illnesses, including bradycardia.

Diagnostics

Bradycardia in children is diagnosed in the following ways:

  • Based on an analysis of complaints (weakness, dizziness, loss of consciousness, excessive exercise, and so on) if the child is of a conscious age;
  • Analysis of diseases (infectious, for example, acute respiratory infections, surgery or heredity);
  • Examination by doctors, therapist and cardiologist (probing the pulse, determining the boundaries of the heart muscle, and so on);
  • Analysis of urine and blood (on the level of hormones);
  • ECG data (sinus bradycardia in children is expressed on the cardiogram as incomplete conduction);
  • Ultrasound of the heart muscle (using this procedure you can find out the cardinal causes of the disease);
  • Test on an exercise bike with a gradual increase in the load (deviations from the norm in terms of heart rate and time required for recovery can be detected).

Treatment

The necessary and correct treatment can only be prescribed by a cardiologist. With such a disease, it is not necessary to begin independent treatment of the child. The child’s body is not fully developed, so you can harm any unprofessional intervention.

Even with acute respiratory infections in children, it is not worth starting treatment without consulting a specialist from the relevant medical field. Therefore, the tips are for guidance only, they can be discussed with a specialist, warning him that these data are taken from the Internet.

  • With mild bradycardia, if arrhythmia is not present, a diet and vitamin intake will be prescribed;
  • With a moderate course of the disease, if arrhythmia is present, treatment is more difficult. If after a course of vitamins and diet, the child does not improve, the doctor will prescribe sympathomimetics. They increase the contraction of the heart muscle, just as much as in sports. The dose and the drug is calculated and prescribed by the doctor after a full examination of the child;
  • With an advanced disease, but only as a last resort, surgery can be prescribed. Surgical intervention is possible in case of a threat to the life of the child. During the surgery, a pacemaker is installed, which helps the heart to contract normally.

Complications

As soon as symptoms similar to those described above appear, take your child to a doctor immediately. After all, even an ordinary acute respiratory disease transferred in childhood can eventually become fatal, as well as excessive sports. If the child has signs of bradycardia, do not wait for the tragic consequences:

  • Sudden death. The heart will stop beating, which is promoted by arrhythmia;
  • Injuries from a fall caused by loss of consciousness, up to a fatal outcome;
  • Cerebrovascular accident. The heart cannot cope with brain blood saturation. This may result in cerebral cortex disease;
  • Cardiovascular failure. The heart is not able to perform the function of blood circulation, even in a dream;
  • Coronary heart disease, after several decades of the course of the disease, myocardial infarction may occur.

Prevention

  • If the child is an athlete, make sure that he does not overwork and does not lead beyond an active lifestyle;
  • Eating fiber-rich foods, eat your baby right from birth so that it doesn’t turn out too late. Give your child fruits and vegetables, avoid fried and spicy;
  • After consulting a doctor, take the medications prescribed by him;
  • In time to treat diseases, even banal ARI.

By observing and following the implementation of these simple rules with your child, you will help him grow up healthy.

For accurate and detailed information and advice, contact your doctor at the hospital.

If the child is diagnosed with bradycardia, he needs to be constantly examined by a cardiologist. Such a measure will allow timely action to be taken to prevent the deterioration of the patient’s health.

Therapy of bradycardia depends on the severity of the disease.

  • Mild sinus bradycardia, which is not accompanied by arrhythmia and heart muscle defects, does not require the use of special drug therapy. In this case, diet food and multivitamin complexes are prescribed. If the child has concomitant diseases, measures are taken for their therapy (drugs that affect electrolytic metabolism and eliminate oxygen starvation are prescribed).
  • With a moderate form of the disease, therapy with vitamins and diets may not be enough. Especially in the case of arrhythmias. If such measures have not led to positive changes, sympathomimetics that increase the heart rate are used. The specific drug, the duration of administration and dosage are determined by the doctor based on the patient’s condition.
  • A pronounced form of the disease is treated with antiarrhythmic drugs, such as: caffeine, tincture based on ginseng root, atropine. Surgery may be performed to treat an advanced disease. This is an extreme measure during which a pacemaker will be installed. With its help, you can achieve an increase in the frequency of heart contractions and normalization of the patient’s condition.

Despite this, it is recommended to be examined when the first signs of the disease are detected. This will exclude CCC violations.

Thus, in medicine, bradycardia means a decrease in the frequency of heart contractions. A disease can develop in life, or be congenital. It can be detected by characteristic symptoms. During the diagnosis of the disease, the doctor will establish the cause of the decrease in heart rate, determine the severity of bradycardia and prescribe treatment. The disease responds well to therapy, but surgery may be necessary in some cases.

To prevent the development of bradycardia in children of any age, it is necessary:

  1. In time to identify and treat any pathological processes in the body.
  2. To live an active lifestyle.
  3. Avoid physical inactivity.
  4. Do not resort to self-medication and do not pick up the drug and its dosage on your own.
  5. Engage in quiet sports.

Parents can significantly strengthen the body of the child, introducing him to the stabbing. This technique strengthens the heart muscle, reduces the risk of contracting infectious diseases. It is important to carry out such procedures correctly, gradually lowering the temperature.

Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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