Tachycardia in adolescents ⋆ Heart Treatment

The physiological and pathological (cardiac, extracardial) sinus tachycardia are divided.

Physiological and pathological extracardial tachycardia occurs as a reaction of the heart to extracardiac stimuli.

Causes of physiological tachycardia:

  • physical, psycho-emotional stress;
  • fear;
  • an increase in the temperature of the environment in which the person is;
  • plentiful meal, drink;
  • lack of oxygen in the room;
  • altitude hypoxia caused by oxygen starvation due to the low partial pressure of oxygen in the air.

Extracardiac pathological tachycardia is provoked by internal factors – an increase in body temperature, a drop in glucose, oxygen in the blood with anemia, lung diseases, thyrotoxicosis, pheochromocytoma (tumor disease), and the use and overdose of certain drugs.

This tachycardia proceeds according to a moderate type at rest and is characterized by a strong heart rate during normal physical and psycho-emotional stress. The disorder usually affects girls aged 7-12 years.

Cardiac sinus tachycardia is associated with heart diseases – inflammatory (heart pericarditis, myocarditis in children, endocarditis), ischemic-necrotic (myocardial infarction, ischemic disease), degenerative, dystrophic-sclerotic processes in the organ. It also occurs when there is a lack or excess of potassium, a low magnesium content.

Common causes of tachycardia in school age are:

  • experiences;
  • physical exercise;
  • puberty and related changes in the body;
  • Iron-deficiency anemia.

Swaddling, overheating, severe crying can cause a rapid heartbeat in the baby.

In childhood, tachycardia is considered a physiological state, and does not require treatment, but even it has certain boundaries. When the heart rate exceeds the permissible level for a given age group, it is necessary to understand: is this tachycardia normal, or is caused by any pathology. Cardiac causes:

  • heart defects (congenital or acquired);
  • myocardial ischemia (acute or chronic);
  • inflammatory diseases (infectious or non-infectious nature);

A rapid heartbeat is not considered a pathological condition after physical exertion, running or strong emotions (both positive and negative).

Causes that are not related to heart disease include the following:

  • neurosis;
  • pathology of the endocrine system (pheochromocytoma, thyrotoxicosis);
  • strong pain;
  • fainting;
  • fever as a symptom of tonsillitis, pneumonia;
  • taking certain drugs (Adrenaline, Noradrenaline, Eufillin, Atropine). Diuretics and thyroid hormones also accelerate heart rate;
  • certain types of drinks – coffee and tea;

In childhood, an increase in body temperature by 1 ° C leads to tachycardia (in excess of 15 beats per minute). When eliminating the factor acting on the myocardium, the heart rate normalizes. With inadequate tachycardia, it persists and does not disappear even at rest.

The causes of increased heartbeat in children can be such natural causes:

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

Also, an increase in heart rate can be noted in such situations:

  • in the presence of oncology;
  • with the development of an infectious or purulent process;
  • with bleeding;
  • with a decrease in blood pressure;
  • in case of violation of the thyroid gland
  • with anemia;
  • when taking certain groups of drugs.

In the case of a pathological appearance of tachycardia, the following disorders are noted:

  • pathology of the endocrine and autonomic nervous system;
  • disturbances in hemodynamics;
  • arrhythmia;
  • cardiovascular diseases.

It should be remembered that an increased heartbeat in a child may be an independent symptom or the cause of a disease.

Tachycardia is characterized by rapid heartbeat. It can form in a teenager due to the influence of various factors. Most often, they are united by the physical characteristics of the child. In children aged 13-16 years, an increase in heart rate and blood pressure can be observed due to rapid growth.

If the child is outwardly physically developed, medium or tall, proportional, then his tachycardia may indicate heart hypertrophy. In children of short stature and lean physique, the organ may be too small, so it works more actively. This leads to the appearance of tachycardia.

  • large physical exertion;
  • a state of constant emotional stress;
  • the presence of problems in the endocrine system;
  • various types of anemia;
  • congenital pathologies in the structure of the heart and vascular system.

Doctors consider sinus tachycardia separately. It develops in children aged 12-16 years for organic and physical reasons. Sinus rhythm in this disease remains normal, but other indicators change. A direct connection is noted between the development of this form of the disease, the situation in the family and the child’s lifestyle. Sinus tachycardia is formed for the following reasons:

  • severe stress and emotional distress;
  • rapid physical development;
  • endocrine diseases;
  • experiencing difficult emotional situations;
  • excessive exercise.

Therefore, it is recommended every year to bring the child to a full medical examination in the clinic. In 90% of cases, this type of tachycardia occurs without symptoms. This means that the ailment is temporary in nature and is not accompanied by any organic changes. But if tachycardia is not diagnosed in time, it can provoke the development of certain pathological conditions, so parents should periodically measure the pulse of their child. If its frequency is more than 90, then this is an occasion to contact a cardiologist.

Some children aged 11-15 years develop paroxysmal tachycardia. The heartbeat in this disease is increased to 160 beats. The attack itself lasts only 3 minutes. Doctors associate the development of this disease with disorders in the formation of the nervous system. This is due to problems in bearing the fetus.

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

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Sinus tachycardia

Physiological tachycardia can occur with emotional stress, a transition from a lying position to an upright position, a change in the microclimate, fear, and excessive intake of food and liquid. The causes of tachycardia in infants may be due to a violation of the automatism of the sinus node, he is a pacemaker – sends an impulse and determines how often the heart muscle contracts. In a teenager, the cause may be accelerated growth of the body, overwork, chronic lack of sleep, endocrine rearrangements.

Pathological extracardial tachycardia occurs with changes in the body: fever, toxicosis due to infectious agents, low blood sugar, hypoxemia (lack of oxygen in the blood), which manifests itself in anemia, respiratory failure. The cause can be acidosis – when taking certain medications, chemicals, poisoning, indomitable vomiting. Endocrine disorders – thyrotoxicosis, pheochromocytoma, tumor processes of the hypothalamus often cause this violation.

Cardiac tachycardia appears as a signal of organic lesion of the sinus node. This is the first sign in inflammatory processes of heart tissues – myocarditis, endocarditis and pericarditis, ischemic processes – IHD, myocardial infarction, degenerative-sclerotic changes – myocardial dystrophy, myocardiosclerosis.

This type of pathology can affect both a one-year-old child and a teenager of 14 years old. It occurs equally often in different groups of children. More often than others, paroxysmal tachycardia is diagnosed in children 7 years old.

Tachycardia of the heart is characterized by a sudden onset, and the same abrupt cessation. The reason for this is the appearance of a new pulse in addition to the sinus node.

The causes of paroxysmal tachycardia are:

  • WPW syndrome
  • Vegetative-vascular dystonia with sympatho-adrenal crises
  • Neurosis on the background of central nervous system damage
  • Organic disorders (see cardiac tachycardia)

Symptoms and treatment of tachycardia in children of different ages are somewhat different and depend on its type, which can be explained by physiological changes in the body, which are characteristic for each age group.

With physiological tachycardia, the rhythm is restored 3-5 minutes after exposure to such a factor.

It is sometimes difficult for a layman to name a specific cause of heart rhythm disturbances in sinus tachycardia. After all, there are many such reasons, they act indirectly and vary greatly depending on the age, as well as the individual characteristics of the child’s development. Rhythm changes that are acceptable in infants immediately after birth are considered a deviation from the norm at the age of six months, and even more so – a year or several years.

Sinus tachycardia occurs in a newborn baby quite easily. Due to the fact that the sinus node immediately after birth is characterized by increased automatism, the rapid rhythm of the heart in the first and even second months of life is considered normal. But if a baby at the age of 3-6 months or even a one-year-old baby suffers from tachycardia, then it is likely that he has a disturbed myocardial metabolism.

Types of tachycardia in children and its causes

Several types of tachycardia are distinguished, and in a child it most often occurs in two types – it is sinus and paroxysmal.

Sinus tachycardia

With sinus tachycardia, a frequent 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, and more precisely in the side wall. His arousal is due to parasympathetic and sympathetic stimulation, therefore, a violation 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. Palpitations increased by 10-20% – a moderate degree.
  2. Heart rate increased by 20-40% – medium degree.
  3. Heart rate increased by 40-60% – pronounced degree.

If the cause of sinus tachycardia is physical or emotional stress, the symptoms should disappear within 5 minutes after its occurrence, without causing any harm to the baby’s health. In the case of a pathological malfunction of the sinus department, the symptoms can often appear, do not disappear for a long time, and when diagnosing sinus tachycardia in children on the ECG, there will be practically no changes.

In childhood, this species occurs in almost 40% of cases, and its causes are such factors:

  • stress and overwork;
  • enhanced body growth;
  • existing problems with cardiovascular activity;
  • violation of endocrine work.

Heart palpitations in a child are observed as often as in adults. A feature of the development of the cardiovascular system of children is that the normal frequency of contractions depends directly on the age of the child. The indicators are almost twice as high as adults. In most cases, in adolescents, the heart rate is leveled and reaches 80–85 beats per minute.

Heart rate normal in children:

  • 0–1 year: 132–162 bpm;
  • 1-2 years: 120-150 bpm;
  • 2-4 years: 115-135 bpm;
  • 4–6 years: 80–133 bpm;
  • 6–8 years: 75–130 bpm;
  • 8–11 years: 70–110 bpm;
  • 11–15 years: 70–80 bpm

An increase in normal values ​​by 20-30 y / m may indicate the development of pathology.

The causes of heart palpitations in children lie in the features of the anatomical structure of the heart at this age. It still has a small volume, the main vessels are also of small diameter, but the needs of the fast-growing organism in the blood supply are quite high. The response to this becomes the rapid rhythm of the heart.

However, in addition to age-related features, the child may experience bouts of heart 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 drugs.

In children, there are two types of tachycardia: sinus and paroxysmal.

Sinus arises due to physical exertion or due to cardiovascular disease. The change in heart rate occurs gradually and also gradually subsides. As a rule, the phenomenon arises in connection with active growth and proceeds as a reaction of the body to this process. Symptoms are usually mild. Medicines are prescribed as necessary and when establishing the cause of the phenomenon.

Also, sinus tachycardia differs in the nature of the course: adequate and inadequate. The inadequate feature is the preservation of the rapid rhythm at rest.

Paroxysmal tachycardia is characterized by a sharp onset and the same sudden cessation of the attack. An impulse that causes frequent heart contractions is concentrated in the atria and ventricles. This type of tachycardia causes organic damage to the heart and the pathology of its development. Treatment consists of taking glycosides, beta-blockers, as well as supporting drugs.

In addition to these species, tachycardia can occur in a chronic form. Its occurrence is associated with congenital cardiac abnormalities and pathologies. In this case, parents should not only follow the doctor’s recommendations for treatment, but also take measures to prevent exacerbations of the process. It is necessary to control the daily routine of the child, make sure that he gets enough sleep, receives moderate physical activity. Food should be balanced and include foods that are good for the heart: fruits, vegetables, cereals, legumes, nuts.

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Symptoms of tachycardia in children do not differ from signs observed in adults. However, it should be noted that due to age, the baby cannot formulate his feelings and causes of anxiety. Considering that tachycardia can develop at a very young age, even in infants, the diagnosis is based not on the complaints of a small patient, but on the results of examination and research.

Listen carefully to the child’s complaints (if he can make them).

Pay attention to the manifestations of tachycardia.

Heart palpitations accompanied by:

  • shortness of breath;
  • sweating;
  • pallor;
  • dizziness;
  • nausea;
  • chest pains.

The tactics of treating tachycardia in children depends on the causes of its occurrence. If the rapid heartbeat is not pathological in nature and is not associated with diseases of the heart and blood vessels, the use of drugs can be avoided.

At the first sign of tachycardia should:

  1. Provide the child with rest and bed rest until the condition improves.
  2. Ventilate the room, provide air access.
  3. Rinse baby’s face with cold water.
  4. Take a few breaths and exhalations with your child.
  5. Suggest, after a deep breath, exhale with a closed mouth and nostrils (Valsalva tests).
  6. Perform eyeball massage.
  7. To reassure the child, since stress is one of the factors in the development of tachycardia.
  8. Seek medical advice.

Treatment of pathology is prescribed according to the results of examination, examination by a cardiologist and pediatrician, establishing the causes of tachycardia. An increased frequency of heart contractions may be a consequence of diseases, but doctors note a favorable prognosis when following the recommendations.

Sinus tachycardia

What to do with a low pressure in a child, how to increase it

As we already understood, tachycardia “hides” a rapid heartbeat, which can reach very high levels. This can occur due to natural factors (large physical overstrain, stress, temperature changes) or as a result of a congenital disease, as well as an acquired one.

Low blood pressure in a child is common today. Children who suffer from hypotension become more and more cases occur even in infancy.

Reducing blood pressure should not be ignored, it can report serious diseases. It is advisable to monitor the condition of the baby, immediately contact a doctor and take appropriate measures.

It is difficult to determine whether there is a decrease in childhood blood pressure because the child has lower blood pressure than an adult. In a newborn, it ranges from 67 / 55-75 / 55 RT. Art., the older the baby becomes, the higher the upper (systolic) pressure rises.

To find out if the blood pressure is normal in infancy, you can use the simple formula: (2 * months of life 76), so you will know if everything is okay with the baby.

High or low pressure may be in adolescents. The norm is finally established only after adulthood, when the puberty period is experienced. In adolescence, it is able to fluctuate within 90 / 70-100 / 78 mercury.

To check if a child has low blood pressure, you need to measure it with a tonometer. To measure blood pressure, a small cuff is worn on the children’s handle. For children up to a year, its width should not exceed 3 centimeters, but for those older, they put on cuffs of 5 centimeters.

The baby must be in a horizontal position during measurement. If the child is not yet 2 months old, then only the upper pressure is calculated by probing the handle.

The device must make 3 measurements. The smallest value is the real state. Blood pressure at the current time.


  • physical activity at an early age;
  • stuffiness in the room, lack of fresh air;
  • physiological changes associated with growth, development of the body;
  • hormonal changes;
  • specifics of anatomical structure. For example, high growth.

Hypotension in children can occur due to pathological factors:

  • Strong emotional experiences.
  • Mental, physical overstrain.
  • Birth injury.
  • A difficult pregnancy that affected the condition of the child.
  • Intestinal ulcer, stomach.
  • Allergies.
  • Pneumonia.
  • Hemorrhages.
  • Blood diseases – leukemia, anemia.
  • Thyroid disease.
  • Diabetes mellitus.
  • Intoxication.
  • Mental disorders, mental trauma.
  • Deficiency / overabundance of vitamins.
  • Poor metabolism.
  • Damage, inflammation of the brain of an infectious and non-infectious nature.
  • Tachycardia, heart disease, cardiac asthma, flickering arrhythmias.
  • ARVI.

In addition, low pressure in a teenager is due to:

  1. Hard diets.
  2. Medicines that change blood pressure.

Adolescents who have gone beyond 12 years are allowed to take a wide range of drugs that increase blood pressure.

How to increase blood pressure in a teenager with medication:

  • Citramon Not used by children under 12 years of age. It provokes liver dystrophy in young children. Due to caffeine increases blood pressure;
  • Fetanol;
  • Heptamyl;

What to do with low pressure in a teenager – general recommendations:

  1. Eat seafood, drink milk with honey or tea.
  2. Regularly spend time outdoors. An active walk should last at least 2 hours.
  3. Do sport. Play outdoor games.
  4. Get enough sleep. A teenager needs at least 8-11 hours of full sleep.
  5. Take a contrast shower. Wipe off with a cool cool towel in the morning.
  6. Establish the regime of the day, do not stay up late.
  7. During a long pastime at a desk, computer – knead your neck, make turns and massage movements to prevent stagnation of blood.

Teenagers are advised to limit their stay at the computer. Do it in the correct position: with a flat back, chin parallel to the floor.

Hypotension in newborns is complex. It is almost impossible to provide first aid; an invasive method is required, which should be carried out by a doctor. A small child should not be given injections on her own without a doctor’s prescription. This can lead to serious complications, even a life threat.

Moreover, at this age it is difficult to calculate when the pressure is lowered. Accidentally, you can take an elevated estimate of Blood Pressure as low or vice versa.

Before using any remedy, it is advisable to go to the hospital for a consultation with a doctor so as not to harm the health and life of the child.

Children are the most precious thing in the life of every parent. And when the child begins to hurt, parents do not find a place for themselves. Tachycardia in children and adolescents is not less common than in adults.

Tachycardia is an accelerated heartbeat, higher than the permissible figures by more than 20 beats. In order to establish the diagnosis of pediatric tachycardia, you need to know the norms of heart rate for each age group:

  • Newborns: norm – 140 beats per minute, borders – 110-170
  • 1-12 months: normal – 132 beats per minute, borders – 102-162
  • 1-2 years: norm – 124 beats per minute, borders – 94-154
  • 2-4 years: norm – 115 beats per minute, borders – 90-140
  • 4-6 years: normal – 106 beats per minute, borders – 86-126
  • 6-8 years: normal – 98 beats per minute, borders – 78-118
  • 8-10 years: normal – 88 beats per minute, borders – 68-108
  • 10-14 years: normal – 80 beats per minute, borders – 60-100

Sinus tachycardia

Sinus tachycardia in children is a too strong heartbeat in conditions of an acceptable sinus rhythm. A sign of it is a pulse of more than 100 beats per minute for adults. In children, the bar above which the heart rate is considered abnormal depends on age. The older the child, the lower the threshold beyond which pathology is determined.

The conditions for heart palpitations are slightly different in infants and adolescents. If we talk about newborns, their heart rate is very fast due to the fact that the automatism of the sinus node is increased. Specific reasons are as follows:

  • physiological causes: overheating, swaddling, pain, anxiety, examination;
  • pathology;
  • myocarditis;
  • hypoglycemia;
  • damage to the nervous central system.

This syndrome is a benign condition for newborns.

If the baby has sinus tachycardia for a long period of time, myocardial metabolism may be impaired. However, most often for newborns, the syndrome we are discussing is a benign condition. The reasons why sinus-type tachycardia occurs in adolescents are slightly different:

  • age-related features, for example, strong growth of the body;
  • emotional overstrain;
  • diseases, endocrine, cardiovascular and so on;
  • physical stress.

Types and symptoms

Sinus tachycardia can be of three types:

  1. Moderate, in which the heart rhythm increases by no more than 20 percent;
  2. Medium, characterized by an increase in rhythm of not more than 40 percent;
  3. Severe – increase in rhythm up to 60 percent.

Symptoms of tachycardia are as follows:

  • felt bouts of palpitations;
  • pain in the heart;
  • weakness;
  • dizziness;
  • dyspnea:
  • fainting;
  • fast fatiguability.

Diagnostics includes a number of methods.

  1. ECG. With it, it is easy to determine the frequency and rhythm of heart contractions, both in infants and adolescents.

Nurse conducts an ECG

  • Daily ECG monitoring. The method is informative and safe both for infants and teenagers.
  • Echocardiography is carried out to determine the sinus pathology, which can affect the heart.
  • Electrophysiological examination of the heart. Allows you to find out the mechanism of tachycardia and impaired conduction of the heart.
  • General blood analysis
  • Determination of thyroid-stimulating hormones in the blood.
  • EEG of the brain. It is with the help of this study that blood disease and CNS pathology can be excluded.

    If you witness a tachycardia attack in a child, you must:

    • Open access to fresh air in the room, it is better to go outside, loosening the collar of a shirt or sweater. The neck should be free.
    • Put a cold, wet towel or scarf on your forehead.

    Only a doctor can prescribe treatment

    If this does not bring relief, be sure to call a doctor. In most cases, the disease goes away by itself. Increased heart rate, resulting from high temperature, returns to normal after its decrease. Treatment of pediatric tachycardia by doctors is the use of soothing drugs based on medicinal herbs.

    1. With a sinus disease of a neurogenic nature, you need to consult a neurologist who will certainly prescribe his own treatment.
    2. It is necessary to distinguish between reflex tachycardia (with hypovolemia) and compensatory tachycardia (anemia, iron deficiency). To do this, it is worth eliminating the causes of sinus disease.
    3. If the patient has endocrine disorders, then they can be eliminated by the doctor endocrinologist, to whom the patient goes for a consultation.
    4. If tachycardia is associated with a malfunction of the heart, then the cardiologist prescribes cardiac glycosides.


    Preventive measures include three main principles.

    1. Early diagnosis. The earlier this disease is detected, the faster the treatment will be prescribed.

    The word “tachycardia” is literally translated as “fast heart.” It can be a symptom of many diseases of the cardiovascular system or a sign of changes in the human body.

    Symptoms and signs

    The main symptom of tachycardia is a 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 constriction in the chest, darkening in the eyes, or fainting are added to the above symptoms, then this requires medical attention and examination. Other risk factors – the duration of the attack is more than 5 minutes, the presence of heart disease.

    In infants, capriciousness, anxiety, poor sleep, and appetite indicate an attack.

    Symptoms and signs

    The clinical picture depends on the heart rate, duration and presence of the disease that caused tachycardia. The main symptoms are:

    1. Dizziness.
    2. Sensation in the chest of an accelerated heartbeat.
    3. Sleep disturbance.
    4. Weakness and decreased activity of the child. They persist after rest.
    5. A feeling of lack of air (the child grabs his mouth while breathing).
    6. Decreased appetite.
    7. Fainting.
    8. Neurological disorders with vascular damage in the brain by a disease.
    9. Decrease in the daily amount of urine.
    10. To the touch – cold limbs.
    11. Pallor.

    In almost all children suffering from one of the varieties of tachycardia, the following symptoms appear:

    • attacks of accelerated heartbeat, accompanied by strong fluctuations of the chest;
    • rapid fatigue;
    • problems with concentration and attention;
    • pain in the chest and under the shoulder blade;
    • severe shortness of breath and oxygen deficiency after light training;
    • bouts of darkening in the eyes;
    • development of fainting conditions.

    It is not necessary that the child manifests all these symptoms at once. The appearance of a rapid heartbeat and chest pain is enough to go to a cardiologist. Do not delay the visit to the doctor, because in addition to the above reasons, tachycardia can be a symptom of a tumor or other ailment.

    The main symptom of sinus tachycardia is an increase in the frequency of heart contractions by 10-60 percent. This can be seen both during external observation and when recording with ECG, MRI and EFI devices. The devices record an electrical impulse emerging from the sinus node during the work of the heart muscle, with their help it is easy to track the sinusoidal rhythm and calculate the increase in frequency compared to the norm. Sinus tachycardia is usually diagnosed with the following beats per minute:

    • under the age of 5 months – more than 180;
    • at the age of six months – more than 155;
    • at the age of 1 year – over 145
    • at the age of two – more than 135;
    • at the age of 3-4 years – more than 130;
    • at the age of 5-7 years – over 125;
    • at the age of 8-9 years – more than 120;
    • at the age of 10-11 years – more than 105;
    • over the age of 12 years – over 95.
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    The consequence of the rapid heart rate is the presence of dizziness, shortness of breath, darkening in the eyes, pain in the chest area. In especially severe cases, sinus tachycardia can lead to temporary loss of consciousness. Keep in mind that children can experience an accelerated heartbeat for many other reasons, such as physical activity, emotions, or illness.

    Increased weakness, rapid fatigue may indicate tachycardia

    The characteristic manifestations indicating the possible presence of sinus tachycardia in a baby include:

    • shortness of breath;
    • increased sweating;
    • darkening of the eyes;
    • severe weakness;
    • pallor of the skin;
    • increased nervousness is possible;
    • severe anxiety for no reason;
    • fainting;
    • infants may experience increased drowsiness;
    • heart palpitations;
    • dizziness;
    • pain in the heart;
    • impaired appetite or its complete absence, in infants – sluggish sucking;
    • schoolchildren have reduced resistance to physical activity and stress.

    The tachycardia, which was triggered by physiological causes, often does not manifest itself in the child with any dangerous symptoms. Such a mild sinus tachycardia passes quite quickly and many children do not notice any discomfort.

    The issues of diagnosis and therapeutic tactics for arrhythmias often present significant difficulties for the pediatrician. At the same time, many types of arrhythmias can cause significant hemodynamic disturbances, resulting in circulatory failure with impaired tissue perfusion. Acute hemodynamic disturbances cause life-threatening conditions and require emergency care.

    Diagnosis of heart rhythm disturbances in children

    In children, rapid diagnosis and therapy require paroxysmal tachycardia, fainting attacks (Morgagni-Adams-Stokes syndrome) with complete lateral blockade, fainting and cardialgia in certain types of ectopic rhythm, often caused by sinus node weakness syndrome.

    Urgent measures depend on the type of arrhythmia, its duration, myocardial condition, and the age of the child. the presence of symptoms of circulatory failure, the cause of the rhythm disturbance (carditis, neuroendocrine changes, anomaly in the development of the cardiac conduction system).

    The difficulties in treating arrhythmias in childhood are also due to the multifaceted action of antiarrhythmic drugs. Most of them, along with the main antiarrhythmic effect, have undesirable effects that are especially difficult to control in infants (hypotensive effect, decreased myocardial contractility, slowed conduction, etc.).

    Only timely diagnosis, knowledge of the pharmacological properties of antiarrhythmic drugs, careful monitoring of their action allow us to provide effective assistance to a child with heart rhythm disturbances.

    Rhythm disorders are most often observed due to a violation of the basic functions of the heart muscle – automatism, excitability, conduction, myocardial contractility.

    Severe arrhythmias include paroxysmal tachycardia, atrial fibrillation, atrial flutter and complete atrioventricular (AV) block with Morgagni-Adams-Stokes syndrome. The correct heart rhythm depends on the uniform occurrence of impulses in the sinus node and the same uniform conduct them along the conduction system of the heart.

    The occurrence of arrhythmia can be associated both with the defeat of various parts of the conducting system, and with a dysfunction of various parts of the complex neurohumoral regulation of heart activity. Of particular importance in the development of rhythm disturbances is given to parasympathetic and sympathetic innervation.

    In the mechanism of occurrence and dynamics of the course of arrhythmias, a certain role is played by the state of the heart muscle, hormonal changes, and especially the relationships of various body systems. Changes in the ratio of potassium and sodium in the cell and extracellular fluid directly affect the excitability and conductivity of the myocardium: a decrease in the concentration of potassium in the cell leads to a violation of excitability, a decrease in sodium leads to a violation of the conductivity of the heart muscle.

    Paroxysmal tachycardia in children

    Paroxysmal tachycardia (PT). An attack of heart palpitations in which the heart rate is on average 2-3 times higher than the normal rhythm. The central role in the occurrence of PT is played by the central nervous system: the cerebral cortex, the bottom of the third ventricle, the hypothalamic region, some parts of the spinal cord. Endocrine disorders, irritation of the mucous membrane of the digestive tract or respiratory tract, the individual sensitivity of the body to certain medicinal substances (digoxin, strophanthin, novocaine, adrenaline, ephedrine, caffeine, atropine, acetyl choline, etc.). The occurrence of PT is promoted by organic changes in the myocardium.

    For the appearance of arrhythmia, the existence of an ectopic focus of excitation is necessary. PT can be considered as a stream of extrasystoles, following each other with the right frequent rhythm. There are: atrial (most common in children), atrioventricular (AB) and ventricular forms of PT.

    Symptoms of paroxysmal tachycardia in children

    Clinically signs of PT. A characteristic sign is a sudden onset. The child has unpleasant sensations in the heart area, like a stroke or injection, there is a sharp increase in heart activity (from 150 to 500 contractions per minute), dizziness, vomiting, convulsions, and sometimes loss of consciousness. Especially characteristic is the frequency of urination, every 10-15 minutes.

    On examination, pallor of the skin and mucous membranes is noted, and with a prolonged attack, cyanosis. Blood pressure drops, shortness of breath appears, heart failure may develop. The liver and spleen are enlarged. The borders of the heart at the beginning of the attack are normal, and subsequently may expand. Frequent contractions lead to a shortening of diastole and a decrease in blood supply to the heart.

    Minute heart volume, despite frequent contractions, also decreases. As a result, tissue and organ blood flow suffers. As a result of the almost simultaneous contraction of the atria and ventricles, the atria in the diastole are not completely emptied, which leads to venous congestion. Marked changes in hemodynamics are noted only with prolonged bouts of PT.

    In the atrial form of PT on the ECG, the TP interval is sharply shortened and the P wave is superimposed on the T wave, deforming it; the ventricular complex can be changed, but more often it is not deformed. In the AV form of PT, the location of the P wave depends on the location of the ectopic focus. If the ectopic focus is located in the atrial part of the node, the negative P precedes the R wave, if in the middle part it is superimposed on the R wave and indistinguishable, if in the lower part of the node the P wave is located after the R wave.

    With the ventricular form, the P wave is absent, and the ventricular complex is deformed. In practice, it is advisable to distinguish between two forms of PT: supraventricular and ventricular in the presence or absence of P wave and deformity of the ventricular complex. To clarify the forms of PT, it is necessary to compare the ECG taken during and after the attack. The attack ends abruptly with a transition to a sinus rhythm.

    Treatment of paroxysmal tachycardia in children

    Treatment. Sometimes it is possible to stop the PT attack by reflex irritation of the vagus nerve (pressure on the eyeballs, synocarotid massage on the right, Valsalva test, stimulation of vomiting, applying cold to the face, pressing the legs to the stomach to raise intra-abdominal pressure). If vagotropic techniques are ineffective, adenosine is administered at a dose of 0.

    1 mg / kg rapidly intravenously. If after this the seizure has not stopped, the dose of the drug is increased to 0,2 mg / kg. Beta-blockers (anaprilin), digitalis preparations (isolanide or digoxin), calcium channel blockers (verapamil), which sometimes slow down the heart rate, sometimes eliminate PT, are advisable.

    In some cases, transesophageal or endocardial electrical stimulation is used. Verapamil and cardiac glycosides should not be used when ventricular PT cannot be ruled out. It is possible to use novocainamide, an effective drug for PT. If there is no treatment effect, electrical defibrillation should be used. In the case of stable PT, surgical destruction of the pathological activity site is indicated.

    ECG Diagnostics

    The indicators during registration of the electrocardiogram during ventricular and supraventricular tachycardia are different. The ventricular form is represented by advanced QRS complexes. ECG sinus tachycardia in children has an accelerated rhythm, in which the number of contractions reaches 200 beats per minute. Ventricular rhythm disturbance is a serious danger to the baby’s life.

    Another sinus tachycardia in children on an ECG looks like regular and regular heartbeats. The rhythm is correct, the number of contractions usually does not exceed 140 per minute. Supraventricular tachycardia quickly appears and disappears, which is often not felt by the child and is visible only on the cardiogram. P waves have a different look, and QRS complexes remain unchanged. RR intervals between heart contractions are shortened.

    You should go to a cardiologist right after you notice a rapid heartbeat in your child. In boys, the appearance of this disease may be associated with the physiological characteristics of the development of the body, but the examination still needs to be passed. To diagnose an ailment, the following methods are used:

    • Ultrasound;
    • echocardiography;
    • ECG;
    • electrocardiography;
    • electrophysiological study.

    The patient will have to describe in detail those symptoms that he encountered and the time when they appeared. If a child is ill with a disease before tachycardia appears, additional diagnostic methods are used to rule out complications. The most accurate is considered echocardiography of the heart. It allows you to detect hidden pathologies in the structure of the organ.

    First of all, do not self-medicate. The group of diseases to which this pathology belongs is a cardiologist.

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

    1. ECG
    2. Echo KG
    3. Holter monitoring
    4. Electrophysiological Study (EFI)
    5. Other research methods that determine the cause of the pathology outside the heart

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

    If no abnormalities were detected on the ECG, and the seizures continue and increase in strength and duration, then the child needs to put a special sensor for 24 hours, which will record the electrocardiogram under normal body activity. This procedure is absolutely painless and safe, while it is quite informative.

    Echo-KG or ultrasound of the heart will show you an organic lesion of the heart muscle and valves, a possible cause of tachycardia.

    An EFI will help to track the pulse from the beginning of the generation – the sinus node, to the end – the Purkinje fibers. This method will reveal even minimal rhythm disturbances.

    The doctor will be able to speak about the presence of sinus tachycardia of the heart in a child after an examination conducted to confirm the proposed diagnosis.

    So the baby can be sent to the following studies:

    • general blood analysis;
    • electrocardiogram – allows you to determine the rhythm and frequency of heart contractions;
    • daily monitoring of the electrocardiogram;
    • Echo KG – this study is carried out to determine sinus pathology;
    • brain electroencephalogram – eliminates damage to the central nervous system and blood diseases;
    • electrophysiological study – reveals conduction disturbances, makes it possible to understand the mechanism of tachycardia;
    • blood test for the level of thyroid-stimulating hormone.

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


    With a rapid heartbeat, the child is given first aid:

    1. The neck and chest are freed from clothing – they open the collar, take off the sweater, scarf, etc.
    2. Those present in the room are asked to go out, provide an influx of fresh air, take the child out to the street.
    3. They give a quick drink of sparkling water.
    4. If the child is older than two years old, apply a cold compress on the forehead, neck. For newborns, this measure is contraindicated!

    An effective method of heart rate recovery is to ask the patient to breathe air, tighten the abdominal muscles and not breathe as much as he can (Valsalva test).

    With a second attack, a medical team is called. It may be necessary to introduce drugs to stabilize the condition.

    Treatment of pediatric tachycardia consists mainly in the appointment of sedatives, dietary supplements, based on valerian, vitamin preparations, which the doctor selects.

    If the cause is a change in the functioning of the heart, cardiac glycosides are indicated. With iron deficiency anemia, drugs with iron are prescribed.

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    If tachycardia was caused by a disease, then the symptom disappears after eliminating the root cause. For example, with an increase in heart rate due to fever, the condition normalizes after a drop in temperature.

    In some cases, there is a need for surgical intervention. The reason for this is thyrotoxicosis and pheochromocytoma. Then remove the part of the gland that produces excess hormones. Operations are performed with some cardiac pathologies.

    The developed condition requires a specific approach, depending on the cause. Treatment of tachycardia includes non-drug methods, taking medications and traditional medicine. Any remedy is agreed with the attending physician.

    The child is provided with a constant flow of fresh air into the room in which he spends most of his time. Nutrition should be balanced and contain all the vitamins and minerals needed at a certain age. Food should be easily digestible.

    Children over 1 year old should not eat junk food: fast food, carbonated drinks, a large number of sweets and confectionery. The baby’s diet should be reviewed and more fruit and freshly squeezed juices included. It is advisable to introduce foods rich in potassium and magnesium – these are dried fruits and baked potatoes. Remove from the diet should coffee, tea and chocolate.

    In addition to the correct daily regimen and nutrition, vagal tests are effective in stabilizing the heart rate. They are common in adults with the onset of a tachycardia attack. The following apply:

    1. Massage of the carotid sinus, which is a branched carotid artery.
    2. Pressure on eyeballs with eyelids drooping.
    3. Straining.
    4. Cough reflex.

    These methods allow, through stimulation of the vagus nerve, which is rich in receptors, to develop a reflex reaction with other organs. After a short exposure to certain parts of the body, the heart rate normalizes.

    Radiofrequency ablation is considered the method of choice in pediatrics for the treatment of tachycardia. It is used for health reasons – severe symptoms, expansion of the heart cavity (dilatation) and ineffectiveness of drugs with antiarrhythmic effect.

    After the procedure, it is important to observe the baby and conduct a comprehensive examination after 3, 6 and 12 months. In the absence of data on relapse of the attack, the patient is deregistered.


    With stable tachycardia, help begins with the introduction of “Adenosine”, the procedure is repeated 2 more times, in the absence of effect.

    A scheme has been developed for the basic treatment of children, the purpose of which is to reduce the frequency of relapse attacks. The following drugs are used:

    1. Nootropics and vegetotropic substances: Encephabol, Aminalon or Cerebrolysin.
    2. Antiarrhythmic – “Propafenone”, “Sotalol”, “Amiodarone”.

    Nootropic drugs are prescribed alternately, with a course of treatment of one of them for 3 months. The duration of therapy is six months. If it is effective, then re-treatment is reduced by 3 months. In the absence of positive dynamics include drugs with antiarrhythmic effect.

    Herbal recipes are not the main treatment for tachycardia. They are allowed to be used only after the permission of the doctor. Widely used plants with a calming effect:

    Tinctures are considered the most effective, but it is better not to prescribe alcohol-containing medicines to children. For this reason, based on medicinal herbs make decoctions and give the child.

    The doctor’s recommendations depend on the type of tachycardia and the reason that provoked its development. If the disease arose after flu or another infection, a course of antibiotics and vitamins is prescribed to completely rid the patient of the pathogen. In case of problems with the functioning of the endocrine system, a patient may be prescribed a course of hormonal drugs.

    In 86% of cases, tachycardia does not require any medical treatment. It is enough to adjust the work regime with rest, balance nutrition, and introduce physical exercises into everyday practice. If a child is exposed to severe emotional stress at school due to the behavior of classmates, you should consult a psychologist or change your educational institution.

    If a child’s attack begins suddenly, the following actions must be urgently performed:

    • To take the child to fresh air
    • Put a damp towel on your forehead
    • Call a doctor

    Emergency care for paroxysmal tachycardia depends on the location of the focus of the generation of a pathological impulse. When placing it in the atria, movements must be performed that reflexively stimulate the activity of the vagus – the vagus nerve.

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

    • Valsalva test – close your nose and stretch for about 10 seconds
    • Massage of the carotid artery alternately on each side for 5 seconds
    • Clicking on the root of the tongue
    • Wiping the body with a cold damp towel
    • Slow deep swallowing

    Emergency care with a focus of an impulse in the ventricles is carried out medically:

    1. 1-1,5 mg / kg of lidocaine 1% is slowly injected intravenously. In the absence of the desired effect, the procedure is repeated in half dosage.
    2. If ineffective, a 2,5% solution of aymaline (guiluritmal) is added per 10,0-20,0 ml of a 0,9% NaCl solution at a dose of 1 mg / kg.
    3. With the continuation of the attack, a 5% solution of amiodarone on 5% glucose is administered intravenously – 10 ml.
    4. Extreme measures – transesophageal pacing.

    It is important to observe non-drug therapy – a good long sleep, a decrease in physical exertion, emotional stability, systematic walks in the fresh air. It is advisable to follow a diet rich in magnesium, potassium, and vitamins. Dried fruits and baked potatoes are rich in potassium and magnesium.

    The doctor prescribes sedative therapy. From 7 years old, it is already possible to use preparations of chemical origin – seduxen, luminal. For children under 6 years old, the doctor recommends the use of homeopathic medicines – valerian, motherwort, hawthorn.

    It is necessary to take a source of potassium – aspartame. Dosage is determined depending on the age of the child.

    If such therapy does not help, it is necessary to treat with antiarrhythmic drugs. For this, verapamil, amiodarone, ATP, digoxin are used. Self-medication is contraindicated, since only a doctor, observing the dynamics of the effect of therapy, determines the sequence of the listed drugs.

    Tachycardia in adolescents and children is unpredictable and, sometimes, it is difficult to cope with the disease. The process will always be more favorable if, during time, seek help and clearly follow the doctor’s instructions.

    Tachycardia in children occurs often enough, it is important for parents to show the baby in time to a specialist and know how to stop an arrhythmia attack. It’s not easy to understand that a child is disturbed by a rapid heartbeat. It happens that even a teenager cannot determine exactly what is bothering him. What can we say about young children? The task of parents is to carefully monitor the health status of their children and, in case of any suspicion of arrhythmia, inform the local pediatrician about them.

    Sinus tachycardia is a serious reason to visit an experienced cardiologist

    What is sinus tachycardia, and for what reasons does it occur?

    A tachycardia is a heartbeat accelerated by more than 20 beats per minute compared to the standard indicator. It is believed that this violation occurs only in adulthood. However, young children (including newborns) and adolescents suffer from them at least.

    AgeNorm, beats per minuteLimits of norm, beats per minute
    Newborns140110 – 170
    1-12 months132102 – 162
    1-2 years12494 – 154
    2-4 years11590 – 140
    4-6 years10686 – 126
    6-8 years9878 – 118
    8-10 years8868 – 108
    10-14 years8060 – 100

    What are the causes of increased heart rate? There are 2 types of tachycardia: sinus and paroxysmal. Sinus tachycardia in children is divided into:

    • Physiological. It occurs with stress, a change in body position, anxiety, after eating and drinking, with a lack of oxygen. In adolescence, increased heart rate occurs due to the transitional age, when there is an active growth of the body. Large loads at school, lack of sleep and hormonal changes cause an acceleration of the heart rhythm.
    • Pathological. The causes of its occurrence are: hyperthermia, intoxication, hypoglycemia, anemia, disorders of the endocrine system.
    • Cardiac. It appears with organic damage to the heart and remains even at rest, regardless of external conditions. This violation is characteristic of myocarditis, endocarditis, pericarditis, IHD, myocardial infarction and other diseases.

    Paroxysmal tachycardia is inherent in children of primary school age and is often diagnosed at the age of 7 years. She is characterized by a sudden appearance and disappearance. There is paroxysmal tachycardia with Wolf-Parkinson-White syndrome, vegetative-vascular dystonia, neurosis, organic heart damage.


    For normal health, the following measures are recommended:

    • maintaining a healthy weight – extra pounds load the heart;
    • regular exercise;
    • limited use of foods containing caffeine;
    • a healthy diet with a limited amount of fat and fast carbohydrates;
    • calm atmosphere in the educational institution and at home;
    • rejection of bad habits – smoking, alcohol, which increase the manifestations of tachycardia.

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

    Hello dear parents. In this article we will consider what a sinus tachycardia in a child is. You will know for what reasons it occurs, what symptoms accompany it. You will learn about possible diagnostic methods, as well as treatment methods.

    1. Timely identification of symptoms of the disease and the same treatment.
    2. In the presence of pathology in the work of the heart, nervous or endocrine system, it is necessary to treat the child in time, to prevent the development of sinus tachycardia.
    3. It is important to observe the daily routine, maintain a healthy lifestyle.
    4. Take care that the baby has proper nutrition, healthy sleep.
    5. It is important to pay attention to physical activity, hardening.

    Now you know what sinus tachycardia in children is, the causes of this condition. Take care of the rules of prevention in order to prevent the development of the disease. If any disturbing symptoms appear, do not delay to see a doctor. After all, it is so important to start treatment on time.

    To prevent problems with heart rhythm in childhood, it is important to accustom the baby to a healthy lifestyle. For this, the baby should have an optimal regime of the day, moderate physical activity, a balanced, varied diet, a full sleep.

    In the next video, the pediatrician will tell you more about children’s tachycardia and give some advice to parents who are faced with this ailment.

    Vitamins and nutrition to strengthen the walls of blood vessels

    In addition, it is useful to eat cereals from various cereals – oatmeal, buckwheat, corn and rice. It will be better to replace pasta with porridges.

    How to strengthen the walls of blood vessels? For this, it is also useful to eat legumes such as peas, beans, lentils, and soybeans. Soy is an indispensable product in order for the walls to be healthy, since it contains all the minerals and compounds required by the body that contribute to the removal of cholesterol from the body.

    There are also vitamins to strengthen the walls of blood vessels. Vitamin P is very significant, which is extremely effectively absorbed by the body in combination with vitamin C. Vitamin Z reduces fragility and restores elasticity to the walls. For this reason, in a daily diet, foods that are rich in this vitamin compound must be present.

    Especially invaluable herbal products for strengthening the walls of blood vessels are onions, garlic and eggplant. They rid the vessels of excess body fat and free the walls of brittleness. Still effective are the active substances that are found in cucumbers.

    As for fruits, grapefruit is the leader among citrus fruits; red and black currants, as well as black chokeberries, should be noted among the berries. If it is impossible to eat fresh fruits and vegetables, it is better to include green tea, decoctions of aronia and rose hips in your diet.

    In order to strengthen it is recommended to temper using contrast dousing. The temperature drop and water pressure on the vessel walls train the cardiovascular system well and produce a normal response to climatic, seasonal and weather changes. In addition, water procedures have a positive effect on the nervous system. There are also drugs that strengthen the walls of blood vessels.

    The continuation of this article, see here: vascular strengthening part 2

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  • Tatyana Jakowenko

    Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

    For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

    He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.