Arrythmias,  CARDIOLOGY

palpitations in children

  • Life threatening cardiac conditions
    • Arrhythmia
      • Wolff-Parkinson-White syndrome
      • prolonged QT syndrome
      • cardiac structural abnormalities [congenital heart disease, intracardiac tumors]
    • Hypertrophic cardiomyopathy (HCM)
      • present with palpitations or syncope during strenuous exercise caused by atrial fibrillation or ventricular arrhythmia
    • Myocarditis
      • most commonly viral in origin, with Coxsackie virus B and other enteroviruses accounting for most cases. Clinical findings of myocarditis include tachycardia out of proportion to fever, poor perfusion, and signs of heart failure.
    • Sick sinus syndrome
    • Pacemaker malfunction
  • Life threatening non-cardiac conditions
    • Hypoglycemia
      • Early manifestations of hypoglycemia in children and adolescents are caused by the autonomic response to hypoglycemia and may include tachycardia with palpitations, sweating, weakness, tremor, and feelings of nervousness and/or hunger. 
      • These symptoms and signs usually occur at higher blood glucose concentrations (between 40 and 70 mg/dL) than the neuroglycopenic signs and symptoms (lethargy, irritability, behavioral abnormalities, seizures, or coma), and may function as a “warning system.”
    • Toxic exposure
    • Pheochromocytoma
      • are rare neoplasms in children
      • classic triad of symptoms in these disorders consists of
        • episodic headache
        • sweating
        • tachycardia
        • hypertension
  • Common conditions
    • Premature atrial contractions
    • Premature ventricular contractions
    • Fever, Anemia – Increased metabolic rate
    • Exercise
    • Catecholamine release
      • associated with exercise, emotional arousal, and psychiatric distress (eg, anxiety, panic attack)
    • Hyperventilation syndrome
    • Drug-induced (caffeine, herbal medications, dietary supplements, albuterol, isotretinoin)
    • Postural orthostatic tachycardia syndrome (POTS)
  • Other conditions
    • Acute rheumatic fever with valvular disease
    • Hyperthyroidism
    • Mitral valve prolapse

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