Fifteen-minute consultation: Palpitations in children

Heechan Kang, Maturu Ravi Kumar, Nicholas Hayes
{"title":"Fifteen-minute consultation: Palpitations in children","authors":"Heechan Kang, Maturu Ravi Kumar, Nicholas Hayes","doi":"10.1136/archdischild-2023-325817","DOIUrl":null,"url":null,"abstract":"Palpitations are a common presenting symptom in the paediatric population and generate understandable anxiety around issues regarding the heart and the possible consequences of an underlying cardiac arrhythmia. That said, many patients will be describing a benign sensation with no associated underlying cardiac pathology. This article aims to provide a practical framework when encountering children with palpitations to assess the likelihood of an underlying arrhythmia and to determine whether further investigation and/or referral to specialist paediatric cardiac services is required. A 10-year-old boy has been referred to the local paediatric outpatient clinic by his general practitioner. He has experienced three episodes of palpitations, each lasting around 10–15 min, over the past couple of months. These have come without warning and stopped spontaneously. He is otherwise fit and well, with no significant medical or family history. His parents are concerned about the possibility of an underlying arrhythmia. Palpitations vary in sensation between individuals, but collectively describe an unpleasant awareness of one’s own heartbeat due to speed, strength and/or irregularity. Often children will report feeling a more rapid and forceful heartbeat, although for others it can be a single ‘thump’ in the chest or ‘skipped beats’. Sometimes parents will report having felt this through the chest wall or seen pulsations in the neck. They may occur in isolation, or in association with a variety of other symptoms, including shortness of breath, chest pain, abdominal pain, neck pain, feeling weak, visual disturbance, headache and dizziness. When presenting acutely with continuing symptoms, assessment of heart rate and contemporaneous ECG can usually accurately identify the presence of an underlying arrhythmia and need for further management. Often, however, as in the scenario above, the encounter is following a symptomatic episode (or episodes) that has since resolved spontaneously prior to evaluation. Baseline cardiac examination and ECG are …","PeriodicalId":501158,"journal":{"name":"Education & Practice","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Education & Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/archdischild-2023-325817","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Palpitations are a common presenting symptom in the paediatric population and generate understandable anxiety around issues regarding the heart and the possible consequences of an underlying cardiac arrhythmia. That said, many patients will be describing a benign sensation with no associated underlying cardiac pathology. This article aims to provide a practical framework when encountering children with palpitations to assess the likelihood of an underlying arrhythmia and to determine whether further investigation and/or referral to specialist paediatric cardiac services is required. A 10-year-old boy has been referred to the local paediatric outpatient clinic by his general practitioner. He has experienced three episodes of palpitations, each lasting around 10–15 min, over the past couple of months. These have come without warning and stopped spontaneously. He is otherwise fit and well, with no significant medical or family history. His parents are concerned about the possibility of an underlying arrhythmia. Palpitations vary in sensation between individuals, but collectively describe an unpleasant awareness of one’s own heartbeat due to speed, strength and/or irregularity. Often children will report feeling a more rapid and forceful heartbeat, although for others it can be a single ‘thump’ in the chest or ‘skipped beats’. Sometimes parents will report having felt this through the chest wall or seen pulsations in the neck. They may occur in isolation, or in association with a variety of other symptoms, including shortness of breath, chest pain, abdominal pain, neck pain, feeling weak, visual disturbance, headache and dizziness. When presenting acutely with continuing symptoms, assessment of heart rate and contemporaneous ECG can usually accurately identify the presence of an underlying arrhythmia and need for further management. Often, however, as in the scenario above, the encounter is following a symptomatic episode (or episodes) that has since resolved spontaneously prior to evaluation. Baseline cardiac examination and ECG are …
十五分钟咨询儿童心悸
心悸是儿科常见的首发症状,患者会因心脏问题和潜在的心律失常可能造成的后果而产生焦虑,这是可以理解的。尽管如此,许多患者描述的是一种良性感觉,并没有潜在的心脏病变。本文旨在提供一个实用的框架,以便在遇到儿童心悸时评估潜在心律失常的可能性,并确定是否需要进一步检查和/或转诊至儿科心脏专科。一名 10 岁男孩由全科医生转诊至当地儿科门诊。在过去的几个月里,他经历了三次心悸,每次持续约 10-15 分钟。这些心悸来得毫无征兆,而且会自动停止。他身体健康,没有明显的病史或家族史。他的父母担心可能存在潜在的心律失常。心悸的感觉因人而异,但总的来说是对自己心跳的速度、强度和/或不规律的一种不愉快的感觉。通常情况下,儿童会感觉心跳更快、更有力,而其他人则可能只是胸口 "砰砰 "作响或 "跳动"。有时,家长会说通过胸壁感觉到这种情况,或在颈部看到搏动。这些症状可能单独出现,也可能与其他各种症状同时出现,包括气短、胸痛、腹痛、颈部疼痛、感觉虚弱、视觉障碍、头痛和头晕。当急性发作并伴有持续症状时,心率评估和当时的心电图通常可以准确确定是否存在潜在的心律失常以及是否需要进一步治疗。但通常情况下,如上文所述,患者是在症状发作后就诊,而在评估前症状已自行缓解。基线心脏检查和心电图 ...
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信