What Does a Diagnosis of a Heart Murmur or Rapid Heartbeat Mean?

    A heart murmur - an extra or unusual sound between heartbeats - is common in healthy children and is often benign. Children with unusually rapid heartbeats may suffer from a heart abnormality and should be evaluated by a cardiologist.

    "If your primary-care physician or pediatrician recommends that a heart specialist evaluate your child, you should follow through," says Gary Satou, MD, director of Pediatric Echocardiography at Mattel Children's Hospital UCLA and co-director of the UCLA Fetal Cardiology Program. "While a significant number of heart murmurs will turn out to be innocent in nature, meaning not representative of structural heart disease, a rapid heart beat may be originating from an electrical heart problem that needs to be addressed."

    The heart's electrical system is what keeps the heart pumping. Sustained rapid heartbeats in children may arise from a heart condition in which the child has the equivalent of an extra electrical path causing a fast, sustained heart rate. Children can usually be successfully treated with either medicine or a same-day procedure in the catheterization lab to destroy the extra electrical path. Rapid heartbeats also can arise from non-cardiac causes, such as hyperthyroidism or anemia.

    Heart problems present at birth

    While some pediatric heart problems are acquired, for example, from infection or inflammation, the majority are congenital, or present at birth. Common heart defects include narrowing of a heart valve or a deficiency (holes) in the walls dividing the heart chambers.

    Diagnosing heart problems may require:

    • Obtaining a detailed family history
    • Obtaining the child's health history
    • Blood pressure check
    • Heart rate check
    • Cutaneous oxygen level measurement
    • EKG (electrocardiogram)
    • ECHO (echocardiogram)
    • Exercise stress test on a treadmill
    • 24-hour Holter monitor

    Signs of a possible heart condition in a child:

    If your child has rapid heartbeats, chest pain or fainting (especially with exertion), or has a family history of sudden cardiac arrest or death, you should consult a pediatric cardiologist for further evaluation.

    illustration by Mark Summers
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