Heart rate indicates the number of times the heart beats in a minute. The heart rate in children may vary depending on their age. Usually, younger children may have a higher heart rate than older children. Our heart beats in rhythm, and the irregularities of rhythm are called arrhythmia. The abnormal heart rate can be too fast or too slow. Although arrhythmia in children is not uncommon, some may have it due to underlying medical conditions. Read this post to learn about children’s normal and abnormal heart rates and ways to manage them.
What Is The Normal Heart Rate In Children?
A child’s heart rate is different than that of an adult. Usually, the average heart rate of children is 60 beats per minute when they are resting, while it can go as high as 220 beats when they are active. Infants have a higher heart rate than children. The ‘normal’ average heart rate for children depends on their age group. Following are the average resting heart rates (pulse rates) for children of different age groups. The heart rate varies from one child to another and depends on their age and activity levels (1).
When And How To Check A Child’s Pulse Rate
Checking a child’s heart rate or pulse rate is usually not a need-to-know, but a good-to-know skill for parents. However, If your child has a medical condition that needs monitoring their heart rate regularly, it is good to check the child’s pulse as ordered by the doctor. You also need to check the heartbeat when the child:
Complains of their heart racing or experiences palpitations
Feels that the heart is skipping a beat
Has chest pain
Has trouble breathing suddenly (not caused by asthma)
Has the lips or skin turning pale gray or blue suddenly
An accurate reading of the pulse is essential to understand whether the child is experiencing abnormalities in heart rates. We have explained the process of testing the pulse in easy steps below. The thumb might also have a pulse in some people, so avoid using it to check the pulse rate. Your doctor will also check for the quality or strength of the pulse to see if it is regular or erratic.
Irregular Heartbeat (Arrhythmia) In Children
Change in the heart rate is normal. When your children are physically active, their heart rate is usually higher. And when they are resting, it could be lower. Likewise, the child’s heart rate can increase considerably during strenuous exercises. But when the heart’s rhythm or rate changes drastically without any physiological triggers, it is abnormal. This condition is called arrhythmia or irregular heartbeat. This could indicate a heart problem or other underlying medical conditions. A fast heart rate might be accompanied by palpitations (noticeable sudden, rigid heartbeat), dizziness, and sometimes fainting (3).
Symptoms Of Abnormal Heart Rate In Children
Arrhythmia can occur at any age and can be diagnosed through proper tests. The symptoms are few or none, which makes detecting it on your own a bit difficult. Signs and symptoms that you may see include (4):
Rapid or slow heartbeat Dizziness Weakness or tiredness Palpitations Pain in the chest
The heart needs to follow a certain rhythm to function properly for a long time. If it doesn’t, the biological processes can get disturbed and lead to potential health risks in the future.
Types of Arrhythmia
There are many types of arrhythmia that your child can develop. While most of these are non-threatening, some are serious conditions that need constant medical attention.
1. Tachycardia
This is a condition where the heart beats too fast. This condition could be normal or abnormal based on age and physical condition. A teenager is said to have tachycardia if the resting heart rate is higher than 90 beats per minute (5), whereas, tachycardia in kids is a condition where the heart rate can go higher than 100 beats per minute. However, since the standard average heartbeat in children is usually 100 or more, it may or may not be considered tachycardia depending on the child’s age. Causes of tachycardia in children can include physiological changes, medications that the child may be taking, and any other form of arrhythmia. Sometimes, an underlying heart condition can also result in an elevated heart rate in the child. There are three known types of tachycardia (5). Sinus tachycardia is the natural increase in the heart rate of the child. The sinus node, which is also known as the pacemaker of the heart, is responsible for sending out the electrical impulses in the body that make the heart’s muscles to expand and contract, thereby, creating a steady rhythm of the heartbeat. The sinus node shoots faster impulses when the metabolic activity is high and slows down when the body is at rest (sleeping). So, in most cases, sinus tachycardia is a natural phenomenon caused due to change in activity levels, and this abnormality results in sinus arrhythmia in children. Supraventricular tachycardia (SVT) is one of the most common types of tachycardia in children. SVT does not cause any life-threatening problems in most children and teens, and it does not bar children from having a normal childhood. However, if the tachycardia is frequent, then your doctor might prescribe medications to control it. Ventricular tachycardia in children is a condition when the fast heart rate in the child is triggered by the lower chambers or ventricles of the heart. Although uncommon, this type of tachycardia can be serious, and sometimes life-threatening for children. If you find that your child’s heart skips a beat or is racing fast, or the child experiences lightheadedness, episodes of chest pain and fainting, then take them to the doctor (6). Wolff-Parkinson-White Syndrome is the presence of an additional pathway in the heart’s electrical system, causing palpitations, dizziness, and shortness of breath. The doctor might treat this heartbeat disorder with medication. If that doesn’t work, they may recommend some tests and eliminate the pathway using a catheter or surgery.
2. Bradycardia
Bradycardia is the opposite of tachycardia. When the heart rate is too slow, say less than 60-50 beats per minute, the child is likely to have bradycardia (7). However, the doctor will consider the age and the activity levels and patterns of the child before diagnosing it as bradycardia. Other heart rate problems in children include the complete heart block and sick sinus syndrome (8).
Who Is At A Risk Of Developing Arrhythmia?
Arrhythmia is more common in children with congenital heart diseases, narrow heart valves, family history of arrhythmia and other heart disorders. In the case of teenagers, lifestyle habits such as alcohol consumption, smoking, and illegal drug usage can also cause Arrhythmias. Medical conditions such as obesity, diabetes, sepsis, sleep apnea, etc. may also increase the risk of Arrhythmias. Other things, such as heart surgeries, medications, or imbalance of certain chemicals, such as potassium in the body, can also lead to irregular heart rate in children. (9).
When To Visit A Doctor?
Often, arrhythmia or abnormal heart rate is the result of a change in physical activity, making it a common occurrence in children. However, if your child’s heart rate is too fast or slow, regardless of the physical activity, and if it happens often, a medical check-up is necessary. Sometimes, erratic heart rate in children is the result of an underlying heart problem, which you should not neglect.
Arrhythmia Treatment
Abnormal heart rate in children could be treated by the following. The doctor will examine your child and prescribe the best possible treatment (9).
Medication
Cardiac catheterization with radio frequency energy application
Use of implant devices such as pacemakers and implantable cardioverter defibrillator
Cardioversion, which involves sending electrical shock or impulses to the heart, to convert the erratic heart beats into a proper rhythm
Surgery to treat atrial fibrillation
Doctors may also teach you how to increase or reduce the heart rate of the child to bring it to a normal range.
Living With Arrhythmia
You may not always be able to prevent arrhythmia because it can also be genetic. In cases when it is not hereditary, maintaining heart health is the only way to avoid triggering tachycardia or bradycardia. If your child’s heart rate and rhythm are not normal, make sure that you:
