HEARTBEAT, RAPID(Tachycardia; Paroxysmal Tachycardia)
(Tachycardia; Paroxysmal Tachycardia)
DESCRIPTIONParoxysmal tachycardia is a heartbeat that is much more rapid than usual and is not caused by overexertion. Normal heartbeat ranges are 80 to 100 beats per minute in children and 70 to 90 beats per minute in adults. Tachycardia ranges from 150 to 300 beats per minute. A child with no heart disease may exercise and raise the heartbeat to 160 or more. This type of tachycardia is normal and is not a medical problem. The heart muscle and the electrical system of the heart are involved.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Self-care after diagnosis.
Hospitalization if the attack persists despite treatment.
DC electrocardioversion, a controlled electric shock (rarely necessary).
Studies to discover underlying cause after treating any life-threatening tachycardia.
SIGNS & SYMPTOMSHeart pounding or palpitations. The pulse at the child's wrist or neck will be 110 to 180 beats per minute, which is much faster than normal.
Faintness or a feeling of impending death.
Increased urination; chest pain; involuntary cough; breathlessness.
Unknown. This usually occurs in young persons with no evidence of disease, but it may also occur in older patients who have coronary-artery disease.
RISK FACTORSHeart disease; stress; smoking; use of some drugs, such as caffeine, ephedrine, or other sympathomimetic drugs; fatigue or overwork.
PREVENTING COMPLICATIONS OR RECURRENCE
Urge your child not to smoke.
Reduce the child's stress, if possible. See Appendix 19.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
EKG (See Glossary).
Special studies that may include ultrasonography, CAT or CT scan, MRI, and radionuclide scan (See Glossary for all).
POSSIBLE COMPLICATIONSUninterrupted tachycardia can lead to life-threatening congestive heart failure, heart attack, or cardiac arrest.
Rapid heartbeat can usually be controlled with treatment.
HOME CAREInstructions for your child that sometimes reduce heartbeat:
Hold your breath briefly.
Pinch the skin on your arm enough to cause pain.
Bathe your face in cold water, submerge your head briefly in a sink of cool water, or take a cool shower and let the water beat on your head.
Hold your nostrils closed and blow gently through the nose, making the eardrums pop.
Massage the carotid area in the neck, if you have been taught to do this safely. Ask your doctor for instructions.
MEDICATIONFor repeated attacks, your doctor may prescribe medication to control your child's heart rhythm. These include digitalis, quinidine, calcium-channel blockers, procainamide, beta-adrenergic blockers, and others.
See Medications section for information regarding medicines your doctor may prescribe.
Your child should lie down during an attack until the heartbeat returns to normal, then resume regular activities. Between attacks, encourage the child to exercise regularly (See Appendix 36) with the doctor's approval. Physical fitness helps prevent tachycardia.
DIET & FLUIDS
No special diet, but your child should avoid caffeinated beverages.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has an episode of rapid, irregular heartbeat that does not end in 4 or 5 minutes.
Your child develops shortness of breath.
Your child has chest pain.