What Causes Severe Chest Pain With Heart Palpitations In A Child?

Posted on Mon, 12 Oct 2015

Question: Hello. I just took my daughter to an EKG in the ER. She had a hole in her heart atrial defect and it was closed with an amplatzer occluded back in 2009. It was not 100% closed. But I am told the amount that is not closed is not supposed to be life threatening. She has episodes where her heart pounds harder and she complains of pain. This doesn't happen to often but it does happen at least 1-2 times a year. I just took her to the ER she complained of chest pain it lasted about 10-15 minutes. By the time I got to the ER it was gone. What all can I ask that she get checked. The ER doctors says that her EKG came back normal. That it was most likely acid reflux. He Recommend I give her Maalox or an antacid. But she says its not that and she knows her heart beat differently when she has the pain. What do I do. She has been screened before with an echo, and EKG at the pediatric cardiology office, they say yes she skips beats but that its normal. They had her run on the treadmill. supposibly everything is normal. But when my baby girl is telling me her chest hurts and that its her heart, I feel hopeless. That is why I preferred to be on the safe side and take her to The ER. I am scared one day something will get worse and I will not know what to do.

Answered by Dr. Ilir Sharka (1 hour later)

Brief Answer:
I would explain as follows

Detailed Answer:
Hello!

Thank you for asking on HCM!

First of all I reviewed your uploaded ECG and would explain that her doctor is right about the ECG (normal sinus rhythm, without any arrhythmic events, without any qqatrio-ventricular conductance disorders or repolarization disorders).

I would like to review her cardiac ultrasound to have a better idea of how small or severe the interatrial jet is and to see also possible cardiac changes due to this congenital defect.

Regarding the different heart beats during chest pain I would recommend performing an ambulatory 24-48hours ECG monitoring (Holter) to be sure that no transient arrhythmic events is happening.

Coming to this point(normal ECG, normal cardiac ultrasound, except for the small small residual jet, normal Treadmill test), the only thing to be considered is endocarditis prophylaxis with antibiotics, which are recommended to be taken before and after invasive or XXXXXXX invasive procedures (like tooth extraction, endoscopy, vascular catheterization, surgery, etc.).

If any cardiac arrhythmias is revealed by the Holter monitoring, then a new cardiac review by her cardiologist would be necessary.

For the moment you should not worry about it, as all her tests are normal.

Please could you upload her last cardiac ultrasound report for a review?

Feel free to ask any other questions, whenever you need!

Hope to have been helpful!

Best wishes,

Dr.Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar