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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Infant With Heart Murmur. Difficulty In Breathing, Getting Stiff, Passing Out. Is This A Concern?

20 month old male has heart murmur. When the child gets really upset he will start to cry but, he will not breathe. He will then get stiff ie.. arch his back(almost contorting looking) turn blue, eyes roll back in head. Passes out for a few seconds. Wakes to be extremely tired. Then he will take a nap. Could this be a concern due to the heart murmur
Sat, 13 Apr 2013
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Pediatrician 's  Response
Hi,

Thank you for your query on Healthcare Magic.

Here two possibilities with your history.

1. Breath holding spell : After a precipitating factor like pain or taking a toy from the child, child starts crying, stops breathing, becomes blue followed by stiffening with rolling of eyeballs. Your description is matching to this.

It is common in children and it is like a developmental issue in some children.

Avoid precipitating events like disappointing the child.

Some times treating underlying iron deficiency anemia if it is present will decrease the frequency of spells.

2. Cyanotic spells : which are associated with congenital heart problems like Tetralogy of Fallot.
Here they are called anoxic spells and they are due to decreased oxygen supply and usually occur in the early mornings.

If the heart murmur is due to this heart problems this episode may be related to heart murmur.

If the heart murmur is not due to a clinically significant heart problems it is not related.

Therefore I advise you to consult your Pediatrician get examined your child.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
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Pediatrician, Neonatology Dr. Uma Rajah Ananth's  Response
Hi,
Difficult to answer this without much details.
what sort of heart murmur and what are the echo findings?

This may be either related to the heart or something called breath holding spells.
Discuss with your cardiologist and pediatrician.
Good luck
Dr Uma
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Infant With Heart Murmur. Difficulty In Breathing, Getting Stiff, Passing Out. Is This A Concern?

Hi, Thank you for your query on Healthcare Magic. Here two possibilities with your history. 1. Breath holding spell : After a precipitating factor like pain or taking a toy from the child, child starts crying, stops breathing, becomes blue followed by stiffening with rolling of eyeballs. Your description is matching to this. It is common in children and it is like a developmental issue in some children. Avoid precipitating events like disappointing the child. Some times treating underlying iron deficiency anemia if it is present will decrease the frequency of spells. 2. Cyanotic spells : which are associated with congenital heart problems like Tetralogy of Fallot. Here they are called anoxic spells and they are due to decreased oxygen supply and usually occur in the early mornings. If the heart murmur is due to this heart problems this episode may be related to heart murmur. If the heart murmur is not due to a clinically significant heart problems it is not related. Therefore I advise you to consult your Pediatrician get examined your child. Hope I have answered your query, if you have any clarification please let me know. Regards.