Docs - Kid's Heart Rate Question

[onewhippedpuppy]

My oldest son is 11 years old. Super athletic, he plays football, baseball, and basketball and is good at all of them. No physical issues whatsoever, he is typically one of the fastest and best conditioned kids on every team. My wife took him in for a routine football physical several weeks ago. Order of events:

Initial nurse check, all is well with a normal heart rate.
Goes back to room, thinks he is getting shots and gets nervous when the doctor comes in. The kid is a huge sissy when it comes to shots.
Doctor finds high heart rate, sends him back out to calm down which only stresses him out.
Comes back in, still a high heart rate, doctor orders an EKG.
Heart rate still high, he gets a 24 hour heart monitoring device the next day.
After returning the device we had my wife’s PA sister take his heart rate several times, I believe it was at about 110 bpm. Nothing of concern for her.
We heard back today that the device recorded a heart rate at up to 210 bpm on several occasions, including when they installed it.
Now we are being told that he will likely need to visit a pediatric cardiologist.

Obviously this is not the entire picture, everything is through my wife and I don’t think the doctor has given her very much information. I keep telling her to ask more questions. Should I be concerned? Because he’s so healthy otherwise I have a hard time believing that he has a heart issue.

[Tobra]

Sounds like someone is covering their ass with a cardiology referral.



I tell everyone to take paper and make notes on what the doctor tells them.



They call what your son has, "white coat syndrome."

[onewhippedpuppy]

A bit of additional data, this is the same doctor that told me that my back was "perfect" despite pain down my leg, my leg falling asleep if I stood still for more than 20 minutes, and constant pain. I went through multiple visits and an MRI for my perfect back. Finally I pushed to see a specialist who found after another MRI that I had a fractured vertebrae birth defect, sciatica, and two herniated discs. So I may be slightly skeptical......

[recycled sixtie]

Matt you have the right to be sceptical about what the doc says in light of what he says about your back. However he is the doc and some misdiagnosis is possible. However your son is your son and it is your obligation to get the best assessment possible. Even a change of doctor might be a step you might want to take but the specialist will likely rule out any major problems.

I remember I was experiencing years back as Tobra would say white coat syndrome. Even two years ago I was hiking up a steep mountain and getting readings of 190's heart rate. I would think that what your son is experiencing is not unusual but you should get it checked out. Anything less is negligence.

Caveat: I am not a health professional.

[Nathans_Dad]

Kids do run higher heart rates than adults. I'm not a pediatric cardiologist but the rate up to 210 does seem pretty high, even for a kid who might have been exercising at the time. There are certain cardiac conduction issues, a common one is Wolff-Parkinson-White syndrome that can cause episodes of rapid heart rate. This should be diagnosable by EKG most times.

I don't think seeing a cardiologist is unreasonable.

[onewhippedpuppy]

Update: he is now not allowed to do any physical activity until his cardiologist appointment.....on 7/30. And the cardiologist only does adults and he "might not" feel comfortable clearing a child. At which point he will have to go to a children's hospital in KC. But go figure, the cardiologist is in their chain of clinic doctors. YGBSM!

We are going to demand tomorrow that they refer is to the children's hospital in KC and skip the local step. We are also going to visit a highly recommended independent family doctor for a second opinion.

[masraum]

Originally Posted by onewhippedpuppy

Update: he is now not allowed to do any physical activity until his cardiologist appointment.....on 7/30. And the cardiologist only does adults and he "might not" feel comfortable clearing a child. At which point he will have to go to a children's hospital in KC. But go figure, the cardiologist is in their chain of clinic doctors. YGBSM!

We are going to demand tomorrow that they refer is to the children's hospital in KC and skip the local step. We are also going to visit a highly recommended independent family doctor for a second opinion.

Sounds like a plan to me. I suspect it's nothing other than the kid getting nervous because of the Dr and if you may have expressed a dubious attitude towards the Dr.

[pavulon]

He's 11 and your son. Get it checked out and deal with the rest in a way that teaches your son how to cope well with such things. Handle it with the composure you've displayed here in writing many times.

[onewhippedpuppy]

We already discussed it with him, he was not happy but overall took it well. What 11 year old likes being told that he can't do anything for weeks?

[pavulon]

Of course no kid wants to lay low for a few weeks but try to find a silver lining in it and stick to that. Perspective is tough for an 11 year-old but this a good time to get a taste of and for what that stuff is about.

[Brian in VA]

Not a cardiologist but 210 seems high unless he's sprinting etc, in fact for his age 209 is his "max hr" for whatever that's worth. While a pain, getting a cards eval and laying low for a week or so isn't the end of the world when compared to how a lot of pediatric heart issues are discovered - sudden cardiac arrest. Good luck, hopefully it really is nothing.

[dewolf]

Do whatever you need to do.

Joel Massey, 14, had a heart attack and suddenly collapsed while playing football with his three friends Sam Seaborn, Rhodri Whittaker and Ben Stevens, all 16, near his home in Ledbury, Hertfordshire.
When he collapsed during a kick-about on April 12, his three friends were able to think back to a biology lesson on First Aid, and remembered what to do. While Sam ran for help, Rhodri dialled 999 and Ben started performing CPR until an ambulance arrived.
Paramedics used a defibrillator to restart his heart and he was taken by ambulance to Birmingham Children's Hospital.
Joel’s heart stopped for ten minutes, but thanks to his friends’ quick thinking, he is expected to make a full recovery.
Joel was diagnosed with Wolff-Parkinson-White when he was 13,

[onewhippedpuppy]

Thanks guys. While we are seeking a second opinion it's not for a blind sign off. Because we now have reason to be suspicious, he will be seen by a specialist. Otherwise we would always wonder. It would be terrible for him to lose sports, but in the grand scheme of things there are far worse things.

[pavulon]

good luck Matt!!

[LeeH]

Hopefully it turns out to be nothing. There are some of us who are healthy, but have higher than average heart rates.

For someone who's fairly in shape, I have an odd heart rate. Low to mid 60s when resting. A light jog can bring it up to 160 or so. Fast run? It'll push 200. I've done the heart monitor, stress test, and nuclear stress test. All came back normal. The oddity that bugs me the most is how high my heart rate can go up for virtually no reason. I usually attend quite a few auctions each year. I've measured my heart rate at 140 when something I've just thought about bidding on comes across the block!

[MFAFF]

Matt,

Having been in your son's position (a long time ago tho') I'd suggest that you doing some heart monitoring yourselves; might make a difference. There are a number of relatively inexpensive heart rate monitors and data loggers...so he can wear one all day and you can download the data and see what is happening. (I use one on the bike every day... logs heart rate during the exercise period, I can download it, see the graphs and get max rates, time in zones and so forth....on my Garmin. However there are others).

This data is a fairly coarse information compared to the medical heart rate monitors, which will give the medics a more detailed picture of what the heart is doing during as opposed to how much its doing it.

Whilst the docs will not necessarily be happy with you supplying additional data, they are adults and should be able to deal with it, the issue is one for you and him to get to understand what is 'normal' heart rate for him at the moment. Getting an idea of what his overall heart rate range is over a typical day and during exercise is interesting (a bit of a science project) and may serve to reduce the stress associated with it.

I recall having to wear at HR monitor over a 24 hr period... fat lot of use as I was stressed out of my box because of it. This was made all the more ironic as my Dad was a medic and for him all this was 'routine' and 'nothing to worry about'; so I can imagine that the whole thing is doubly stressful for you and your son. I often look at my traces with my son (13).. he is fascinated by the whole thing... and it makes sense to make the most of it.

Hope everything is well with your son.

[Brian in VA]

Hey, so what happened? Turn out to be nothing?

[onewhippedpuppy]

Thanks for asking, I meant to post a follow up. We had to go around the family doctor that wouldn't refer outside of their medical chain, turns out there are multiple pediatric cardiologists in Wichita, just with competing companies. Freaking BS, the guy flat out lied to us.

Long story short he was cleared on Wednesday about one hour before his baseball game. We have one follow up but its all good, his heart is fine. Thank God.....

[wildthing]

That's great then! I'm still using the outdated 220 minus age for simplicity.

[onewhippedpuppy]

He said it's pretty common for kids to exceed 220 when exercising or stressed.