Arrhythmia in a one-year-old child. Sinus arrhythmia in a child. Normal sinus rhythm in children by age

The human heart consists of several segments, each of which is capable of generating impulses of different frequencies. Only the sinus section is the one that is capable of contracting 60 times per minute, thereby ensuring stable functioning of the myocardium. Severe sinus arrhythmia in a child refers to various heart rhythm disturbances. These may appear in the form of:

• sinus tachycardia (rapid heartbeat);
• sinus bradycardia (slow heart rate);
• extrasystoles (untimely contractions of the myocardial chambers).

Normal age-related heart rate indicators are individual for each person. However, there are average values ​​that doctors use to diagnose heart disease (child’s age – number of beats/minute):

Classification

Sinus arrhythmia in children (hereinafter referred to as SA) can be of different nature:

1. Respiratory (heart rate increases when inhaling, and decreases when exhaling). This phenomenon is recognized by doctors as physically caused, has a neurovegetative origin, and does not require special treatment.
2. Not dependent on breathing. This kind of SA is much less common than respiratory SA and is usually associated with malfunctions thyroid gland, congenital anomalies development of the baby’s body or is a consequence of previous infectious diseases(these often cause heart complications).

Depending on the severity of the anomaly, the following types of SA are distinguished:

• Severe sinus arrhythmia in a child. In children and adolescents, this phenomenon is quite rare; usually the problem is diagnosed in older patients with atherosclerosis, neurosis, rheumatism, etc.
• Moderate SA. Often occurs in adolescents during puberty and children under 6 years of age. It is not considered dangerous and requires mild medical correction with homeopathic sedatives.

Why is there a problem?

The causes of SA depend on its type. Thus, respiratory arrhythmia in children is a consequence of:

• fear, fright, stress;
• increased physical activity;
• hysterical states, crying;
• hypothermia (overheating);
• dehydration;
• drinking strong tea, coffee.

SA not associated with breathing is caused by the following factors:

• heredity;
• infectious diseases (cause changes chemical composition blood and lead to disruption of the heart muscle);
• vegetative-vascular dystonia;
• myocarditis (inflammation of the heart muscle of infectious or viral origin);
• congenital heart defects;
• intoxications;
• disorders of intrauterine development of the baby;
• benign and malignant neoplasms.

Sinus tachycardia in most cases clinical cases caused by myocarditis, oxygen deficiency, general intoxication of the child’s body, as well as heart diseases of a bacterial nature. The child’s heart begins to beat faster after suffering a psycho-emotional shock, during increased physical activity or against the background of hyperthermia.

Bradycardia is a consequence severe stress, overexcitation, nervous overstrain.

Causes of extrasystole in a child:

• myocardial damage;
• cardiac ischemia;
• myocardial dystrophy;
• inflammatory processes in the body;
• drinking strong tea (coffee).

Symptoms and diagnosis

Irregular sinus rhythm, which is of a respiratory nature, usually does not “announce” itself in any way. The pulse returns to normal after the influence of the conditioning factor ceases.

If SA is not dependent on breathing, parents should pay attention to the following alarming “signals” from the baby’s body:

• shortness of breath, difficulty breathing;
• chest pain;
• fast fatiguability;
• frequent dizziness;
• general weakness, swelling;
• fainting conditions;
• causeless apathy, or, conversely, unsubstantiated anxiety;
• body weight deficiency;
• insomnia or intermittent restless night sleep;
• hyperhidrosis (periodic attacks of increased sweating even with minimal physical exertion);
• nasolabial triangle turns blue.

These manifestations are a reason for an immediate visit to a cardiologist.

Diagnosis of SA involves:

1. Listening to the heart using a phonendoscope, determining heart rate/minute and comparing the data obtained with normal age indicators.
2. Carrying out electrocardiography (sinus arrhythmia in adolescents and children under 12 years of age “makes itself known” by lengthening during bradycardia or shortening the PP interval against the background of tachycardia).

Additional diagnostic measures:

• blood test (general, biochemical), urine;
• Ultrasound of the heart.

Severe or moderate sinus arrhythmia in a child is a reason to register him with a cardiologist.

How to deal with the problem using traditional methods

Respiratory SA does not require special treatment. A specialist can recommend certain time refuse intense physical activity. Treatment methods for severe sinus arrhythmia depend on the causes of its occurrence:

• reception antibacterial drugs if the problem is infectious;
• treatment with glycosides for heart failure;
• elimination of heart defects ( surgical intervention).

Symptoms of respiratory and moderate SA can be corrected with natural sedative compounds (tinctures of valerian, motherwort). Drug therapy severe sinus arrhythmia involves the use of the following groups of drugs:

• antiarrhythmic medications (Verapamil, Obzidan);
• means restoring the correct metabolic processes in the tissues of the heart muscle (Cocarboxylase, Riboxin);
• medicinal compositions for normalization electrolyte balance(Asparkam, Panangin, Potassium orotate).

Extrasystoles in children, as a rule, do not require special treatment, but a child with frequent attacks of this type of arrhythmia should be under the supervision of a specialist.

Traditional therapy

With the permission of your attending cardiologist, you can fight SA at home using natural, safe remedies.

Let's look at a few useful recipes:

1. This mixture has a positive effect on the functioning of the heart muscle and improves blood composition: 100 g of kernels walnuts and raisins + 200 g dried apricots + 2 tbsp. l. honey + juice of half a lemon. The solid ingredients of the medicine are ground in a meat grinder (coffee grinder), combined with honey and lemon juice, placed in a glass container and sent to the refrigerator. Treatment regimen: children under 7 years old are given 1 tsp daily on an empty stomach, schoolchildren 7-10 - 2 tsp, 10-12 - 1 tbsp. l., adolescents over 12 years old - 2 tbsp. l. facilities.
2. Grape and pear juices are the best helpers in healing the heart. It is recommended to drink at least a glass of these healthy drinks every day.
3. 2 tsp. Dry pre-crushed calendula flowers are poured into 400 ml of boiling water, left to infuse for half an hour, filtered, and cooled. How to take the decoction: 1 tablespoon/three times a day.
4. The following healing mixture helps to cope with the symptoms of SA: 1 tsp. dry crushed motherwort and valerian herbs + half a teaspoon of yarrow flower powder + several anise fruits. The resulting collection is poured with boiling water (200-250 ml), left for about an hour, and given to children a tablespoon three times a day.

Possible complications and prevention

Why is childhood SA dangerous? Sinus respiratory arrhythmia does not pose any threat to the child’s health. Typically, such heart rhythm disturbances have completely “harmless” reasons, due to which children instinctively hold their breath.

But severe or moderate SA, independent of breathing, is not a physiological variant of the norm; it is a clear symptom of disturbances in the functioning of the heart, endocrine system or other body functions. Such sinus arrhythmia in children is a reason for an immediate visit to a cardiologist.

Thus, pronounced SA in adolescents is not only accompanied by pronounced clinical symptoms, but is also usually a “companion” of cardiosclerosis and rheumatism. Particularly dangerous is bradycardia - a consequence of neurosis, since it often turns into chronic form, leads to serious violations myocardial functions.

Preventive measures aimed at preventing SA are as follows:

• organizing the correct regime, creating a balanced diet;
• moderate regular physical activity;
• eliminating stress, hypothermia, overheating;
• hardening;
• timely treatment acute (chronic) diseases, especially infectious and viral in nature.

Violations sinus rhythm affect the overall performance of the heart muscle, which, in turn, sooner or later will affect the amount of blood pumped by the myocardium. Deficiency of oxygen and nutrients supplied to internal organs, tissues, cells entails disruptions in the functioning of the entire organism.

As a result, in addition to general weakness, decreased ability to work, dizziness and other unpleasant symptoms, over time, SA can lead to disruption coronary circulation and heart failure. Only timely diagnosis and treatment (if necessary) of sinus arrhythmia will help avoid consequences for the child’s growing body.

Respiratory sinus arrhythmia in a child is not regarded by doctors as a pathology. Heart rhythm disturbances develop when the function of the sinus node or the conduction of impulses to the myocardium fails.

Arrhythmia does not always indicate pathology, but can be a sign of a number of organic diseases. Treatment options are different for each patient.

What does sinus arrhythmia mean?

The normal heartbeat in a child according to an electrocardiogram (ECG) is sinus rhythm. Impulses for myocardial contraction are generated in the sinus node.

The intervals between the complexes of waves on the ECG are the same. However, in children, heart rate is related to age.

On an ECG, doctors sometimes make a conclusion - sinus arrhythmia. In most children, it is caused by body growth or hormonal changes in puberty. And only in in rare cases indicates a serious illness.

Sinus arrhythmia is a group of heartbeat disorders in frequency, strength and rhythm. Rhythm disturbances occur when changes occur in the node of the same name, which generates signals for the heart to contract. At normal pace Heartbeat intervals between beats may vary.

In this case, the ECG reveals a rapid (tachyarrhythmia) or slow (bradyarrhythmia) heartbeat.

Respiratory arrhythmia

In some children, the frequency of myocardial contractions changes during breathing. When you inhale it increases, when you exhale it decreases. The number of heart beats in a child reflexively decreases during conducting an ECG on a cold couch. The so-called respiratory arrhythmia does not affect the health of children in any way.

The main reason for changes in heart rate lies in the imperfection of the autonomic nervous system. Respiratory arrhythmia occurs in cases of developmental abnormalities or diseases:

• excess weight;
• rickets;
• encephalopathy;
• prematurity;
• intracranial hypertension;
• a period of intensive growth of 4–5 years, when vegetative system does not keep up with the physical development of the child.

Most often, sinus rhythm disturbance is detected in children 7 years old. At this age, the deviation is not considered a disease because it is associated with puberty and physical maturation.

IN adolescence hormonal changes occur in the body, which also affects autonomic function. Rhythm disturbances can occur after negative emotions.

By the way! Respiratory arrhythmia is not dangerous for children. As physical development matures nervous system, and the problem goes away on its own.

Mild heartbeat disorders do not require treatment. Sedatives are prescribed herbal preparations. However, the child should be consulted with a cardiologist and pediatrician.

Types of pathological heartbeat

Non-respiratory arrhythmia is detected in 30% of children. It occurs in the form of attacks or is observed constantly:

• Sinus tachycardia is characterized by an increase in heart rate by 20–30 per minute. Occurs in diseases that occur with elevated temperature bodies. May appear due to infection or emotional stress.
• Severe cardiac arrhythmia - paroxysmal tachycardia - begins suddenly, accompanied by dizziness, low blood pressure. The number of heart contractions reaches 160–180 beats per minute. In this case, the organ cannot cope with the function of blood supply. The brain is the first to suffer.
• Sinus bradycardia is a slow heartbeat. The production of signals for heart contraction is reduced by 20–30 beats compared to age norm. It often develops after stressful situations.
• Sinus extrasystole is characterized by the appearance of extraordinary myocardial contractions, often of functional origin. The cause is also vegetative-vascular dystonia, diseases of the endocrine glands or strong negative emotions.
• Unstable sinus rhythm indicates that the intervals between the waves vary. The most common cause is weakness of the sinus node. The pathology is observed in children with a hereditary predisposition to cardiovascular diseases. But sometimes irregularities in the rhythm are caused by a violation of the autonomic nervous system. To reveal the real reason, conduct a Holter study, ultrasound.

Important! Abnormal heartbeat may manifest as loss of consciousness. If a child has ever experienced such an episode, a cardiac examination should be performed.

Children with cardiac abnormalities need a separate sports regimen and vaccination schedule.

Causes of abnormal heartbeat

The source of non-respiratory arrhythmia is previous organic diseases that damage the sinus node.

Causes of pacemaker dysfunction:

• bacterial or viral myocarditis after a sore throat or flu;
• Congenital heart defect;
• vegetative-vascular dystonia;
• rheumatic heart disease;
• pericarditis, endocarditis;
• poisoning;
• cardiomyopathy;
• heart tumors;
• mitral valve prolapse;
• thyroid problems;
• infections, including intestinal forms.

Genetic predisposition plays a leading role in the occurrence of arrhythmia. If parents suffer from heart and vascular diseases, there is a high probability of a child’s heartbeat failure.

What are the dangers of rhythm disturbance?

Organic myocardial diseases occur with severe arrhythmia, which aggravates the course of the disease. Prolonged attacks of atrial fibrillation and paroxysmal tachycardia dangerous for the development of heart failure.

In some cases, rhythm disturbance is fatal. Sinus arrhythmia, which appears after a serious illness, requires special comprehensive treatment.

Signs of heart palpitations in a child

Sinus arrhythmia in young children is often diagnosed late. It is usually detected when scheduled inspection. But there are still signs that indicate a heartbeat disorder in newborns.

Symptoms that may alert parents:

• excessive sweating;
• causeless crying;
• lethargy or restlessness;
• insufficient weight gain;
• shortness of breath after physical effort - turning over, crawling;
• pallor or blueness of lips, nails;
• loss of appetite - the baby sucks sluggishly or does not take the bottle;
• interrupted sleep.

Signs of arrhythmia in preschool and older children:

• interruptions in the heart;
• attacks of weakness;
• shortness of breath after physical activity;
• fatigue;
• fainting;
• stabbing pain in the chest.

Important! Such signs cannot be ignored. To find out the cause, your pediatrician will conduct a study and outline a plan for further action.

What to do if your heartbeat fails

Sinus arrhythmia most often does not affect the child’s health. But if it is detected on the ECG, you should visit a pediatric cardiologist.

In such cases, it is carried out ultrasonography(ultrasound). If necessary, the doctor prescribes Holter monitoring, which records several dozen ECG records over 24 hours, including at night. Besides instrumental diagnostics, apply laboratory methods – general analysis urine and blood.

If sinus arrhythmia without organic pathology is detected, children are observed by a cardiologist. In this case, an ECG should be done every 6 months.

For non-respiratory arrhythmia, treatment measures related to the main disease are carried out.

How to treat heart palpitations in children

Most arrhythmias do not require therapeutic measures. Specific treatment is prescribed after a comprehensive study by laboratory and instrumental ways. Depending on the disease, a course of antibiotic therapy is carried out, antitumor treatment. For heart defects it is required surgical correction valves The choice of medications is related to clinical manifestations pathology.

Types of drug therapy:

• for heart failure, glycosides and diuretics are prescribed;
• antiarrhythmic drugs are used that reduce and increase cardiac conductivity;
• medications containing magnesium, potassium and vitamins;
• restorative treatment – ​​aloe, propolis;
• Mildronate and Elcar are used to improve myocardial metabolism.

In addition to medications, breathing exercises and special massage are prescribed for children with arrhythmia. Dietary nutrition given great importance. The diet includes foods plant origin containing vitamins and magnesium - nuts, cashews, honey, dried apricots. The frequency of infant feeding is increased to 6 times a day in small portions.

Playing sports

With moderate respiratory arrhythmia, children engage in physical activity in general group. But there are restrictions on participation in competitions. At the same time, you are allowed to play sports. It is recommended to periodically consult a cardiologist so that physical activity does not provoke the transition of arrhythmia to a severe form.

Children who play sports with arrhythmia are observed by a doctor. ECG and Holter monitoring are performed periodically once every 3 months. After the examination results, the sports doctor decides on admission to competitions. If non-respiratory sinus arrhythmia is detected in a child, sports activities are limited. Such children benefit from morning exercises, a walk on fresh air.

Sinus arrhythmia in children has a favorable course. It only requires observation so that it does not develop dangerous pathology. To do this, it is recommended to do an ECG once every six months. If your child experiences shortness of breath during physical activity, pale face, or fatigue, consult a doctor. Severe form Arrhythmias are easier to prevent than to treat.

Any parent should take care of the health of their child from the first years of life, so even the slightest violations in the state of a small organism should cause concern, especially if they relate to the functioning of the heart. Serious cardiac diseases are not that common, but arrhythmia in children is quite common, and it is important to understand in time whether it is dangerous or not. To identify the causes of the pathology, you need to consult a doctor as soon as the first symptoms appear in order to make a diagnosis and, if necessary, prescribe treatment.

Cardiac arrhythmia is a collective name various pathologies, which are characterized by a violation normal rhythm heartbeat. This happens as a result of a malfunction in the body’s conduction system. This is a long network consisting of many nodes, between which a nerve impulse is sequentially transmitted, causing the heart to contract. If in one of the nodes there are pathological changes, the impulse has to “look for” a workaround, as a result of which the heart rate changes.

The types of arrhythmia in children do not differ from the types of this pathology in adults. The most susceptible to heart rhythm disturbances are newborns and children aged 4-5, 7-8 and 12-14 years. It is important to immediately establish the reasons for such changes, since in some cases arrhythmia is considered normal occurrence and is not associated with more serious diseases.

Sinus arrhythmia

The main node of the conduction system, which generates nerve impulses, is sinus, while healthy person heartbeats repeat at regular intervals. Sinus arrhythmia is characterized by deviations associated with both rhythm disturbances and changes in heart rate that arise due to pathologies of the sinus node.

Moderate sinus arrhythmia is the most favorable option of all possible violations rhythm of heart contractions. In most cases, this pathology does not require treatment; you just need to constantly monitor the child’s condition from the first years of life with the attending physician in order to notice the occurrence of complications in time, if they occur.

Sinus arrhythmia in children can be constant or occur in the form of attacks of heart palpitations.

Sinus arrhythmia includes several types of heartbeat disorders. Most often, tachycardia (rapid contraction rhythm), bradycardia (slow rhythm) or extrasystole (single irregular impulses) occurs. All of them are treatable and in most cases are temporary.

Atrial fibrillation

Atrial fibrillation in childhood occurs quite rarely, but such cases still occur, and this pathology is considered the most serious of all types of heart rhythm disturbances. The name of this condition appears due to the fact that very frequent contractions of the heart muscle are observed, as a result of which it seems that it is flickering.

The human heart has four sections (chambers) - two atria and two ventricles, in in good condition in a healthy person, the coordinated work of all these elements is observed, impulses are transmitted sequentially along the chain. At atrial fibrillation Coherence of work is lost, each camera works separately. As a result, chaotic, frequent and ineffective contractions of the heart occur, the frequency of which can reach 350-600 beats per minute. This pathology is very dangerous for a child, so it needs to be urgently treated from the first years of life to prevent serious complications. In this case, you must contact ambulance at each occurrence of an attack of atrial fibrillation, in order to eliminate ailments and prevent their development. In especially severe cases, such an attack can even lead to coma or death.

Respiratory arrhythmia

Respiratory arrhythmia is a subtype of sinus arrhythmia, but disturbances in heart rhythm do not occur spontaneously or in the form of attacks. This pathology manifests itself in the fact that when you inhale, the heart begins to beat much faster, and when you exhale, on the contrary, it slows down. Respiratory arrhythmia in adolescents and children – common occurrence, but in adults such a disorder is rare.

This type of heart rhythm disturbance is not as dangerous as, for example, atrial fibrillation, and often goes away by adulthood. Despite this, the child should be regularly examined by a doctor, starting from an early age, in order to detect the slightest changes in the condition. In addition, if necessary, a specialist may prescribe one or another therapy or prevention that must be followed.

Why does pathology occur?

Before you start doing anything to eliminate the symptoms of arrhythmia in a child, you need to identify the causes of its occurrence. Pathological disorders Heart rhythms that go beyond the normal range in most cases are not an independent pathology, but a sign of a more serious disease. First of all, the attending physician must conduct an examination to identify possible cardiac pathologies, which include:

• individual characteristics of the body associated with changes in the conduction system;
• congenital and acquired heart defects;
• myocarditis;
• pericarditis;
• heart injuries accompanied by hemorrhage;
• malignant heart tumors;
• abnormal development of the heart;
• vegetative-vascular dystonia.

In addition, diseases of other systems and organs can also affect the occurrence of arrhythmia in a child. In particular, it is necessary to check the endocrine and respiratory system, as well as hormone balance. Often the causes of tachycardia lie in the presence of infectious diseases (sore throat, bronchitis, intestinal infections). Prenatal factors should not be ruled out, for example, an unhealthy pregnancy or premature birth(prematurity).

How does the disease manifest itself?

Children's arrhythmia, as a rule, has symptoms that are immediately inexplicable, and it is not always clearly expressed. In some cases, signs of heart rhythm disturbances are detected only during a routine examination by a cardiologist. For any type of arrhythmia, you can observe general symptoms, For example:

• interrupted, weak sleep;
• crying for no apparent reason;
• shortness of breath and difficulty breathing during any physical activity;
• increased sweating;
• loss of appetite or complete failure from any food;
• insufficient weight gain;
• cyanosis of nails and lips;
• pallor skin;
• lethargy or hyperactivity.

Children over the age of four can complete the picture by describing additional symptoms which are felt during attacks of arrhythmia. This could include chest pain, darkening of the eyes, dizziness, pronounced weakness, rapid fatigue, long rest after physical activity, etc. In any case, even if one suspicious sign appears, you should consult a doctor, since the child’s health is very fragile, and It is necessary to stop any diseases at the stage of their inception.

To monitor your heart rate, simply check your pulse regularly; this can be done manually or using a heart rate monitor. However, it should be taken into account that children have different normal heart rate values. For newborns, the norm is 140 beats per minute, for children from 1 year to 3 years – 120 beats, from 3 to 5 years – 110 beats, from 5 to 10 years – 100, over 10 years – 90 beats. In adolescence, as a rule, the heart rate normalizes and is, as in adults, in the range from 60 to 80 beats per minute.

How to treat pathology

If your child has problems with the heart rhythm, you should contact your pediatrician or pediatric cardiologist. As a rule, in this case, the doctor conducts general examination and survey little patient and his parents, after which he gives a referral for electrocardiography (ECG). This simple examination allows you to identify all existing disorders and monitor whether there are any abnormalities in the functioning of the heart muscle.

If a child's arrhythmia is within normal limits, it does not need to be treated; it will go away on its own by adolescence. It is enough just to ensure that the child eats properly, receives all the substances necessary for the growing body, and does not fall under the influence of negative factors and exercised physically active work. The heart, like any muscle in the body, needs training, so the child must engage in some kind of sport or at least regular physical exercise. In most cases, active children do not even need this, since they train in a unique way while playing with their peers.

When a pathological arrhythmia is detected in a child, parents need to understand what to do next to stop the disorder and prevent Negative consequences. It is important to remember that self-medication in this case is unacceptable; therapy should be prescribed exclusively by the attending physician. Any independent actions are likely to cause harm, but not benefit.

Treatment of arrhythmia in children should be based on eliminating the disease that caused the development of heart rhythm disturbances. Most often, therapy is carried out on an outpatient basis using medicines and medical procedures. Hospitalization is required only in extreme cases when arrhythmia is associated with serious diseases.

Drug treatment is based in most cases on taking medications that restore the balance of electrolytes in the heart muscle. In addition, specialized antiarrhythmic drugs may be prescribed. In addition to this, the doctor may prescribe medications that improve the nutrition of the heart muscle. If your child has severe symptoms such as pain, insomnia, weakness, or increased fatigue, are appointed specialized means to eliminate ailments. They can be used symptomatically, that is, only when attacks occur, or as a separate treatment course.

If such treatment does not bring results, surgery may be prescribed. During it, the cause of arrhythmia is eliminated, that is, the pathology that causes disturbances in the functioning of the heart. If the heart rhythm disturbance is not associated with other cardiac diseases, cauterization may be prescribed, which is performed using modern techniques radio wave ablation and cryoablation. In this case, the part of the myocardium that causes problems with heartbeat is directly cauterized. In particularly serious cases, when there is a risk of the child's heart stopping, a pacemaker may be installed.

It is better not to use traditional medicine at all in the treatment of arrhythmia in children, even if the remedies seem absolutely harmless and have been repeatedly tested on adults. Any substances that are inappropriate for a child can disrupt the overall picture of his condition and aggravate the situation, causing complications. In consultation with your doctor, you can only adjust your diet to include healthy foods and, if possible, excluding as much as possible junk food. Also, in some cases, it is permissible to use herbal medicine for general strengthening of the body, but also only after consultation with a doctor.

Further forecast

The consequences of arrhythmia that occurs in childhood can be different, it all depends on the degree of the disease and individual characteristics child. Abnormal heart rhythms, which are normal, usually go away by adolescence, so there is no need to worry about them. However, in modern conditions, where active games with peers are gradually replaced by “communication” with gadgets, not all children get rid of pathology without outside help. In some cases, even in adulthood, a person remains with childhood sinus arrhythmia due to the fact that at one time he did not sufficiently train his heart muscle.

Pathological arrhythmia in children does not have such a positive prognosis, especially if it is associated with other cardiac diseases. Moreover, the later the treatment of the disease begins, the more serious the consequences will be; heart problems can become chronic, and all that remains is to muffle the symptoms throughout life.

However, such complications can only occur in advanced cases, when inappropriate treatment was selected or was not carried out at all. If you notice signs of heart rhythm disturbances early stages, you can get rid of the problem without any consequences. Modern medicine pays close attention to cardiology, especially children’s, so in the vast majority of cases the resulting pathology can be quickly and effectively eliminated.

Violation of the sinus rhythm of heart contractions in a child is often associated with physiological processes in the growing body, but sometimes sinus arrhythmia serves as a symptom of the disease. Any disturbance in the functioning of the heart in children should be a reason to consult a doctor.

Sinus arrhythmia

Sinus arrhythmia is a disorder of sinus heart rhythm that is caused by autonomic immaturity nervous regulation work, which in a child is manifested by an increase or decrease in heart rate (HR).

Sinus rhythm is set by the sinus node, the main pacemaker. You can learn more about the properties of the sinus node and the sinus rhythm of heart contractions in the article “Sinus Rhythm.”

Sinus arrhythmia, not exceeding 10% of normal, is not a disease and does not cause concern to the child. This developmental abnormality is often detected by chance during an ECG study.

Physiological form

There are two types of sinus arrhythmia in children:

1. cyclic form or respiratory sinus arrhythmia - on inspiration, heart rate increases, on exhalation it decreases;
2. non-respiratory form - there is no dependence of heart rate on the breathing phase.

Respiratory sinus arrhythmia is one option physiological norm. It occurs in children and manifests itself in an increase in heart rate during inhalation and a decrease in heart rate during exhalation.

Periods of pronounced sinus respiratory arrhythmia occur in a child at the age of 6-7 years, 9-10 years, when organs are actively growing and autonomic innervation is improving.

Sometimes the heart rhythm is disrupted, like the “white coat” effect. The child develops anxiety before the examination, caused by an unusual place and frightening manipulations, which can cause fear and holding his breath.

Test results in young children may be affected by:

• the effect of cold - the couch on which the ECG is performed is too cold, cool air in the room;
• baby's excess weight;
• physical activity immediately before the examination.

Sinus rhythm, caused by immaturity of regulatory structures, is typical for premature newborns, as well as for children with increased intracranial pressure.

With non-respiratory sinus arrhythmia, heart rate does not depend on the phase of breathing, and attacks sometimes develop several times a year. If attacks occur more often, up to several times a day, then in this case the heart can be absolutely healthy.

The reason for the change in the rhythm of myocardial contractions can be internal disease, causing change in the conduction system of the heart.

Pathological form

Among the many factors that cause heart rhythm disturbances in a child, the main groups of causes of changes in sinus rhythm are distinguished:

• physiological;
  • imperfection of the autonomic innervation of the heart associated with the active growth of the child;
  • hereditary characteristics;
  • hormonal changes during periods of active growth;
• pathological;
  • diseases affecting the conduction system of the heart;
  • vascular disorders;
  • infectious diseases, causing complications myocardium, heart valves;
  • congenital and acquired heart defects.

Sinus rhythm disturbance can be caused by a complication of a viral respiratory infection, intestinal disease, or urinary system disease.

The contractility of the heart can be affected by:

• infections of the myocardium or pericardial membranes - myocarditis, endocarditis;
• diseases of the ENT organs, teeth, especially with a chronic long-term course of the disease;
• dehydration of the body and the resulting electrolyte imbalance;
• dysfunction of the thyroid gland;
• prolonged diarrhea;
• anemia;
• physical, emotional overload.

In adolescents, the cause of sinus arrhythmia may be cardiac neurosis. This disease is psychosomatic in nature, which is expressed in the relationship between the functions of the cerebral cortex, the regulatory centers of the hypothalamus and the work of the heart.

Heart rate norms in children

With sinus arrhythmia, heart rate depends on the age of the child (in beats per minute):

• first 30 days of life – 140;
• first 12 months – 130;
• from one year to 2 years – 125;
• from 2 years to 5 years – 115;
• from 6 to 8 years – 106;
• 8-10 – 88;
• from 10 to 12 – 80;
• in adults and adolescents from 12 to 15 – 75.

Sinus rhythm appears during periods of active growth. Sinus arrhythmia is found in children more often at the age of 6-7 years, 9-10 years, it is caused by an inconsistency between the autonomic innervation of the heart and rapid growth, this disorder goes away as they grow, but sometimes this condition serves as a symptom dangerous disease, which only manifests itself with age.

In cases of suspected heart disease, an ECG must be repeated periodically to monitor the contractile work of the myocardium, to systematically determine whether the sinus arrhythmia in a child 6-7, 9-10 years old is within normal limits or not.

Symptoms

When the heart rate accelerates while maintaining the correct heart rhythm, sinus tachycardia develops. The pulse accelerates during sports and emotional experiences.

With physiological sinus arrhythmia, the child does not feel any discomfort or pain. He can only feel the acceleration of his heart. But if the acceleration of heart rate is accompanied by weakness, heart pain, shortness of breath, then this, of course, is a reason to consult a doctor.

Sinus arrhythmia, which occurs in adolescents with a slowing of the heart rate, is bradycardia; symptoms accompany this phenomenon oxygen starvation, which is dangerous for the brain.

In infants and very young children up to one year old, sinus arrhythmia can manifest itself:

• changes in behavior - anxiety, increased excitability, or, on the contrary, indifference to the environment;
• lack of appetite, regurgitation;
• lag in weight gain compared to peers;
• pallor, bluishness of the skin, increased sweating.

In older children, heart rhythm disturbances may include:

• fainting;
• shortness of breath on exertion;
• heartache;
• edema;
• cyanosis of the nasolabial triangle;
• dizziness;
• fatigue.

Appearance similar symptoms indicates the likelihood of heart disease or vascular pathology. When discomfort The child must be thoroughly examined to find the cause of this condition.

Treatment

Prescription for sinus arrhythmia depends on the reasons that caused this disorder and on the severity of the phenomenon. With moderate sinus arrhythmia in a child, provided that the deviation of the heart rate from the norm is not more than 10%, treatment may not be necessary.

A child can play sports, and sinus arrhythmia is not contraindicated even for professional sports, provided that it is within normal limits and has a physiological origin and is not caused by a serious illness.

Parents should pay close attention to the diet:

• The diet should not contain:
  • foods rich in cholesterol - fried, fatty, salty, smoked should be limited or excluded;
  • caffeine, hot spices that enhance sympathetic activity;
• needs to be controlled:
  • weight – excess weight is an additional burden on the heart and blood vessels;
  • sleeping mode;
  • physical activity - the load should be gentle, but sufficient to stimulate blood circulation in the body.

A stable heart rate is also determined by the home environment in which the child grows up. Positive emotions and a calm environment in the family are no less important to a child than medications and diet.

Physiological sinus arrhythmia does not threaten the child’s life. It requires only medical supervision, attentive attitude of parents, and compliance with all doctor’s recommendations.

Pathological sinus arrhythmia requires treatment aimed at the disease that caused this disorder. For each child, such reasons are very individual. They can be identified and treatment prescribed after a comprehensive examination by a pediatrician, cardiologist, neurologist, or endocrinologist.

The heart is the main vital organ, and malfunctions in its functioning lead to disruption of the functioning of many body systems. Most often, when a child is diagnosed with arrhythmia, parents begin to panic. So how dangerous is sinus arrhythmia in children? What are its causes, symptoms, consequences, and in what cases should we sound the alarm?

This arrhythmia is characterized by disturbances in the rhythm of the heart, in which the sinus node induces impulses with variable frequency. Moreover, a slight irregularity of sinus rhythm is present in almost everyone, but if the difference between heart contractions is more than 10%, a diagnosis of “sinus arrhythmia” is made.

From a physiological point of view, the sinus node, located in the wall of the right atrium, is an autonomous part of the cardiac system. But some parts of the nervous system still influence its work, stimulate or depress it. That is why the delicate balance can deviate towards slowing down or increasing the speed of contractions.

You can reassure parents by saying that such arrhythmia has virtually no effect on the child’s well-being and does not require special treatment. The only exceptions are cases when, along with sinus, other types of arrhythmia occur (atrial, ventricular).

Kinds

The heart rate characterizes the type of arrhythmia. Exists general norm the number of heartbeats, deviations from which determine the name of the disease.

Tachyarrhythmia

Tachycardia, or tachyarrhythmia - an increase in the number of contractions. Diagnosed when the pulse rate is more than 80 beats per minute.

Tachycardia in children is often provoked by heart, respiratory and circulatory system, external factors. The first alarming symptom is a rapid heartbeat at rest. During physical activity, stress, and anxiety, tachyarrhythmia is not a deviation.

The danger of childhood tachyarrhythmia is insufficient blood supply to the heart. Hence depression, shortness of breath, chills, trembling, and a feeling of lack of air. For the treatment of isolated heart rate problems not related to external influence, the cardiologist needs to discover the pathology that led to this condition.

Bradyarrhythmia

Bradycardia, or bradyarrhythmia, is characterized by a slow rhythm. Diagnosed when the pulse rate is less than 60 beats per minute.

Bradyarrhythmia in children can be of two types: relative and absolute.

• If the child’s condition is unchanged and no external factors affect him, but bradyarrhythmia is still observed, we can talk about absolute bradycardia.
• If the heart rate decreases as a result of the influence of some factors (hypothermia, overheating), this indicates a relative bradyarrhythmia.

Such conditions often occur in children involved in professional sports. For them this is the norm. Some medications can be stimulants to speed up the rhythm. For example, sympatholytics, morphine, cardiac glycosides. Cancelling them will allow you to return normal frequency heartbeat. In adolescence, the culprits of bradycardia are malfunctions of the thyroid gland.

Severe symptoms of bradyarrhythmia: general weakness, dizziness, headaches. In 90% of cases sinus bradycardia It is not permanent, occurs under certain circumstances and goes away completely as the child grows older. Potassium, magnesium and B vitamins reduce the risk of bradycardia.

Both types of disorders are asymptomatic in the vast majority of cases, however, sinus bradyarrhythmia in children is more common than tachyarrhythmia. Both one and the second type, due to their physiological nature, do not require treatment. And with pharmacological and pathological influences, the disease is considered individually.

Normal heart rate

This type is characterized by the coincidence of heart rate with age norms.

In young children, the heart rate varies depending on age. Eg:

• the norm for the first months of life is 140 beats/min;
• up to 1 year, a pulse rate of 130-135 beats is also considered acceptable;
• from one to two years - 124 beats/min.;
• from 2 to 5 years – 115 strokes;
• a contraction frequency of 106 beats per minute is typical for six-year-old children up to 8 years old;
• the norm for ten-year-olds is 98 beats/min.

Normal and abnormal heart rhythms

Severity

The difference in deviations from the norm determines the severity of the arrhythmia. There are 2 degrees.

1. Moderate. In this case, there is no need to worry, because moderate sinus arrhythmia in a child is not considered dangerous forms. Symptoms do not appear in any way and do not bother the baby. Moderate arrhythmia can be detected on an ECG during routine examinations.
2. Expressed. It cannot be isolated. As a rule, it manifests itself along with vascular or heart diseases. Severe sinus arrhythmia in a child is subject to treatment.

At-risk groups

Depending on the age of the child, risk groups are distinguished. The greatest likelihood of arrhythmia occurs during the period:

• from four to eight months;
• at 4-5 years, although at 3 years accelerated heart contractions are also possible;
• at 6-8 years old. This is why at age 7, when children start school, they are often diagnosed with sinus arrhythmia. Parents complain about overwork and stressful situations. Although natural has a greater influence accelerated growth body;
• during puberty, when hormonal disruptions inevitably occur.

Forms

There are respiratory, non-respiratory, and organic arrhythmia. It all depends on the cause.

Respiratory

This arrhythmia is associated with respiratory functions and affects blood pumping. Inhalation is characterized by a reflex increase in the number of heart contractions, and exhalation is characterized by a decrease. This type of arrhythmia is not dangerous and does not require therapeutic measures.

The reason is the immaturity of the nervous system. Respiratory view arrhythmias are often observed in children:

• those born prematurely;
• With high pressure, postnatal encephalopathy;
• patients with rickets;
• with obesity;
• with intensive growth from six to nine years.

When the nervous system is fully formed, the risk of arrhythmia will not exceed 20%.

Non-respiratory

This type of arrhythmia has nothing to do with respiratory processes. It usually occurs spontaneously and can manifest itself either in the form of attacks or on an ongoing basis. The frequency of changes is completely different. They can appear once a year or several times a day. This type of arrhythmia is often accompanied by diseases that occur in parallel with the arrhythmia. These may be problems of the thyroid gland, heart disease, infectious lesions, etc.

There are many causes of non-respiratory arrhythmia, but most often it is diagnosed in connection with cardiac pathologies. So, the provoking factors:

• the child’s predisposition due to the presence of such a problem in one of the parents;
• infectious diseases in which dehydration and intoxication are present. In this case, the heart rhythm may become imbalanced due to the changed water-electrolyte composition of the blood;
• myocarditis affects not only the rhythm of contractions, but also provokes shortness of breath, heart failure, and heart block;
• rheumatism with cardiac lesions;
• vegetative-vascular dystonia can lead to disruption of changes in the lumen of the vessels supplying blood to the heart, as a result of which the child develops arrhythmia;
• neoplasms in the heart area.

When the cause of the arrhythmia is eliminated, it will go away without special treatment.

Organic

It is most dangerous for children. If it occurs, then most likely the pathological process has affected the system designed to conduct the impulse, or there are problems with the heart.

Organic sinus arrhythmia in children happens to everyone severe symptoms failures of the cardiac system. In such a situation, it is necessary to undergo examination as quickly as possible and follow all treatment instructions.

Symptoms

The main manifestation of heart rhythm disturbances is a paradoxical deviation of the pulse rate from the normal norm. Such failures may go unnoticed with moderate arrhythmia. Neither the child nor the parents will see any external manifestations or changes in health. Doctors can tell you this after performing an ECG.

The following symptoms can help identify arrhythmia in infants:

• restless night and day sleep;
• frequent, causeless crying during sleep;
• reluctance to eat food that the child normally eats with pleasure;
• there may be a complete refusal of food;
• shortness of breath during normal activities such as walking or crawling;
• excessive sweating;
• restless behavior during the day.

Sinus arrhythmia in older children can manifest itself as:

• getting tired too quickly;
• intolerance to even moderate physical activity;
• spontaneous fainting, presyncope;
• feeling of discomfort in the heart area;
• chest pain, feeling of chest compression;
• excessive sweating.

If your child experiences fainting, shortness of breath, the nasolabial triangle turns blue, or chest pain is felt, go to the doctor immediately!

Such signs may indicate serious heart problems, the result of treatment of which depends on the parents’ timely seeking of medical help.

Diagnostics

Parents can independently count the number of heartbeats of the baby before contacting a doctor. To do this, you need to place your palm on the left half of the child’s chest and count the number of beats for a minute. The second option is based on the pulse on the wrist. To do this, grasp the child's wrist with four fingers. outside, A thumb placed on the inside of the wrist, pressing tightly against the skin. In this way, the difference between individual beats can be detected during counting.

Electrocardiography

In conditions medical institution The first reliable research method is electrocardiography. The specialist immediately gives an explanation of the result, and further directions are given by a pediatrician or therapist.

It is important that the child is calm during the ECG. Active physical activity before the study is contraindicated, be it brisk walking up the steps or jogging to the clinic. Give your baby time to calm down, restore his breathing, and only then go for an ECG.

Manifestation of arrhythmia on ECG

Electrophysiological study

During the procedure, the parts of the heart are stimulated and the results are recorded. To do this, special electrodes are placed for some time as close to the heart as possible.

Holter ECG monitoring

The results of the procedure are recorded over a period of 24 hours or more. The cardiogram is recorded continuously, allowing you to track the dynamics of your heart rhythm.

Stress test

It is carried out using electrocardiography with physical activity.

Orthostatic test

Defines significant indicators while changing body position (lying down, then standing or vice versa).

Treatment

If the ECG results revealed sinus arrhythmia, the pediatrician or physician will give a referral to a cardiologist. He, in turn, sends the little patient for a control electrocardiogram and ultrasound examination of the heart. It is also necessary to take a blood test (clinical) and urine test (general). Blood biochemistry is often required.

In case everything necessary tests Normally, arrhythmia in children is considered isolated. The cardiologist will register the child with the condition of undergoing an ECG every 6 months. Special treatment in this case, it is not prescribed, and the child can perform the same physical activities as his peers.

If non-respiratory arrhythmia is detected, other research methods may be prescribed. They are used to identify the exact cause and determine the form and severity of the pathology. Treatment consists of eliminating the cardiac problems that caused the arrhythmia. Treatment options may include:

• a course of taking antibacterial agents;
• anti-tumor therapy;
• course of relieving heart failure;
• correction course of heart disease;
• antiarrhythmic therapy with drugs: Mildronate, Elcar.

If the research results have diagnosed organic arrhythmia, then all treatment measures will be selected individually by your attending physician. Cardiac pathologies that cause arrhythmia are treated comprehensively over a long period of time.

Painkillers may be used in treatment, sedatives, as well as products including vitamins and minerals.

In any case, a child who has been diagnosed with sinus arrhythmia should be transferred to correct mode sleep and wakefulness, provide healthy food, in which dairy and herbal products. It wouldn’t hurt to sign up for a massage or do it yourself, paying attention Special attention cervical region.

Folk remedies

Herbal preparations and herbs are used together with general purposes or separately. To regulate the rhythm of the heart, folk recipes are often used.

1. In 100 ml cooled boiled water add yarrow juice (25 drops). Offer the child an infusion throughout the day.
2. Infuse hawthorn flowers in a water bath for 15 minutes. Cool, strain and dilute with a glass warm water. This decoction is given to children 100 ml before meals.
3. It is useful to use mint, St. John's wort, valerian, and calendula as calming and normalizing heart rate components. You can make one-component infusions or brew them as a complex. The preparation procedure is similar to the previous point.

Consequences

Most often, sinus arrhythmia goes away successfully on its own, and with timely treatment does not cause any consequences. However, advanced cases threaten heart failure, which may result in the child becoming disabled.

The worst consequences that result from complex forms of arrhythmia together with extremely severe pathologies are:

• fibrillation is a condition of the heart when certain muscle fibers contract rapidly, disrupting the heart rhythm and its pumping function;
• Asystole is a condition in which different parts of the heart stop contracting, stopping blood circulation.

In these cases death inevitable.

Prevention

To reduce the risk of sinus arrhythmia, you need to ensure a healthy lifestyle for your child. Briefly point by point.

1. Daily regime. Teach your child to wake up and fall asleep at the same time. Make sure your baby gets enough sleep. The norm is at least 8 hours a day. If necessary, he can be put to sleep during the day.
2. Nutrition . It should be according to the regime, in small portions. Give preference plant foods and introduce heart-healthy foods into your diet. This is a pumpkin walnuts, honey Small, light meals will help prevent obesity.
3. Stress. Help your child avoid it and not lead to nervous breakdowns. Explain how you can calm yourself down. If necessary, give a nervous baby a sedative or motherwort tincture.
4. Alcohol. Their use and smoking during adolescence also lead to arrhythmia. Be carefull.
5. Honey. inspections . Do not neglect routine medical examinations. The norm is to visit specialists once every six months. If you have any suspicions, inform your doctor or consult a cardiologist yourself.
6. Healthy lifestyle. Moderate physical activity and walks in the fresh air will have a beneficial effect on the functioning of the heart and overall immunity.

Keep in mind that extremely hot summers and inappropriate warm clothing or heavy exercise increase the risk of mild respiratory arrhythmia.

Arrhythmia and sports

Parents whose children engage in intensive physical activity and who are diagnosed with arrhythmia, they are asked whether these stresses could provoke the disease. Therefore, you need to know that a child who has no predisposition to arrhythmia or heart problems can safely play sports even at professional level. And children at risk can get sinus arrhythmia even from minor physical exertion.

If there is a respiratory arrhythmia, the child is allowed to play sports. In this case, you need to be observed by a cardiologist and undergo ECG examinations every 3 months in order to monitor the condition and identify violations in time (if they appear).

Non-respiratory arrhythmia involves release from intense exercise and sports. The possibility of performing light exercises is agreed upon with the attending physician.

Most parents, hearing the term “arrhythmia” in relation to their child, become terribly upset. For some reason, there is an opinion that the age of a patient with such a diagnosis must necessarily be elderly. Therefore, the first thing you need to do is to calm down and move on. necessary examinations. When the cause is identified and the parents understand that it is not so scary, proceed to following the instructions. Severe cases There are very few children with arrhythmia. So everything is curable if you provide the proper conditions and care.

Summary

In most cases, sinus arrhythmia is not life-threatening. Most often it is associated with rapid growth, hormonal changes or stressful situations. If arrhythmia appeared against the background of other diseases, it will disappear without a trace after they are eliminated. Treatment can only be prescribed by a cardiologist after examination results. To protect the baby from arrhythmia, parents should instill in him the basics from childhood healthy image life and do not neglect medical examinations. And if there is hereditary predisposition- See a cardiologist.