Doc, My Kid’s Heart Is Beating Out His Chest!

This week’s guest columnist is Dr. Danielle Duhon, a family practice resident at the University Hospital and Clinics here in Lafayette.

First the child complains of chest pain.  She might even say it in scarier terms: “My heart hurts.”  Then mom puts a hand on daughter’s chest- mom can feel her heart beating!   Maybe Uncle Joe just died of heart disease.  Now it’s panic time!

Chest pain and palpitations are scary things.  Adults think about heart problems and assume the worst.  After all, we have been told over and over: if you have chest pain, get seen, it could be a heart attack.  In kids however, chest pain is rarely the heart- it’s usually strains in the chest wall- ribs, cartilege, and muscle. Sometimes it’s heart burn or occasionally lung issues.

But what about palpitations- that feeling of heart pounding?  Your child complains, you feel their chest, and you’re certain the heart is going to jump right out!  Before you lose your cool, try to think.  Lots of things can cause your child’s heart to race: recent activity, caffeine, or many medicines.  If your child has been running around or doing other high-energy exercise, have them rest for a moment.  See if it slows down.

Consider other causes of a pounding heart.  Caffeine can ramp up your child’s heart rate. Soda, coffee, and especially energy drinks all contain caffeine and other stimulants. The extra ingredients that give energy drinks their “boost,” like guanara, can be more stimulating than caffeine and make the heart race like crazy.  Now there are “energy” candies, gum, gels, and water mix-ins.  With all that stimulant coursing through your veins, it’s no wonder your heart is going BA-DUM, BA-DUM!

There are several medications that can push the heart. Even if your kid is adult-sized, children metabolize medications differently than adults. Always read the bottle or talk to your doctor to make sure the medication and dose are safe.  Examples of medications that can stimulate the heart include antihistamines (benadryl, chlorpheniramine, hydroxyzine, zyrtec, claritin, allegra), decongestants (pseudophedrine, phenylephrine), and cough suppressants (dextromethorphan).

Besides caffeine and over-the-counter medications, your child could be prescribed a medication that can cause palpitations.  These include stimulants to treat ADHD or inhalers for asthma.  If a kid combines those medications with other stimulating medications or caffeinated drinks, he is getting double duty and can certainly have a pounding heart.

Unfortunately some teenagers smoke cigarettes (real or electronic) or use chewing tobacco.  These contain nicotine, which is a stimulant.  Used alone or in combination with medications, caffeinated or “energy” drinks, and/or prescriptions, nicotine will certainly get some teenagers’ hearts going overtime.

Finally, anxiety is a common cause of palpitations.  Some kids are worriers.  Kids have lots to worry about.  There is pressure to do well in school.  There can be family strife like parental fighting and divorce, bullying siblings, or loss of a loved one through moving or death.  There are social worries: am I too fat/ugly/stupid/boring/etc? Some kids also worry about the big questions: Will the world end?  What is the meaning of life?  Does the little red-haired girl like me?

Some kids live with worry so much they internalize it and don’t realize that worries are the cause of their pounding heart.  Sometimes we ask the child what is worrying them and they can’t say because they are so used to the worry that they don’t realize it IS a worry. Or they are afraid to talk about it in front of a parent.  This is where counseling can be helpful so the child can explore and diffuse the anxiety.

Now don’t hesitate to call your doctor if your child is having a pounding heart with dizziness, fainting spells, or breathlessness.  There are medical conditions that need be checked.  If you can’t talk to your doctor and are concerned, you can go to the Emergency Department. But perhaps you can think back and figure it out before you get to that point. Kids have strong hearts, so strong that even though it’s probably not a heart problem, it feels like its going to beat right out of his chest!

 

 

23 thoughts on “Doc, My Kid’s Heart Is Beating Out His Chest!

  1. Can childrens zyrtec cause a fast hard pounding in toddler? My 2 year old is sick and everytime she coughs her heart feels like it is beating super fast and hard. Once she settles her heart slows back down. Her dr increased the dose of allergy meds while she is sick to 2.5 mils twice a day. I’m going to go back to once a day since her congestion cleared up and it’s just the coughing that seems to be lingering. Thanks in advance.

    • Zyrtec, also known by the generic name Cetirizine, typically does not cause fast heart rates. However, some preparations combine it with pseudoephedrine, which can cause fast heart rates. Also, many over-the-counter cold and cough remedies contain meds which can also speed heart rates. Thus we never recommend pseudoephedrine (a.k.a “pseudofed”), or any other cough and cold remedy, to infants and children. Science has not shown they help anyway.

  2. I suffer from a fib and high blood pressure. My 7 year old has watched / listened to my problems. Over the last couple of years she has frequently complained of her heart beating too fast or pounding. More recently she has complained of feeling dizzy. She takes Zyrtec daily for her allergies. When they flair up badly, she is given Benadryl. Her dizzy spells do not appear similar to mine. I have to stop, cannot hear anything going on around me and communication stops. My daughter is able to tell me she is dizzy while it’s happening. She has been having stress that she is internalizing. I am just wondering if she is trying to relate to me, or if this is a situation that needs medical attention? It is happening multiple times a week. Please advise.

    • As is stated at the intro to this blog, we cannot comment on individual children’s cases, as we have not seen them as a patient. This is something certainly to discuss with the child’s primary doctor, and discuss referral to a specialist if that does not seem satisfactory.

  3. Hi my 8 year old kid is been having chest pain not get said it feels like something is moving needs it comes n goes Dr gave him inhaler is not working.but I’m worried cause Dr say his ekg came a little abnormal just little that’s what Dr say.should I take him to cardiology.or be worried

    • As is stated at the intro to this blog, we cannot comment on individual children’s cases, as we have not seen them as patients.

  4. What have you noticed about skinny kids with no chest fat. Rest your hand over their heart and you can feel it through their chest!

    No palpitations No symptoms It’s a spooky thing to watch

    • Many kids, not just skinny kids “with no chest fat,” have heart beats you can feel through their chest. This is the majority of the time a normal thing. If the child is growing normally, active and playful and smiling, and breathing and eating normally, no worries!

  5. Hi my child is one year and a week old she has a cold right now but tonight while sleeping I put my hand on her chest and felt her heart was beating really hard and fast and like it was going to come out of her chest. Is this supposed to be normal.

    • This is a common worry from mom’s, but most often it is normal. Babies have thin chest walls, and strong hearts. Sometimes this can be exaggerated by fevers. Cough medicines can also cause fast heart beats that are more easily felt, and make babies jittery as well.

  6. Hi, When I was 6 mths pregnant, I was told my son would not survive due to his low heartbeat. When he was 2, and he got upset and thru a tantrum, then he got scared because he said his chest hurt and he touched his chest. He is typically a worry wart althought that wasn’t visible when he was a toddler. Now at 12 yrs old, he had an episode where he complained about chest pains and he was sweating, shortness of breath and I could see his heart pumping really fast out of his chest. I could literally see it for like 40 minutes. When we got thru the the ER, the EKG didn’t get to monitor much because while we waited, it subsided. What should I do?

    • As per our policy, we cannot comment on individual cases. You should see your child’s doctor about this, and discuss with him/her a referral to a specialist.

  7. Thank you Doc for the replies to others comments! I got my answer from that too! I appreciate you taking the time to answer us. I am sure you’re a busy person and it’s very kind of you to take time out for this.

  8. Hi, doc I need to chk with u as my daughter since the age of 6 months, as normal chk up for fever when I use to visit doc. She use to say that she’s got a increase in her heart beat and till now by the age of 8 yearit still increase in the hear neat, so is it normal

    • As per our policy, we cannot comment on individual cases. You should all your daughter’s doctor to discuss your concerns.

    • As per our policy, we cannot comment on individual cases. You should call your daughter’s doctor to discuss your concerns.

  9. Thank you for comments. I’m a health care professional so of course when my 7 year old boy tonight said his heart was racing out of his chest while he was doing nothing, I naturally thought the worst case scenarios then whittled my way down in my assessment. I figured if nothing else it’s PVCs however after reading the posts I see Zyrtec can sometimes cause this feeling and he’s been on since feb due to severe allergies that cause sinus infections when untreated too long. Not sure if this truly is the culprit however I’ll be weaning him off and replacing with a holistic alternative just to be safe. Thank you all for your posts and to the medical team responding to them.

  10. Hi Dr. Hamilton,
    In a 6-7 year old male patient who is of normal ht/wt (not small or large for age), takes Loratadine pill at bedtime, and tends to be mildly anxious (moderately at times from being high-functioning on spectrum, and a bit controlling):
    Could night sweats (severe as younger child but mildly improved) that vary from 2-5 days per week be related to cardiac issue; also,
    Normally has a very strong (forceful, bounding) heart felt through chest and seen in neck, but had 2 episodes of CP that caused tears, curling up, holding very still that lasted 5-20 mins AND requires very little increase in activity to cause heart to beat pretty fast and EXTREMELY hard on chest wall (1 ER ECG was sinus/wnl)… How much concern do you see in the above stated and which part, is it worth pursuing with PCP, and which direction would you recommend for only the s/s listed above (referral, what diagnostics, etc)?
    And THANK YOU FOR YOUR DEDICATION IN THIS FIELD AND ADDITIONAL TIME TO ADDRESSING EVERYONE’S CONCERNS HERE <3

    • As per our policy, we cannot comment on individual cases. As always, you should see your child’s primary care provider to answer these questions.

    • No, there is no indication that melatonin, a naturally occuring hormone, causes pounding heartbeat. The use of synthetic melatonin as a sleep aid has been increasing in recent years in kids. More important to get kids to sleep is a sleep routine- bedtime at the same time every night, rituals of bath, quiet talk with parents, then reading books (not screens!), then prayers, then lights out. There should be no TVs, computers, tablets, phones, or other screens in the child’s bedroom at all.

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