Causes, diagnosis and treatment of sinus arrhythmia in children. Sinus arrhythmia in a child: causes, symptoms, treatment Sinus arrhythmia in a 12-year-old teenager

The child’s body is not yet strong enough to fully resist external and internal factors. Sinus arrhythmia in children is considered the most a common consequence their impact. The appearance is associated with disruption of the nervous and cardiovascular systems. In most cases, the resulting malfunction does not have a significant impact on health, but parents must take measures to prevent the occurrence of new attacks (paroxysms). They will have to take the baby to the doctor for an examination. The specialist will tell you what sinus arrhythmia is in children and, based on the diagnostic results, will conclude whether it is necessary to draw up a course of treatment, or whether it is enough to follow the rules of prevention.

Sinus arrhythmia that occurs in a child is a consequence of a malfunction of the natural pacemaker (sinus node). It arises due to the influence of various external and internal factors(stress, overwork, pathologies, endocrine disruptions). A cardiologist treats abnormal heartbeats.

Any parent can detect arrhythmia, knowing the heart rate norms by age:

Deviation from the norm by more than 20 beats per minute (up or down) is already considered a violation heart rate. The baby cannot fully express his discomfort, so it is advisable to show the child to the doctor.

Expert opinion

Evgeniy Olegovich Komarovsky is one of the best specialists in the field of pediatrics. In his opinion, mild forms of arrhythmia are characteristic of virtually all children. It is extremely difficult to meet a child who has never suffered from this problem. Treatment is prescribed by a doctor, based on the patient’s condition. If the case is not severe, then the specialist will strive to limit himself to lifestyle correction and folk remedies. Medicines and surgical intervention in the treatment regimen for children, they are used only as needed.

Types of failure

Sinus failure in the heart rhythm is divided into the following types according to the nature of its manifestation:

• tachycardia (rapid heartbeat);
• bradycardia (slow rhythm);
• extrasystole (extraordinary contraction).

Classifying the malfunction according to severity will help you understand what the sinus form of heart arrhythmia is in a child:

• A mild type of heartbeat disorder is a consequence of immaturity nervous system. It goes away on its own and is not considered dangerous.
• A moderate form of the malfunction occurs in children 5-6 years old. It has no special symptoms, so it is detected only with the help of an electrocardiogram (ECG).
• Severe sinus arrhythmia in a child occurs at 10-13 years of age. It manifests itself in fairly persistent paroxysms and a vivid clinical picture. Experts believe this type dangerous due to the likelihood of developing heart pathologies.

Non-hazardous forms of failure

Respiratory arrhythmia occurs in many children. It is characterized by increased heart rate when inhaling and slowing down when exhaling. A similar reflex reaction is checked during electrocardiography by placing the patient on a couch with a cold oilcloth on top. Because of its impact, the child instinctively holds his breath. In the presence of this form of arrhythmia, the heart rate will decrease slightly.

A respiratory type of heart rhythm disturbance occurs due to the immaturity of the nervous system. The frequency of attacks and their intensity depend on the age of the patient. This arrhythmia develops due to the influence of the following factors:

• postnatal (from birth to 1 week) encephalopathy;
• high level of pressure inside the skull;
• prematurity of the child;
• rickets, which provokes excessive stimulation of the nervous system;

• excess body weight causes tachyarrhythmia after exercise;
• active growth phase (6-10 years).

The severity of the failure depends on the cause of its occurrence. Often arrhythmia is provoked by the inability of the autonomic department to keep up with the active growth of the child. Over the years this problem eliminates itself.

The functional form is not as common as the respiratory form. It is not considered dangerous, and in most cases goes away without medical intervention. Arrhythmia occurs for the following reasons:

• endocrine disruptions;
• weakened immune defense;
• immature nervous system.

A functional failure caused by the following factors is more dangerous:

• diseases caused by infections (bacterial or viral);
• impaired functioning of the thyroid gland.

Dangerous failure modes

The organic form of arrhythmia is considered the most severe. It is characterized by prolonged paroxysms or a constant course. The sinus node continues to work, but due to a violation of the integrity of cardiomyocytes (heart cells) or failures in the conduction system, the heart rate (HR) jumps. The organic form develops under the influence of various diseases.

The incidence of dangerous forms of heart failure in children is 25-30% of total number. You can see the reasons for them in the list below:

Sports and sinus arrhythmia

Parents send many children to sports clubs, thanks to which the body strengthens and its full development becomes possible. When identifying sinus arrhythmia, it is important to find out its nature in order to understand what physical activity is acceptable for a child:

• Non-dangerous types of failure are not a contraindication to sports. It is enough for parents to show their baby to a cardiologist and conduct an electrocardiographic examination several times a year. The purpose of diagnosis is to monitor the development of arrhythmia. If it begins to turn into more dangerous varieties, then the process must be stopped in a timely manner.
• Dangerous forms of failure should be treated immediately when they occur. Permissible physical activity is determined by the attending physician, focusing on causative factor and the condition of the baby.

In most cases, arrhythmia manifests itself during physical activity due to hereditary predisposition. Children who play sports professionally should periodically consult a doctor and have an ECG done every 3-4 months. If respiratory arrhythmia is detected, the child may be allowed to compete, but if its form is more severe, then the issue of terminating the athlete’s career and reducing the physical activity received will be decided.

Diagnosis and treatment

To draw up a full course of therapy, the child should be shown to a cardiologist. The doctor will examine and prescribe necessary examinations. The main one among them is electrocardiography. It is performed in a standing and lying position, as well as with a load and during the day (daily monitoring).

An important indicator indicated on the electrocardiogram is electric axle heart (EOS). With its help, you can determine the location of the organ and assess its size and performance. The position can be normal, horizontal, vertical or shifted to the side. This nuance is influenced by various factors:

• With hypertension, a shift to the left or a horizontal position is observed.
• Lung diseases congenital type force the heart to move to the right.
• Thin people tend to have a vertical EOS, while fat people have a horizontal EOS.

During the examination, it is important to identify the presence of a sharp change in EOS, which may indicate the development serious failures in organism.
To obtain more accurate data, other diagnostic methods can be used:

• rheoencephalography;
• ultrasound examination of the heart;
• X-ray of the thoracic and cervical spine.

Based on the results obtained, a treatment regimen is drawn up. Functional and respiratory arrhythmia cannot be eliminated with medication. Doctors give advice on lifestyle changes. The main emphasis will be on the following points:

• rest.

Moderate arrhythmia can be stopped not only by lifestyle correction, but also sedatives(“Corvalol”, tinctures of hawthorn, mint, glod) and tranquilizers (“Oxazepam”, “Diazepam”). Drugs and their dosages are selected exclusively by the attending physician.

The pronounced variety is eliminated by correcting nutrition, rest and physical activity in combination with drug therapy. In advanced cases, as well as in the absence of results from treatment with tablets, surgical intervention is used.

To begin with, the specialist will have to cut Negative influence factor causing arrhythmia. The following measures will help with this:

• elimination of the underlying pathological process;
• treatment chronic infection;
• discontinuation of medications that cause heart rhythm disturbances.

Treatment regimens are supplemented with folk remedies and physiotherapeutic procedures. They are selected depending on the characteristics of the child’s body and the presence of other pathologies.

Drug treatment

For sinus arrhythmia, the following drugs are prescribed to stabilize heart rate:

• Drugs with arrhythmic effects (Digoxin, Adenosine, Bretilium) dilate blood vessels and normalize the heart rate.
• Improvement pills metabolic processes(“Inosine”, “Riboxin”) protect the myocardium from oxygen starvation, thereby eliminating arrhythmia.
• Preparations based on magnesium and potassium (Panangin, Orocamag) normalize electrolyte balance, regulate blood pressure and stimulate neuromuscular transmission.

Surgery

If drug treatment did not help eliminate severe arrhythmia, then the following types of minimally invasive surgical intervention are used:

• Radiofrequency ablation, the purpose of which is to cauterize the source of ectopic signal in the heart by passing a catheter through the femoral artery.
• Installation of an artificial pacemaker (pacemaker, defibrillator).

Physiotherapeutic procedures complement the treatment regimen well. Their list is given below:

• acupuncture;
• medicinal baths
• laser or magnetic therapy.

ethnoscience

Traditional medicines are prepared from plants with healing properties and have minimum quantity contraindications. Before using them, you should consult your doctor to avoid undesirable consequences. The most popular recipes are:

• 300 g dried apricots, 130 g raisins and walnuts It is necessary to grind thoroughly and mix with 150 ml of honey and lemon. This paste helps cleanse the blood and improve the functioning of the heart muscle. Use it in quantities of 1 to 2 tbsp. l., depending on age (up to 3 years, 15-20 ml, over four years, 45-60 ml).
• The daily diet must be filled with fruits. They can be cut into porridges, desserts and other dishes. Instead of a regular drink, it is recommended to drink Fresh Juice(apple, grape).
• Pour 30 g of dry lemon balm with a glass of boiling water and let it brew for half an hour. It is advisable to drink such tea with a sedative effect for at least 2 weeks.

• A decoction of valerian is prepared from the roots of the plant. They must be cleaned and filled with boiling water in a ratio of 30 g per 250 ml. Then put it on fire. After 10 minutes, remove from heat and let cool. Take a decoction with a pronounced sedative effect, 0.5 tbsp. l. It can also be added to the bath.
• Pour 30 g of rose hips into 1 cup of boiling water and add 20 ml of honey. The finished drink tones the nervous system and improves heart function.
• Adding celery and greens to salads will saturate the body useful substances, which will have a beneficial effect on the functioning of the heart and nervous system.

Preventive measures

Compliance with the rules of prevention will prevent attacks of arrhythmia and improve the overall well-being of the child. They can be found below:

• Compose proper diet nutrition, saturating it with herbs, vegetables, fruits and berries. It is recommended to cook by steaming or boiling. Take food in small portions, but 5-6 times a day, avoiding overeating. You should have dinner no later than 3-4 hours before bedtime.
• It’s better to forget about intense physical activity. The child needs more rest. Among sports, it is recommended to choose running or swimming, but initially you should limit yourself to morning exercises.

• Regardless of the season, the child should be outside more fresh air. It is recommended to reduce the amount of time on the computer and TV to a minimum.
• From stressful situations The child should be completely protected. Any experiences and conflicts can aggravate his condition.
• If complications occur, side effects and other problems - you need to consult your doctor. Using medications on your own is strictly prohibited.

Forecast

Non-dangerous forms of arrhythmia go away virtually without the participation of a doctor and do not provoke the development of complications. Organic species failure often leads to heart failure, asystole, atrial fibrillation and others dangerous consequence. Because of them, the child may become disabled or die. The prognosis will depend on the severity of the underlying pathological process and the effectiveness of the course of therapy. In advanced cases, surgical intervention is used.

The sinus form of arrhythmia occurs in every second baby. It rarely leads to complications and is virtually invisible. In most cases, such a failure is detected using an ECG. If it was caused by pathologies of the heart or other organs, then the course of therapy will be aimed at eliminating them. The treatment regimen will include medications, physiotherapeutic procedures and lifestyle adjustments. If there is no result, surgical intervention will be used. Milder cases of arrhythmia can be managed by reducing physical activity, avoiding stress and correct drafting diet.

Sinus arrhythmia in children is a manifestation of age-related changes in the body or a complication of any disease. According to research, it is diagnosed in childhood in 0.5% of cases.

The danger of arrhythmia is determined by the reasons for its occurrence and the nature of its manifestations. In most cases this state is only temporary, associated with the development and growth of the body. In others, it is a consequence of pathological processes in the heart and blood vessels.

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What is sinus arrhythmia?

The heart, like a pump, pumps blood throughout the body, pulsating at a certain frequency. This is possible due to electrical signals emanating from the pacemakers. Their main source is sinus rhythm. If for some reason the impulse is advanced or delayed, a failure of heart contractions is provoked.

The diagnosis of sinus arrhythmia in a child is made based on the results of electrocardiography. This condition is mainly caused by rapid growth and hormonal changes in organism. Only rarely is the cause due to some serious heart pathology.



Classification

Sinus arrhythmia is divided according to heart rate (HR) into 3 types:

• normal - the number of beats per minute is maintained;
• tachyarrhythmia - increases;
• bradyarrhythmia decreases.

By origin they are distinguished:

• hereditary;
• congenital;
• acquired.

Classification is also carried out according to severity:

1. 1. Moderate. It is a harmless form of arrhythmia with mild symptoms. In most cases, it is diagnosed during routine ECGs.
2. 2. Expressed. Accompanies pathologies of the heart and blood vessels, has obvious Clinical signs.

Sinus arrhythmia is divided into 2 types according to its manifestation:

• respiratory;
• non-respiratory.

The first type of arrhythmia is characterized by a reflex increase in heart rate during inhalation and a decrease during exhalation. Second form of violation sinus rhythm may be paroxysmal or constant. These types of arrhythmia are provoked by different reasons.

In order to determine if your child has a heart rhythm disorder, you can use the table with normal indicators Heart rate for different ages.

Age, years	Heart rate, beats per minute
First month of life	140
1 month - 1 year	135
1-2	125
2-5	115
6-8	105
8-10	88
10-12	80
12-15	75



Causes

Respiratory arrhythmia occurs due to the immaturity of the child’s nervous system. The younger he is, the more easily he may have seizures. Children at risk are:

• with postnatal encephalopathy;
• premature;
• with intracranial hypertension syndrome;
• with rickets, which changes the excitability of the nervous system;
• overweight;
• between the ages of 6 and 10 years, when rapid growth occurs and vegetative system does not have time to adapt to the body's requirements.

Once the autonomic nervous system has fully developed, attacks of respiratory sinus arrhythmia will disappear on their own.

Non-respiratory sinus arrhythmia manifests itself paroxysmally or is constant. It can occur several times a year or bother the child every day. This is caused by the fact that there are changes in the conduction system of the heart or its cells (cardiocytes) that lead to disruption correct rhythm. In most cases, this is not due to diseases, but to some pathological conditions.

In almost 30% of cases, sinus arrhythmia occurs against the background of cardiac changes. Main causes of the disease:

1. 1. Hereditary predisposition. 100% dependency transfer pathological condition from parents to children is not observed. But in most cases, sinus arrhythmia of non-respiratory origin also occurs in children if the parents were exposed to it.
2. 2. Infectious diseases leading to intoxication, dehydration or fever. Nerve impulses to heart contractions travel along muscle fibers. This process is highly dependent on the presence of potassium, chlorine and sodium in them. If any reasons lead to a change in the water-electrolyte balance, then a rhythm disturbance is provoked.
3. 3. Vegetovascular dystonia (neurocirculatory). If the ability of blood vessels to adequately change the lumen depending on the oxygen needs of tissues is impaired, arrhythmia may occur.
4. 4. Myocarditis. Inflammatory process in the cardiac muscle of a bacterial or viral nature causes sinus arrhythmia or other disorders (atrial fibrillation, heart block, extrasystole). Associated symptoms infectious lesions myocardium: dullness of heart sounds, pain in the heart area, fever, swelling, shortness of breath.
5. 5. Rheumatism is a disease that can cause endocarditis or myocarditis and affects the valvular apparatus of the heart. It is provoked by a previous sore throat. Accompanied by inflammation large joints, fever and heart pain.
6. 6. Congenital heart defects.
7. 7. Tumors.



Risk factors

Regardless of the type of sinus arrhythmia, the likelihood of its occurrence is higher during certain periods of a child’s life. This is due to physiological characteristics. Infants aged 4 to 8 months are more susceptible to the disease. Preschoolers - from 4 to 5 years old. Also, sinus arrhythmia often occurs in children aged 6 to 8 years and older than 12 years.

Arrhythmia and sports

Often, when a child who participates in sports is diagnosed with sinus arrhythmia, parents wonder about the appropriateness of sports in the life of their child. Most of all they are interested in whether physical activity is to blame for the development of pathology.

Without a physiological predisposition to the development of heart rhythm disturbances, even professional sports cannot provoke it in children. If the child had grounds for the appearance of sinus arrhythmia, then any physical activity can become an impetus for its development.

Regardless of the severity of the disease, sports are not contraindicated in case of respiratory arrhythmia. But the child must be periodically observed by a cardiologist; he needs constant monitoring and electrocardiographic examinations. This is necessary to prevent the development of more severe heart rhythm disturbances.

For children involved professional sports, shown mandatory examinations ECG once every three months and Holter monitoring. The decision on the advisability of physical activity for respiratory arrhythmia is determined by the doctor individually. If a child is diagnosed with a non-respiratory form of pathology, then he is strictly prohibited from playing sports.

Symptoms

The danger of this pathological condition is that it can occur without characteristic symptoms. But in some cases, the child still exhibits certain clinical signs.

In a newborn baby, sinus arrhythmia can be recognized by:

• constant crying at night and poor sleep;
• changes in skin color;
• noticeable shortness of breath;
• poor appetite;
• causeless worries.

In older children and teenagers, the following symptoms are possible:

• fainting conditions;
• poor tolerance to even minor physical activity;
• fast fatiguability;
• sensations of interruptions in the work of the heart.

If clinical signs are not observed, then sinus arrhythmia can be recognized by ECG readings. Tachycardia and bradycardia are distinguished by the RR interval, which decreases or lengthens respectively. Electrocardiograph readings normally show the presence of a P wave in front of the QRS complex, which represents electrical excitation. For myocardial contraction, impulses must travel from the atria to the ventricles. Their passage time is characterized by the length of the PQ interval.

Treatment

If sinus arrhythmia in children is caused by dysregulation of the autonomic nervous system, then they are not prescribed drug treatment. Dr. Komarovsky recommends preventive actions aimed at reducing the likelihood of seizures. To normalize the heart rate, the child needs:

• Healthy food;
• do exercises in the morning;
• be physically active;
• spend more time in the fresh air;
• avoid stressful situations and unnecessary emotional stress.

If a child has a non-respiratory arrhythmia with severe clinical symptoms, that is, there are two treatment options:

• medicinal;
• surgical.

First of all, actions are aimed at eliminating the factors that provoke heart rhythm disturbances:

• treat the underlying heart or vascular disease;
• remove foci of chronic infections;
• discontinue medications that negatively affect heart contractions.

Drug therapy consists of using a complex of medications:

1. 1. Antiarrhythmic to restore normal heart rate. The most effective: Novocainamide, Verapamil, Obzidan.
2. 2. Means for improving the metabolism of heart tissue: Cocarboxylase, Riboxin.
3. 3. Medicines to stabilize the balance of electrolytes: Panangin, Potassium Orotate, Asparkam.

If drug treatment does not work, then minimally invasive surgical techniques are used to restore normal heart rhythm. Using radiofrequency ablation, areas of excessive nerve impulses are eliminated. If it is ineffective, the child is implanted with a pacemaker, which normalizes the heart rhythm.

When children get sick it is always scary. Especially if the disease is related to the work of the heart.

Unfortunately, heart problems are also diagnosed in children. Typically, such violations are detected during routine medical examinations.

Parents are frightened by any violation of the child’s health, especially problems with the heart. What is sinus arrhythmia in children and adolescents? How dangerous is the disease?

Based on the results of electrocardiography, a violation of sinus rhythm is diagnosed - sinus arrhythmia. But let us immediately note that Most often this condition is associated with rapid growth and hormonal changes in the body and only occasionally indicates serious heart pathologies.

In any case, the baby should be examined by a doctor who, after additional research, determine the cause of the disease and choose the appropriate treatment tactics.

With sinus arrhythmia (that is, the number of heart beats per minute) may persist. The duration of the intervals between heart contractions is disrupted, that is, the rhythm is disrupted.

General description of the disease

The heart is a pump for pumping blood. Ripple occurs due to electrical impulses that travel along muscle fibers, causing them to contract. This is done automatically. If for some reason the impulse is formed with a delay or advance, a malfunction occurs in the heart rhythm.

Based on heart rate, there are three types of arrhythmias:

1. While maintaining the normal number of beats per minute.
2. With an increase in the number of contractions - tachyarrhythmia.
3. With a decrease in heart rate - bradyarrhythmia.

Sinus arrhythmia occurs as a result of changes in the conductivity of cardiac fibers, increased or decreased excitability, and failure of the automaticity of heart contractions.

The origin of the disease may be congenital, acquired or hereditary.

There are two degrees of severity:

1. Moderate sinus arrhythmia in a child. Characteristic of non-dangerous forms of arrhythmia. Mild or absent symptoms. It is usually detected accidentally during routine ECGs.
2. Expressed sinus arrhythmia in a child. Has obvious symptoms. Accompanies diseases of the heart and blood vessels.

Prevalence

Heart rhythm disturbance is not independent disease , rather a manifestation or complication of the disease or occurs as a temporary phenomenon during age-related changes in the body.

According to research by I.P. Minkov “ Modern methods diagnosis of problematic infections in children,” heart rhythm disturbances occur in 0.5% of children. In cardiac pathologies, arrhythmia is detected in 15–20% of cases.

Dangerous and non-hazardous forms

Depending on the cause, heart rhythm failure is classified as respiratory, functional or organic.

Respiratory

The respiratory form is considered the least dangerous type of disease. It is expressed in increased heart rate when inhaling and decreased when exhaling.

A common cause is the immaturity of the baby’s nervous system. Heart rhythm disturbance It goes away with age, but you need to see a doctor so as not to miss possible complications.

TO pathological reasons Respiratory sinus arrhythmia may include:

• increased intracranial pressure;
• non-inflammatory brain damage in infants which is caused oxygen starvation fetus during intrauterine development;
• immaturity child's body as a result of premature birth;
• metabolic disorders in the body, rickets.

Functional

Functional form less common than respiratory, but also rarely dangerous. The cause may be disturbances in the functioning of the nervous, immune, and endocrine systems. Occurs as a consequence of an infectious or viral disease or as a manifestation of thyroid disease.

After eliminating the cause, the arrhythmia goes away.

Organic

Organic form – most dangerous. Indicates pathological malfunctions in the impulse conducting system and other disturbances in the functioning of the heart.

This form is inherent pronounced symptoms arrhythmias. The condition requires immediate examination and long-term treatment.

Causes and risk factors

Arrhythmia is caused by cardiac dysfunction:

• Malfunctions in the system that conducts impulses. Violations may relate to the rate of formation and conduction of the impulse.
• Irregular structure of the heart. If abnormalities interfere with normal contraction of the heart muscle.
• Disorders of the autonomic nervous system.

Also heart rate abnormality may be one of the manifestations of the disease:

• inflammatory heart diseases;
• severe intoxication of the body (including drugs);
• neoplasms (benign or malignant tumors);
• severe cases of infectious or viral diseases;
• nervous tension and stress;
• disruptions during embryonic development;
• hereditary diseases;
• dehydration of the body;
• excessive physical activity, especially against the background of vitamin deficiency or general weakness.

Temporary disruptions in heart rhythm cause hormonal surges as a result of strong emotions.

In childhood and adolescence, several periods are distinguished: when the risk of arrhythmia is increased due to physiological characteristics:

• Infants from 4 to 8 months;
• children preschool age from 4 to 5 years;
• junior schoolchildren from 6 to 8 years old;
• teenagers from 12 years old.

During these periods, it is better to conduct an ECG (electrocardiography) and visit a cardiologist. You can read about it in a separate article.

Main symptoms

In mild cases of arrhythmia there are no pronounced manifestations. The situation is complicated by the fact that children younger age can’t articulate what’s bothering them. Rhythm disturbances are detected by a cardiologist during examination or during an ECG.

Symptoms that should alert parents:

• Repeated loss of consciousness.
• Poor sleep for a long time. The baby often wakes up crying.
• Against any background physical activity(crawling, walking, lifting, etc.) shortness of breath occurs.
• The child often cries for no apparent reason.
• Increased sweating.
• Decreased appetite or complete refusal to eat.
• Blueness of the nasolabial triangle, nail plates, feet against the background of general pallor of the skin.
• Behavioral disorder. Restlessness or lethargy.

Older children may complain of:

• feeling of weakness, lethargy, loss of strength;
• discomfort in the heart area (interruptions);
• sensations of compression in the heart area, chest pain;
• dizziness;
• cardiopalmus;
• deterioration after physical activity.

Diagnostic measures

The very first method for diagnosing cardiac disorders is electrocardiography.

For getting reliable results It is important to perform the ECG procedure correctly. If the little patient is uncomfortable, scared, or ran around before the test, then the cardiogram will show an abnormal heart rhythm. But in this case, the arrhythmia is caused by natural disruptions in breathing due to nervousness.

Therefore, the child needs to be adjusted to the procedure and the most comfortable conditions created.

In addition, additional research methods are used:

• . The study is carried out using ultrasound.
• Daily ECG. Long-term continuous recording of a cardiogram throughout the day or longer period time.
• Stress test. Recording an ECG during exercise.
• Orthostatic test. Determination of certain indicators (pressure, pulse rate and others) when moving from a lying position to a standing position and vice versa.
• Electrophysiological study. A method in which parts of the heart are stimulated and the results are recorded. In this case, electrodes are inserted directly into the heart.
• Analyzes. Hormonal indicators are carried out and examined.

Most often, an ECG is performed with different load options. An example of what sinus arrhythmia looks like on an ECG in a child:

In addition to the main one they use differential diagnosis . This is a research method in which diseases that do not meet certain criteria are excluded until the only correct diagnosis is identified.

There are computer programs that, based on a number of data, can create a list possible diseases patient. And the doctor has already made a diagnosis.

Therapy tactics

If the results of the cardiogram reveal a violation, need to visit a cardiologist. Additional examinations will be prescribed to help determine the cause, form and severity of the pathology. Only after this is treatment prescribed.

Arrhythmias respiratory type In most cases, they do not require treatment and go away on their own. But they require medical supervision.

Functional heart rhythm disorders disappear after eliminating the cause of the disease.

Organic arrhythmia needs long term complex treatment, as it is caused by cardiac pathology. Treatment tactics are selected individually.

Treatment for any type of arrhythmia includes organization correct mode day, healthy varied diet(mainly plant and dairy foods), gentle regimen, massages (especially neck massage).

You can’t feed your baby before bedtime; you need to avoid foods with caffeine, avoid obesity, and reduce your time at the computer.

Intensity permissible physical activity determined in each case individually. It is usually useful to do swimming, gymnastics, and hiking. Children with arrhythmia should not be nervous or overtired.

General treatment plan:

• The basis of therapy is antiarrhythmic drugs, which normalize heart rhythm and relieve unpleasant symptoms. For example, Aymalin, Anaprilin, Verapamil and others.
• Painkillers.
• Sedatives.
• Complexes of vitamins and minerals.

The medicine is selected by the doctor. It is strictly forbidden to give heart medications to children without medical advice.

In severe cases, the child should be under medical supervision. May be required surgery for installation of a pacemaker.

Prognosis and possible complications

In most cases, the arrhythmia goes away on its own, with no further consequences. In severe cases, heart failure may develop. The child is assigned a disability.

The most terrible complications are asystole(cessation of heart contractions) and fibrillation(a condition in which different parts of the heart fibers contract differently - flutter). The result is death.

Learn more about heart rhythm disturbances in children, as well as the syndrome of which this may be a symptom, from the video:

Prevention

The best preventative measure is healthy lifestyle. The baby should have a daily routine, sufficient quantity sleep, full balanced diet, absence of stressful situations and excessive loads.

No need to miss routine examinations at doctors. At the slightest suspicion, contact a cardiologist. If there are diseases that can cause arrhythmia, or a hereditary predisposition, monitor the condition and see a doctor.

Sinus arrhythmia in children and adolescents is most often caused by hormonal changes and rapid growth. As you grow older, it goes away on its own. But it requires constant medical supervision and a comprehensive examination.

To rule out cardiac pathologies or serious illnesses, a symptom of which may be arrhythmia. Treatment tactics and prognosis depend on the type of heart rhythm disorder and the reasons that caused the failure.

Heart problems occur at any age, and children are not immune from them. Often, parents are faced with the fact that during an appointment with a doctor, sinus arrhythmia is detected in their child, which requires additional research tests and the prescription of specific therapy.

Many parents are frightened by this diagnosis, which raises a lot of questions. But with the right approach to treatment, in most cases it is possible not only to stop all manifestations of the disease, but also to avoid its dangerous complications.

Definition of concepts

The term “sinus arrhythmia” refers to various types of cardiac disorders that manifest themselves in changes in the sequence, regularity and frequency of heart contractions. They can occur at any age, but the most dangerous periods The intervals between 4–5, 7–8, 12–14 years are considered, which require the most careful attention from parents and specialists.

One of the features of childhood, even among healthy children, is the occurrence of transient heart rhythm disturbances. And it will depend only on the specialists whether the child will need additional examination and prescribing appropriate treatment. That is why an official decision was made to include consultations in the childhood medical examination plan pediatric cardiologist and ECG screening.

General characteristics of the disease

The full functioning of the heart is represented by regular contractions triggered by the pacemaker, which is represented by the sinus node. The intervals between these contractions should normally be the same. When this interval is violated, we speak of sinus arrhythmia. The heart rate suffers and may change towards a decrease (bradyarrhythmia or bradycardia) or an increase (tachyarrhythmia).

With the functional form of arrhythmia, they always talk about a favorable outcome. In most cases, it only requires regular monitoring by specialists to exclude progression or development of complications. At timely diagnosis and competent therapy can cope with all manifestations of arrhythmia and prevent adverse consequences.

Clinical forms of the disease

Sinus arrhythmias are usually divided into 3 large groups:

1. . They do not provoke cardiac dysfunction, therefore they are considered harmless to children's health. Directly related to respiratory function, when the heart rate increases during inhalation and decreases during exhalation, even in a quiet position. They arise due to the immaturity of the nervous system.
2. Functional. They are less common compared to the previous form. Often they are not associated with serious cardiac pathology, but arise as a result of interruptions in the functioning of other organs and systems.
3. Organic. Directly related to organic pathology in the conduction system and cardiac muscle. They are characterized by persistent heart rhythm disturbances of a constant nature, which negatively affects the general well-being of the sick child. They require urgent clarification of the underlying cause and proper therapy.

In addition to the listed forms, it is also customary to divide arrhythmias into moderate and severe. In childhood, the first, more easy option, which is characterized by minimal symptoms and rarely requires serious therapy.

Severe sinus arrhythmia most often occurs in adults, but can also occur in children. It is characterized by vivid symptoms and often accompanies diseases such as cardiosclerosis and rheumatism. Ventricular (or atrial) flutter may also occur. atrial fibrillation, .

About risk factors

In childhood, there are many reasons for the occurrence of arrhythmias. Compared to adults, children do not have sufficiently mature immune and nervous systems. Several years must pass before the leading pacemaker, represented by the sinus node, begins to correctly generate electrical impulses for the full contraction of the heart chambers.

All causes that can provoke the development of sinus arrhythmias in childhood can be divided into 2 large groups.

Important! In some cases, it is customary to talk about mixed forms of arrhythmia, when there is a pronounced combination of organic damage and disorders neurohumoral regulation. We should not forget about the functional nature of arrhythmias, when they arise as a natural response of the child’s body to intense stress, hot weather, and so on.

Not the least role in the development of sinus arrhythmias is played by such a significant factor as heredity. Among the risk factors for sinus arrhythmias, it is customary to distinguish frequent infectious and viral diseases, intoxication, increased body temperature to high numbers.

Description of symptoms

Almost half of all arrhythmias in children are determined by chance during dispensary observation or during examination due to other diseases.

In other cases, the following nonspecific symptoms allow one to suspect arrhythmia:

1. Infancy: paroxysmal shortness of breath, cyanosis skin or pallor, lethargy, abrupt refusal from eating, sleep disturbance, slight weight gain, pulsation of blood vessels in the neck, increased sweating, bluish tint of lips and nails; the child may cry frequently and become restless;
2. Older age: excessive fatigue, severe intolerance to physical activity, interruptions in heart rhythm, fainting, drops in blood pressure, dizziness.

Sometimes complete heart block (), which is characterized by severe pallor or bluishness of the skin, a rare heartbeat (about 30 beats per minute or less), convulsions, and loss of consciousness, may occur. Most often it appears at night.

Diagnostic methods

When examining children with suspected sinus arrhythmia, the very first sign is an increase in heart rate or a decrease in heart rate compared to age norm. There is insufficient pulse and irregular heartbeat.

An external inspection is carried out chest area, clarification of the medical history. An electrocardiogram, which is taken while lying down, standing and after physical activity, shows a rhythm disturbance. When performing an ultrasound of the heart, its location in the vertical plane is often noted.

If necessary, carried out daily monitoring. Hidden conduction and rhythm disturbances make it possible to identify indicators of stress tests in the form of a treadmill test and bicycle ergometry. With their help, resistance to physical stress is determined and a forecast is made regarding the further course of arrhythmias.

Special tests using atropine or potassium (potassium obsidanoic acid) help to identify arrhythmias. If there is a suspicion of a relationship between the disease and the pathology of the central nervous system, rheoencephalography, radiography of the spine in cervical spine, EEG, a consultation is scheduled with pediatric neurologist. Laboratory tests often indicate elevated cardiac enzymes in the case of organic pathology.

Therapeutic measures

To prescribe competent therapy when diagnosing sinus arrhythmia, it is first necessary to establish correct form diseases. If respiratory sinus arrhythmia or functional arrhythmia is detected, no therapy will most often be required.

But it is necessary to exclude the possibility of organic disorders and pay attention to the organization of the child’s activities and rest. You should set aside time for both regular physical activity and good sleep. If an organic form of arrhythmia is detected, conservative therapy or surgical intervention will be required.

It is necessary to act in stages:

1. Eliminate factors that provoke rhythm disturbances: sanitize foci of chronic infection (treat caries, perform adenotomy, tonsillectomy, etc.), discontinue medications that affect the rhythm, prescribe treatment for rheumatism if it is detected, and so on;
2. Carry out conservative pharmacotherapy:
   • normalize electrolyte balance (magnesium and potassium supplements);
   • use antiarrhythmic drugs (Propranolol);
   • speed up heart metabolism (Riboxin, Cocarboxylase).

Important! Ineffective drug therapy means that cryoablation in the area of ​​pathological areas or radiofrequency ablation, implantation of a cardioverter-defibrillator or pacemaker is required.

To obtain maximum results in the overall complex therapeutic treatment often included. Most often, herbal decoctions are used for these purposes, which have beneficial influence on cardiovascular system. These could be viburnum berries or dill seeds.

In the first case, it is enough to brew the berries with boiling water and leave to steep until they cool completely. It is necessary to take the prepared decoction in the morning and evening, 2/3 cup. In the second case, pour boiling water (one glass) over the dill seeds (1/3 cup). Take 1 tsp. in the morning and before meals during lunch.

Complications and prognosis

Functional arrhythmias rarely provoke the development of complications. In the organic form of the disease, the occurrence of fainting, chaotic contractions of the heart muscle and the development of ischemia of brain tissue are dangerous. Sometimes heart failure develops sharply, which can threaten the child’s life. Third degree blockades and combined forms diseases.

Atrial fibrillation increases the risk of heart failure. And with moderate sinus arrhythmia or the functional nature of the disease, the prognosis is most often favorable. The course of arrhythmias in childhood is always determined by the reasons that provoked it and the possibility of eliminating them. The degree of hemodynamic disorders also matters.

Prevention measures

As preventive measures For sinus arrhythmias in childhood, experts recommend eliminating predisposing factors, treating the underlying pathology, and be sure to undergo follow-up examinations with a cardiologist.

Other preventive measures include:

• establishing an optimal daily routine with adequate sleep;
• application balanced diet with sufficient content plant food, rich in magnesium and potassium; it is necessary to limit fatty, fried and floury foods;
• exclusion of stressful situations;
• Frequent walks and avoidance of overwork and fatigue are useful;
• strengthening immunity;
• regular visits to the pediatrician.

Important! It is necessary to define the boundaries of possible loads and include daily training in the child’s life in the form hiking, swimming or exercise. They will promote a healthy lifestyle and strengthen immune system. For teenagers, eliminating bad habits will be important.

Sports life with arrhythmia

In case of arrhythmias, sports sections are not prohibited for children. The child can study various types sports But before choosing a specific type, you will need to determine the form of the disease. For respiratory arrhythmia special contraindications will not, but regular visits to a cardiologist and a cardiogram are recommended. This will prevent the development of possible complications.

In the organic form, it will be necessary to limit physical activity depending on the cause that led to the arrhythmia. Weights, anaerobic exercise, and wrestling will be contraindicated. Swimming and yoga will bring certain benefits. A pediatric cardiologist will help you choose the number of classes, their type and duration.

Sinus arrhythmias in children occur in all age groups and require careful attention from parents and specialists. In this regard, the medical examination plan in childhood includes consultations with a pediatric cardiologist and an ECG.

From parents, this diagnosis requires an attentive attitude towards their child and compliance with all the instructions of the attending physician. Only in this case can it be prevented further development disease with the help of appropriate therapy and stop its manifestations. Every parent should understand that the future of their child, who still has a lot to do in life, directly depends on the health of the heart.

in children, it is a fairly common disease characterized by cardiac arrhythmia. For the most part, this disease does not cause discomfort to the child and does not affect his well-being in any way. But this does not mean at all that you can give up on the disease.

How to treat sinus arrhythmia?

For the most part, sinus arrhythmia does not require treatment. However, in some cases, medical intervention is necessary only to ensure that the disease does not develop complications and develop into a more serious pathology.

Today there are several main types of treatment:

However, before introducing certain restrictions into a child’s life, you need to think seriously and consult with a doctor: perhaps arrhythmia is a temporary phenomenon, and it will go away as the baby grows up.

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How can arrhythmia be dangerous?

Untreated arrhythmia in a child does not always go away completely without a trace. In some cases, it may not manifest itself in any way until a certain moment, but over time it will lead to quite serious consequences, such as:

• thrombosis;
• risk of developing myocardial infarction;
• stroke.

All these factors will not make themselves felt immediately, but only after many years. However, it is definitely worth thinking about these consequences if the child has just become aware of them. Its symptoms manifest themselves almost immediately, which allows the parent to quickly take appropriate measures:

1. The child complains of a lack of air and is haunted by a feeling of suffocation. For minor physical activity The baby may begin to experience shortness of breath, regardless of how intense the exercises were.
2. With arrhythmia, there may be discomfort in the area of ​​the heart. Rapid heartbeat can occur without any reason, and sometimes, on the contrary, it will seem that it is freezing.
3. Dizziness, frequent headaches. Unpleasant symptoms may occur when sudden movements: raising the head, lifting, jumping or tense muscles. Most parents mistakenly attribute these symptoms to pressure surges, thereby giving the disease the opportunity to progress.

Having noticed changes in a child’s behavior and well-being, you should question him in detail, asking him to indicate all the disturbing symptoms.

Having collected the complete clinical picture, you can safely contact your doctor for additional advice. At the same time, it is important to remember that for children this is not a death sentence, but only temporary difficulties, which, with the right approach, can be easily eliminated without causing any consequences.