Chest pain, edema, fainting and palpitations can all be symptoms of a heart condition.
Chest pain
Chest pain is more common among teens. Chest pain in children is not necessarily a sign of a serious problem. Chest pain can be related to anything from muscle strain to a lung infection or a gastrointestinal problem. Lots of structures in the chest can cause pain, like the ribs or the diaphragm. Chest pain can sometimes be caused by stress. It is rare for chest pain in children to be tied to a heart disorder.
Your child may experience chest pain along with one or more of the following:
- an irregular heart rhythm, such as the heart racing or skipping beats
- pounding in the chest
- fever
- sweating
- dizziness or passing out
- trouble breathing
While chest pain is an uncommon symptom of a cardiac problem, it is important to rule it out as a cause. To investigate chest pain, the doctor will take a patient history and do a physical examination. Sometimes more testing is needed, like a chest X-ray, an ECG, pulmonary function tests (PFTs) or breathing studies, or exercise tests. Based on the results, the doctor will decide how to proceed.
Edema
Edema is swelling caused by extra fluid in the body. It can be a symptom of a number of different problems, including:
- too much salt in the diet
- some drugs
- heart failure
- liver failure
Fluid that builds up in the lungs is called pulmonary edema. This is associated with increased blood flow and heart failure on the left side of the heart.
In heart failure, edema occurs when the right side of the heart is not strong enough to pump blood to the lungs, or the pulmonary valve or artery is too narrow and does not let enough blood pass through. Instead, the blood backs up into the body’s veins. Often the fluid collects in the liver or abdomen.
In babies and young children, edema is often noticed as swelling around the eyes first thing in the morning. In adults, it can also be noticed as swelling in the ankles.
To treat edema, doctors must first treat the condition causing the edema. Once that is done, changes to diet, restricting how much a child drinks, and using drugs that help remove extra fluid from the body (diuretics) can all help.
Fainting
Fainting is a brief loss of consciousness. It usually lasts just a few seconds or minutes. It happens when not enough oxygen reaches the brain or when there is a sudden drop in blood pressure. Fainting is also called syncope or "passing out."
Fainting is pretty common and is usually nothing to worry about. It can be caused by lots of things, like stress, exercising too hard, stretching, or standing up suddenly. Very rarely is it a sign of a heart disorder. Before it happens, there is a tendency for people to feel lightheaded or dizzy, and possibly sick to their stomach.
If your child is about to faint, get them to lie down or sit down with their head between their knees.
You should call the doctor if you think your child fainted in response to something, like a medicine or a condition. This is especially important if your child experiences any of the following:
- irregular heartbeat
- chest pain
- shortness of breath
- sudden fainting without warning
- blurred vision
- confusion
- trouble speaking
If you have a family history of fainting, have your child checked out, and call the doctor if your child faints more than once a month or the symptoms don’t go away. A thorough medical history and examination of your child is important.
Some tests that might be done to see whether the fainting is a sign of something serious include:
- blood tests to see if there’s low blood sugar or dehydration
- anelectrocardiogram
- a tilt table test
- the use of a Holter monitor
- an echocardiogram
Exercise-induced fainting is often an indicator of a heart condition.
When it is related to a heart disorder, fainting is usually caused by a blood obstruction resulting from a heart defect or an irregular heart rhythm, since the ventricles have less time to fill with blood. Fainting can also occur with heart problems like myocarditis (inflammation of the heart muscle caused by infection or another medical condition) because the heart muscle is not able to pump blood normally to all parts of the body.
Palpitations
A palpitation is a feeling or awareness of having a very rapid or unusual heartbeat. Palpitations can occur when the heart is working very hard, such as with exercise, fever, or anxiety. Sometimes palpitations happen along with other symptoms, like shortness of breath.
To determine the cause of the palpitations, the doctor will do a physical examination and perhaps one or more of the following: an ECGor an echocardiogram, a Holter monitor, and blood tests. Palpitations are treated by treating their underlying cause.