Heart Rate In Children: What Is Normal And What Is Not


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Imagine this.

A live band is playing your child’s favorite song. Just as he starts to enjoy it, they start to go off-rhythm! The beats are irregular – some are playing it too fast and some too slow.

Doesn’t sound good, right? So is the case with his heartbeat. There is a certain rhythm to it, which keeps the heart healthy enough to continue functioning. If the rhythm is irregular, the heart might beat too quickly or just skip a beat. Abnormal heart rate is not uncommon in children, but it can be a serious condition at times.

MomJunction tells you everything you need to know about heart rate in children – what is normal pulse rate and what is abnormal, i.e understanding arrhythmia and how to deal with it.

What Is The Normal Heart Rate In Children?

A child’s heart rate is different than that of an adult. Usually, the average heart rate of children is 60 beats per minute when they are resting, while it can go as high as 220 beats when they are active. Infants have a higher heart rate than children. The ‘normal’ average heart rate for children depends on their age group. Following are the average resting heart rates (pulse rates) for children of different age groups.

Age Average Resting Heart Rate ( Beats Per Minute)
3 to 4 between 80 and 120
5 to 6 between 75 and 115
7 to 9 between 70 and 110
10 years or more between 60 and 100

The heart rate varies from one child to another and depends on his or her age and their activity levels.

[ Read: Chest Infection In Children ]

Arrhythmia In Children

Is your child’s heart rate too fast or slow?

Change in the heart rate is normal. When your children are physically active, their heart rate is higher. And when they are resting, it is lower. In fact, the sleeping heart rate in a child can be much lower than the normal resting heart rate. Likewise, the child’s heart rate can increase considerably during strenuous exercises.

But when the heart’s rhythm or rate changes drastically without any physiological triggers, it is abnormal. This condition is called arrhythmia. It hampers the normal heart rate for kids. The kids with arrhythmia can experience variations in their heartbeat. Sometimes, they may experience a flutter in the heart, and then they may feel like their heart skipped a beat. That is arrhythmia (not love!).

Types of Arrhythmia

There are many types of arrhythmia that your child can develop. While most of these are non-threatening, some are serious conditions that need constant medical attention.

1. Tachycardia

Tachycardia in kids is a condition where the heart rate can go higher than 100 beats per minute. However, since the standard average heart beat in children is usually 100 or more, it may or may not be considered tachycardia depending on the child’s age.

Causes of tachycardia in children can include physiological changes, medications that the child may be taking, and any other form of arrhythmia. Sometimes, an underlying heart condition can also result in elevated heart rate in the child.

[ Read: Heart Murmur In Children ]

There are three known types of tachycardia (1).

Sinus tachycardia is the natural increase of the heart rate of the child. The sinus node, which is also known as the pacemaker of the heart, is responsible for sending out the electrical impulses in the body that make the heart’s muscles to expand and contract, thereby, creating a steady rhythm of the heartbeat.

The sinus node shoots faster impulses when the metabolic activity is high and slows down when the body is at rest (sleeping). So in most cases, sinus tachycardia is a natural phenomenon caused due to change in activity levels and this abnormality results in sinus arrhythmia in children.

Supraventricular tachycardia (SVT) happens when the heartbeat of the child is abnormally high, over 220 heart beats per minute. This is also the most common type of tachycardia in children. SVT can be a result of the heart defects like the Wolff-Parkinson-White Syndrome, congenital heart disease or Ebstein’s anomaly. It can be present in the child even before birth.

SVT involves both the lower and upper chambers of the heart and is not life-threatening in most cases.

Ventricular tachycardia in children is a condition when the fast heart rate in the child is triggered by the lower chambers or ventricles of the heart. Although uncommon, this type of tachycardia can be serious, and sometimes life-threatening, for kids.

Wolff-Parkinson-White Syndrome is the presence of an additional pathway in the heart’s electrical system, causing palpitations, dizziness, and shortness of breath. The doctor can treat this heartbeat disorder with medication. If that doesn’t work, he may recommend some tests and eliminate the pathway using a catheter or surgery.

[ Read: Ventricular Septal Defect In Children ]

2. Bradycardia

Bradycardia is the opposite of tachycardia. When the heart rate is too slow, say less than 50 beats per minute, the child is likely to have bradycardia. However, the doctor will consider the age and the activity levels and patterns of the child before diagnosing it as bradycardia.

Other heart rate problems in children include the complete heart block and sick sinus syndrome.

Symptoms Of Abnormal Heart Rate In Children

Arrhythmia can occur at any age and can be diagnosed through proper tests. The symptoms are few or none, which makes detecting it on your own a bit difficult. Signs and symptoms that you may see include (2):

  • Rapid or slow heartbeat
  • Dizziness
  • Weakness or tiredness
  • Palpitations
  • Pain in the chest

The heart needs to follow a certain rhythm to function properly for a long time. If it doesn’t, the biological processes can get disturbed and lead to potential health risks in the future.

[ Read: Congenital Heart Disease In Kids ]

Who Is At A Risk Of Developing Arrhythmia?

Arrhythmia is more common in children with congenital heart diseases, narrow heart valves, and other heart disorders.

People with sleep apnea, diabetes, and infections that can damage the sac or the muscles around the heart are also at the risk of arrhythmia.

Other things such as heart surgeries, medications or imbalance of certain chemicals, such as potassium in the body, can also lead to irregular heart rate in kids. (3).

When To Visit A Doctor?

More often than not, arrhythmia or abnormal heart rate is the result of a change in physical activity, making it a common occurrence in children. However, if your child’s heart rate is too fast or slow, regardless of the physical activity, and if it happens often, a medical check-up is necessary. Sometimes, erratic heart rate in children is the result of an underlying heart problem, which you should not neglect.

Arrhythmia Treatment

Abnormal heart rate in children can be treated using:

  • Medication
  • Cardiac catheterization with radio frequency energy application
  • Use of implant devices such as pacemakers and implantable cardioverter defibrillator
  • Cardioversion, which involves sending electrical shock or impulses to the heart, to convert the erratic heart beats into a proper rhythm
  • Surgery to treat atrial fibrillation

Doctors may also teach you how to increase or reduce the heart rate of the child to bring it to a normal range.

[ Read: Loss Of Appetite In Children ]

When And How To Check A Child’s Pulse Rate

Checking a child’s heart rate or pulse rate is usually not a need-to-know, but a good-to-know skill for parents. However, if your child has a medical condition that needs you to monitor his or her heart rate regularly, it is good to check the child’s pulse as ordered by the doctor or when your child:

  • Complains of his heart racing or experiences palpitations
  • Feels that the heart is skipping a beat
  • Has chest pain
  • Has trouble breathing suddenly (not caused by asthma)
  • Has the lips or skin turning pale gray or blue suddenly

An accurate reading of the pulse is essential to understand whether the child is experiencing tachycardia or bradycardia. We have explained the process of testing the pulse in easy steps below.

  1. The first step is to know the pulse points – or places where the artery is close to the skin. The neck and the wrist are the two places where the arteries are the closest to the skin. You can also check pulse behind the knees, on the top of the foot, in the groin, on the elbow when the hand is stretched, and at the temple, although not easily.
  1. The child should have been resting for at least 10 minutes before you check the pulse.
  1. Have the child extend his or her hand out with the palm facing up. Place the index finger and the middle finger together on the wrist, as shown in the image. You will feel a thumping against your finger.
check the pulse

Image: Shutterstock

  1. Use a clock or a timer to count the beats pulsing against your hand. Count the number of beats in 15 seconds.
  1. To get the pulse rate, multiply the number of beats recorded in 15 seconds by 4. For instance, if you’ve counted 20 beats in 15 seconds, the per-minute heart rate would be 100.

The thumb also has a pulse in some people, so avoid using it to check the pulse rate. Your doctor will also check for the quality or strength of the pulse, to see if it is regular or erratic.

Living With Arrhythmia

You may not always be able to prevent arrhythmia because it can also be genetic. In cases when it is not hereditary, maintaining heart health is the only way to avoid triggering tachycardia or bradycardia. If your child’s heart rate and rhythm are not normal, make sure that you:

  1. Go for check-ups regularly. Take the help of a professional to keep track of your child’s heart health.
  1. Check the child’s pulse rate regularly, as advised by the doctor.
  1. Give your child a healthy diet with low fat and cholesterol to maintain heart health.
  1. Help your child get adequate exercise, as well as rest, to keep the heart rate within the normal range.
  1. Stay informed about the developments in treatments or prevention techniques available for abnormal heart rate or rhythm.

Arrhythmia is a condition with few outward symptoms, which is why it is important to keep a record of the child’s heartbeat rate and rhythm regularly. Give your doctor regular and accurate reports about the child’s health and also report any new symptoms that you notice in the kid. In the case of heart problems, make sure that the child takes necessary medication and follows the necessary diet to prevent triggering arrhythmia.

Want to share something about heart rate in children and health? Tell us about it in the comments section.

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