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Bradycardia (low heart rate) and Tachycardia (high heart rate)
The heart muscle cells are all able to contract together at the same time because of electrical signals that are quickly passed throughout the heart tissue. These signals start in cells in the top chambers of the heart before spreading to the bottom chambers. The group of cells that starts the heart rhythm for the whole heart is called the sinoatrial node (SA node). This node can be told to speed up or slow down by many signals from the body and other organs, including from the nervous system. The result can sometimes cause problems with body functioning.
Your Team:
A specialist in the study or treatment of heart diseases and heart abnormalities.
An interdisciplinary specialist who helps manage the medical, social and emotional challenges of complex and/or long-term care.
A specialist in evaluation, diagnosis, and management of patients with hereditary conditions.
A therapist who treats through the therapeutic use of everyday activities. They help patients develop, recover, improve, as well as maintain the skills needed for daily living and working.
A specialist whose aim is to improve the quality of life of their patients over the course of their illness regardless of stage, by relieving pain and other symptoms of that illness.
A specialist in the treatment of disease or injury by means of exercise to improve movement and manage pain.
A medical professional who practices general medicine.
Your child’s primary physician will monitor your child’s blood pressure and heart rate and watch for the development of cardiac abnormalities or concerns. A geneticist can aid in determining if an underlying genetic disorder could be affecting your child’s heart. A cardiologist can help diagnose and treat cardiac conditions, working closely with your primary physician and complex care team. Physical and occupational therapists will promote strength and exercise to keep the heart and the rest of the body healthy. Palliative care physicians can assist you in making difficult decisions around treatments or procedures and in communicating with other members of the team.
What Your Child May Experience
Reasons for lower heart rate in children with SNI
The heart rate may be slower than typical in children with SNI, if the different nervous system signals that tell the SA node to speed up or slow down are out of balance. A lower heart rate may also occur in children with SNI who have limited physical activity and when the body temperature is below 95° F, especially during sleep. When the body temperature is at 95° F, the heart rate can be lower by 7-12 beats per minute compared to when the body temperature is 98.6° F. During sleep, the heart rate can be lower by 10-15 beats per minute compared to when awake, lowest during a certain stage of sleep. The slow heart rate is often first noted during sleep when a home monitor is used, with the heart rate increasing once awake or rewarmed, indicating a normal response.
Hypothyroidism may contribute to a lower heart rate. Blood tests can assess thyroid function. Sometimes, multiple medications that can cause sedation and less activity can be a reason for a lower heart rate. The medical team can review all medications and determine if there is a medication dose to lower, especially if there is unclear benefit from a medication.
Lightheadedness, dizziness, tiredness, fainting or nearly fainting
Any new or acute change in your child’s responsiveness, energy level, and/or circulation / color in their extremities should be communicated with your medical team, as these could be signs that the heart rate is too slow and that further evaluation is needed.
No symptoms
Many times, a slower heart rate may not lead to any symptoms. Normal heart rate ranges may not apply to every child with SNI who may have a different baseline heart rate than typical children with more activity. Children who are not experiencing any symptoms associated with a lower heart rate, and who do not have any problems with the way that signals are sent to their heart, can often be observed by their medical team without need for treatment or intervention.
Reasons for a higher heart rate in children with SNI
New onset high heart rate in a child with changes in responsiveness or risk for dehydration requires acute medical assessment and treatment. Some children with SNI will have recurrent episodes that include a high heart rate and features of discomfort. The medical team will consider different causes, including chronic pain sources and autonomic dysfunction as reasons for these episodes. Management includes nonpharmacologic strategies, chronic medications, and medications that are used when there are breakthrough symptoms.
