Is It a Heart Rhythm Problem? When to Call a Pediatric Cardiologist

As a parent, you instinctively pay attention to every cough, fever, and night waking, and that vigilance can be especially important when it comes to your child’s heart health. Most children have normal, healthy heart rhythms, but it’s possible to develop heart rhythm problems (arrhythmias) that require evaluation and care.

Understanding when a symptom could be a sign of a heart rhythm issue versus something benign can help you make informed decisions about seeking pediatric cardiology care, and we’re here to help.

Devyani Chowdhury, MD, MHA, and our team at Cardiology Care for Children specialize in diagnosing and treating heart rhythm problems in children of all ages in Lancaster, Mifflinburg, and Gordonville, Pennsylvania, and Shipshewana, Indiana. Here’s what you need to know about common symptoms of heart rhythm problems and when to call a pediatric cardiologist.

The basics of heart rhythm problems

Arrhythmia is the medical term for an irregular heartbeat or heart rhythm problem. It can mean the heart is beating too fast (tachycardia), too slow (bradycardia), or irregularly.

In a healthy heart, electrical signals coordinate each heartbeat, keeping the rhythm steady and efficient. When those signals misfire or travel along abnormal pathways, arrhythmias can develop. The type of arrhythmia depends on what part of the heart’s electrical system the issue comes from.

Some rhythm changes are harmless (like occasional extra beats) and may not require treatment. However, others can affect how well the heart pumps blood, and lead to symptoms that should be evaluated to protect your child’s overall well-being.

Signs of possible pediatric heart rhythm problems

It’s not always easy to tell if your child’s symptoms are related to their heart, but the following signs may be due to arrhythmia:

1. Palpitations or ‘fluttering’ sensations

If your child can talk, they may describe a pounding or racing heartbeat, sudden awareness of heartbeats, or a feeling that their heart is skipping beats. These sensations can signal rhythm problems, whether they occur during rest or activity.

2. Dizziness, lightheadedness, or fainting

Any episode of fainting — especially if it happens during physical activity, excitement, or emotional stress — warrants immediate evaluation. Dizziness or lightheadedness may accompany rhythm changes that temporarily compromise blood flow to your child’s brain.

3. Extreme fatigue or exercise intolerance

Children with heart rhythm problems may tire unusually quickly during play or exercise. If your child avoids activities they once enjoyed or becomes breathless and fatigued with minimal exertion, this could be a red flag.

4. Shortness of breath or chest discomfort

Chest pain in children can sometimes stem from musculoskeletal sources or anxiety. But heart rhythm issues that affect cardiac output can also cause discomfort or difficulty breathing, particularly with activity. If your child complains of chest pain, it’s important to take it seriously.

5. Slow or fast heart rates under observation

If you notice that your child has a resting heart rate that’s consistently below or above age-appropriate norms, it’s worth discussing with a cardiologist, especially if it comes with other symptoms.

When to call a pediatric cardiologist

You know your child best, and when something feels “off,” trust your instincts. Heart rhythm problems in children can present subtly or dramatically, so paying attention to patterns and triggers is key.

If your child experiences any of the above symptoms, a pediatric cardiologist like Dr. Chowdhury can help you determine the cause and find an appropriate path forward. We start with a thorough medical history and physical examination, focusing on the features of your child’s symptoms.

Diagnostic testing may include electrocardiogram (ECG) to record the electrical activity of the heart, echocardiogram to evaluate structure and function, or exercise stress testing to determine how your child’s heart responds to physical activity.

We may also do Holter or event monitoring, which involves wearing a device that records heart rhythms over hours or days to capture intermittent arrhythmias that don’t show up on a brief ECG. These tools allow us to identify rhythm disturbances accurately and determine whether they are benign or require intervention.

When to seek immediate medical attention

Some heart rhythm problems require urgent evaluation, especially if symptoms are sudden or severe. Call 911 or go to the nearest emergency room if your child has:

• Fainting with persistent symptoms or occurring during exercise
• Signs of shock (pale, cool, clammy skin; confusion; rapid breathing)
• Persistent chest pain
• Difficulty breathing
• Unresponsiveness or seizure-like activity

These symptoms could signal a serious rhythm disturbance, particularly when associated with a racing or irregular heartbeat, and prompt assessment is essential.

It’s normal to be worried if you suspect that your child may have a heart rhythm issue, but many causes are treatable. Contact our team today to book your first appointment and start getting the answers you need.