Concerns About Rapid Heart Rate and Chest Pain in Active Teenagers - Cardiology

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It's understandable to be concerned about your son's health, especially given his active lifestyle and the symptoms he's experiencing. Rapid heart rate (tachycardia) and chest pain during intense physical activity can be alarming, and it's important to address these symptoms appropriately.

Firstly, it's worth noting that during vigorous exercise, it's normal for the heart rate to increase significantly. In a healthy teenager, heart rates can rise to 180 beats per minute or more during intense activities like basketball. However, if your son is experiencing chest pain and a sensation of not being able to catch his breath, this could indicate that something more serious might be occurring.

The fact that he has previously undergone an electrocardiogram (ECG) and was told everything was normal is reassuring, but it's essential to consider the context of his symptoms. If the rapid heart rate and chest pain are recurring, especially if they last for an extended period (like the two hours you mentioned), it would be prudent to seek further evaluation. Symptoms like these can sometimes be associated with conditions such as exercise-induced asthma, anxiety, or even cardiac issues like arrhythmias, especially if there is a family history of heart disease.

In teenagers, anxiety can also manifest physically, leading to symptoms such as palpitations and chest discomfort. If your son has a history of anxiety, this could be a contributing factor. However, it’s crucial to rule out any potential cardiac issues first.
Given the recurrence of his symptoms, I would recommend that you consult with a pediatric cardiologist or a healthcare provider specializing in adolescent medicine. They may suggest further testing, such as a Holter monitor (which records the heart's activity over 24 hours) or an exercise stress test, to observe how his heart responds to physical exertion. These tests can provide more insight into whether his symptoms are related to a benign condition or something that requires treatment.

In terms of immediate danger, while it's unlikely that he is in acute danger if he has been cleared by a doctor previously, it is essential to take his symptoms seriously. If he experiences severe chest pain, shortness of breath, or fainting, you should seek emergency medical attention immediately.

In the meantime, encourage your son to listen to his body. If he feels unwell during exercise, he should stop and rest. Staying hydrated, managing stress, and ensuring he has a balanced diet can also help support his overall health and potentially mitigate some symptoms.

In summary, while it’s possible that your son’s symptoms could be related to normal physiological responses to exercise or anxiety, the recurrence and nature of his symptoms warrant further investigation. It’s always better to err on the side of caution when it comes to heart health, especially in an active teenager.