Strong Heartbeats in a 13-Year-Old: When to Seek Help

Increased heart contractions?

Hello, doctor.
My daughter is 13 years old, has a slim build, is 162 cm tall, and weighs 38 kg.
She has not yet entered puberty.
This month, she has occasionally experienced symptoms of her heart beating stronger (which I believe is palpitations).
When these symptoms occur, I can feel a noticeable heartbeat when touching her chest, while the rest of her body feels completely normal with no discomfort.
Her heart rate measures around 100 beats per minute.
After a while, the palpitations subside, and her heart rate remains between 90 and 100.
Since last summer, after entering junior high school, her homework has significantly increased, and she often stays up writing assignments until 11 or 12 at night.
However, her attitude towards her studies is relatively healthy, and she does not feel stressed.
She previously visited a family medicine clinic (which is quite well-known in Hsinchu), where the doctor measured her heart rate and blood pressure, determined that there were no issues, and did not prescribe any medication.
Since my daughter dislikes going to large hospitals, I am concerned and would like to ask if these palpitations are considered normal or if she needs to visit a larger hospital for further evaluation.
Thank you.

Mr. Wang, 50~59 year old female. Ask Date: 2019/03/07

Dr. He Dongjin reply Cardiology

Hello, based on your description, it seems to be normal.
You should just observe for now.
Changhua Hospital cares about you.

Reply Date: 2019/03/07

More Info

It's understandable to be concerned about your daughter's health, especially when it comes to symptoms like strong heartbeats or palpitations. At 13 years old, your daughter is still in a stage of development where her body is undergoing various changes, and it's not uncommon for adolescents to experience fluctuations in heart rate due to a variety of factors.

From your description, it seems that your daughter is experiencing episodes of palpitations, where she feels her heart beating strongly, sometimes reaching a heart rate of around 100 beats per minute. While this can be alarming, it's important to consider several factors that could contribute to this sensation:
1. Physical Activity: If your daughter is engaging in physical activities or exercise, her heart rate can naturally increase. Even if she feels fine otherwise, physical exertion can lead to temporary increases in heart rate.

2. Stress and Anxiety: Adolescence can be a stressful time, with increased academic pressures and social dynamics. Even if she appears to have a healthy attitude towards her studies, underlying stress can manifest as physical symptoms, including palpitations.

3. Caffeine and Diet: Consumption of caffeine (found in sodas, energy drinks, or even chocolate) can lead to increased heart rates. Additionally, dehydration or poor nutrition can also affect heart function.

4. Hormonal Changes: Although she hasn't entered puberty yet, hormonal fluctuations can still occur and may influence heart rate.

5. Underlying Medical Conditions: While less common, it's essential to rule out any underlying medical issues that could cause palpitations, such as anemia, thyroid problems, or heart conditions.

Given that your daughter has already been evaluated by a family physician who found no immediate concerns, it may be reassuring to know that many cases of palpitations in adolescents are benign. However, there are certain situations where it would be prudent to seek further evaluation:
- If the palpitations become more frequent or are accompanied by other symptoms such as dizziness, chest pain, shortness of breath, or fainting, it would be advisable to consult a pediatric cardiologist.

- If your daughter expresses anxiety about her symptoms or if they significantly impact her daily life, a referral to a mental health professional may also be beneficial.

- If you notice any changes in her overall health, such as fatigue, changes in appetite, or weight loss, these could warrant further investigation.

In terms of next steps, if the episodes of palpitations continue or worsen, it may be worth considering a visit to a pediatric cardiologist, even if it means going to a larger hospital. They can perform more specialized tests, such as an electrocardiogram (ECG) or a Holter monitor, to assess her heart's rhythm over a more extended period.

Lastly, it's essential to maintain open communication with your daughter about her feelings and experiences. Encouraging her to express any concerns she has about her health can help alleviate anxiety and ensure she feels supported during this time of change.

In conclusion, while occasional palpitations can be normal in adolescents, it's crucial to monitor the situation closely. If you have any doubts or if her symptoms change, seeking further medical advice is always a wise decision.

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