Our heartbeat has a rhythm to it. This rhythm keeps the heart healthy and functioning right. Sometimes, you may notice that a child's heartbeat is fast when they are sleeping, or that the rhythm may be irregular with the heartbeat being too fast or slow. Abnormal heart rate is not uncommon in children, but it can be a serious condition at times.

In this post, MomJunction tells you about heart rate in children, when it is normal and when abnormal, 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 their age and activity levels (1).

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 monitoring their heart rate regularly, it is good to check the child's pulse as ordered by the doctor. You also need to check the heartbeat when the child:

  • Complains of their 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 abnormalities in heart rates. 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 the 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).
  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 (2).

The thumb might also have 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.

Irregular Heartbeat (Arrhythmia) In Children

Change in the heart rate is normal. When your children are physically active, their heart rate is usually higher. And when they are resting, it could be lower. 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 or irregular heartbeat. This could indicate a heart problem or other underlying medical conditions. A fast heart rate might be accompanied by palpitations (noticeable sudden, rigid heartbeat), dizziness, and sometimes fainting (3).

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 (4):

  • 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.

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

This is a condition where the heart beats too fast. This condition could be normal or abnormal based on age and physical condition. A teenager is said to have tachycardia if the resting heart rate is higher than 90 beats per minute (5), whereas, tachycardia in kids is a condition where the heart rate can go higher than 100 beats per minute. However, since the standard average heartbeat 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 an elevated heart rate in the child.

There are three known types of tachycardia (5).

Sinus tachycardia is the natural increase in 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) is one of the most common types of tachycardia in children. SVT does not cause any life-threatening problems in most children and teens, and it does not bar children from having a normal childhood. However, if the tachycardia is frequent, then your doctor might prescribe medications to control it.

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 children. If you find that your child's heart skips a beat or is racing fast, or the child experiences lightheadedness, episodes of chest pain and fainting, then take them to the doctor (6).

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 might treat this heartbeat disorder with medication. If that doesn't work, they may recommend some tests and eliminate the pathway using a catheter or surgery.

2. Bradycardia

Bradycardia is the opposite of tachycardia. When the heart rate is too slow, say less than 60-50 beats per minute, the child is likely to have bradycardia (7). 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 (8).

Who Is At A Risk Of Developing Arrhythmia?

Arrhythmia is more common in children with congenital heart diseases, narrow heart valves, family history of arrhythmia and other heart disorders. In the case of teenagers, lifestyle habits such as alcohol consumption, smoking, and illegal drug usage can also cause Arrhythmias.

Medical conditions such as obesity, diabetes, sepsis, sleep apnea, etc. may also increase the risk of Arrhythmias.

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 children. (9).

When To Visit A Doctor?

Often, 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 could be treated by the following. The doctor will examine your child and prescribe the best possible treatment (9).

  • 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.

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.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

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Dr. Vikas Kohli is the director of the Delhi Child Heart Center. He graduated with 5 gold medals from the University College of Medical Sciences, New Delhi in 1986 and is certified by the American Board of Pediatrics. He completed his Pediatric Residency (US) at the Montefiore Medical Center, New York, and trained in Pediatric Cardiology at the University of... more

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has 3+ years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education made... more