Jackson As a parent, it can be hard to know when a child’s health complaint is a minor irritation or a sign of a serious problem. That’s especially true for heart issues. Heart issues are relatively rare in children but require immediate medical attention when they occur. We spoke with Matthew Elias, MD, a pediatric cardiologist at Children’s Hospital of Philadelphia (CHOP), to learn what symptoms could be signs of heart problems, when to see a pediatrician, and when a pediatrician might refer you to a pediatric heart specialist.

Chest pain

If your child complains of chest pain, you’ll likely worry something is wrong with your child’s heart. Worry is appropriate, but chest pain is actually quite common in growing children and usually not a cause for concern.

Most chest pain in children is actually not related to the heart. Often, pain is due to stretching or irritation of the muscles and bones in the chest, or there may be issues of asthma or reflux. But chest pain can sometimes be an indication for a serious heart problem, especially if it occurs with exercise and play. To rule out a serious problem, make an appointment with your child's primary care provider. Your family doctor will be able to determine whether your child should see a pediatric cardiologist for further evaluation and testing.

Heart palpitations

Palpitations are typically a sign of your child’s heart beating slightly faster or harder than usual, or there can sometimes be some extra heart beats from the upper or lower chambers of the heart. These issues are usually harmless and typically do not indicate a serious heart problem. That said, some children and young adults do experience irregular or rapid heart rates that are not normal, and if your child is experiencing palpitations, we recommend discussing with your child’s primary care provider.

Fainting (syncope)

Syncope is a medical term for fainting or passing out. A person faints when blood pressure drops and reduces the flow of blood to the brain.

It can be very frightening to everyone when a child loses consciousness. The child can also be hurt by falling when they faint. Fear and fall-risk aside, the majority of children and young adults who pass out don’t have a heart problem. In fact, dehydration is a more common cause of fainting in adolescents. However, all episodes of fainting must be addressed by a physician. Your child’s primary care provider will want to know the specifics of when and where the fainting happened, if your child had eaten that day, and if they were feeling sick or if they felt completely normal before passing out. It’s common for many doctors to order an electrocardiogram (ECG) for anyone who faints.

Heart murmurs

A normal heartbeat makes a “lub-dub” sound that can be heard through a stethoscope. This is the sound of the valves opening and closing to let blood into and out of the various chambers of the heart. A heart murmur is an extra sound after the valve closure sounds. Murmurs often make a swishing or whooshing noise and are caused by blood that’s flowing faster than normal through the heart. Pediatricians listen for murmurs when they examine a patient with a stethoscope during a routine physical exam.


Heart murmurs are very common and occur in most children during their growing years. Most are considered normal, or “innocent,” and don’t require any medical interventions. An abnormal heart murmur, though, may suggest a structural problem or heart defect, which requires further evaluation by a cardiologist.

Should your child see a cardiologist?

A few of the reasons your family doctor may recommended seeing a pediatric cardiologist include if:

  • The symptoms occur during physical activity.
  • Your child has had palpitations or chest pain during fainting spells.
  • A close family member developed heart disease or had sudden cardiac or unexplained death under the age of 50.
  • There is a family history of heart conditions that can be inherited, such as cardiomyopathy, long QT syndrome, Marfan syndrome, among others.

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