zoey holding hearts on string Most people think of heart problems as conditions that only affect adults, but kids can have heart problems, too. While most heart symptoms — such as chest pains and palpitations — are usually harmless, there are times when these common concerns should be evaluated by a pediatrician or a pediatric cardiologist. Here, we explain when it may be time to make an appointment.

Heart murmurs

A normal heartbeat makes a “lub-dub” sound that can be heard through a stethoscope. This sound is the closing of the valves that let blood into and out 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.

Heart murmurs are very common and can occur in 1 out of 4 children during their growing years. And 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?

Your child’s pediatrician can evaluate many characteristics of the heart murmur to help determine whether it’s normal or abnormal. She can also determine whether or not additional evaluation by a pediatric cardiologist is required.

If your child is referred to a specialist, he may undergo common screening tests including an electrocardiogram (ECG). An ECG will look at the heart rhythm to see if there are any abnormal electrical patterns. Your child may also receive an echocardiogram, which is a targeted ultrasound of the heart to look for structural abnormalities.

Chest pains and palpitations

Understandably, if your child complains of chest pain or an irregular heartbeat, you’ll likely worry there is something wrong with his heart. Rest assured that chest pains and palpitations are common in growing children and usually are not cause for concern.

Most chest pains are caused by stretching or an irritation of the muscles and bones in the chest. Palpitations are typically a sign of your child’s heart beating slightly faster than usual, or occasionally some extra heart beats from the upper or lower chambers of the heart. All of these are usually harmless and do not indicate a more serious heart problem.

Should your child see a cardiologist?

While chest pain and palpitations are usually harmless, that doesn’t mean you should ignore these heart symptoms. To rule out anything more serious, make an appointment with your child's pediatrician. Your family doctor will be able to determine whether or not your child should visit a pediatric cardiologist for further evaluation and testing.

Some of the factors that determine whether or not chest pains indicate an underlying problem are how frequently they occur, if they happen during exercise, and if there is a family history of heart disease.

Fainting (Syncope)

Syncope is a medical term for fainting or passing out. A person faints when the brain isn’t getting enough blood pressure.

When a child loses consciousness, it can be very frightening to family members and friends. Additionally, injuries can occur when someone faints.

While the majority of children and young adults who pass out don’t have a heart problem, all episodes of fainting must be addressed by a physician. Your child’s pediatrician will want to know the specifics of when and where the fainting happened, if your child had eaten that day, if she was sick, and if she felt normal before passing out. Most doctors will also order an ECG for anyone who faints.

Should your child see a cardiologist?

You should make an appointment with a pediatric cardiologist if:

  • There is a family history of fainting or heart disease
  • Anyone in your family needed a pacemaker
  • Your child has palpitations or chest pains during fainting spells
  • Your child is passing out frequently during physical activity