Red Flags & When to Go In Person for Palpitations in Children

Audience: pediatric

Palpitations are feelings that a child's heart is pounding, fluttering, or beating irregularly. These sensations are common and often harmless, especially when related to activity, stress, or excitement. However, in some cases, palpitations may signal an underlying heart condition or other health issues. Telemedicine can help evaluate many cases by discussing symptoms, medical history, and risk factors. Yet, certain warning signs require urgent in-person evaluation to ensure safety and proper care. Knowing when to seek immediate or routine in-person care is important for parents and caregivers. This guide explains red flags to watch for, what telemedicine can and cannot manage, how to prepare for a tele-visit, and what steps typically follow. Always prioritize a child's safety by acting promptly when serious symptoms appear.

Red flags — go in person / ER

• Chest pain or pressure lasting more than a few minutes — seek emergency care immediately.
• Fainting, dizziness, or near-fainting episodes with palpitations — go to emergency services.
• Difficulty breathing or bluish lips/face during palpitations — call emergency services without delay.

What telemedicine can do

• Initial evaluation of mild palpitations without severe symptoms.
• Review of symptom history and risk factors.
• Providing advice on symptom monitoring and lifestyle adjustments.
• Determining the need for in-person evaluation or tests.

What telemedicine cannot do

• Physical examination including heart and lung assessment.
• Performing diagnostic tests like ECG, blood tests, or imaging.
• Managing emergencies such as chest pain, fainting, or severe breathing difficulty.
• Diagnosing or treating serious heart rhythm disorders or structural heart problems.

What Are Palpitations in Children?

Palpitations are sensations where a child feels their heart beating too fast, skipping beats, fluttering, or pounding. These feelings may last seconds to minutes and can happen during rest or activity. Common causes include stress, fever, dehydration, caffeine, or vigorous play. Most palpitations in children are not dangerous and resolve on their own. However, some palpitations may be signs of heart rhythm problems or other medical conditions that need attention.

When to Use Telemedicine for Palpitations

Telemedicine can be a helpful first step to discuss your child's palpitations with a healthcare provider. Through video or phone visits, the provider can ask about symptoms, medical history, family history, and other factors. They may guide you on monitoring and managing mild palpitations and decide if further testing or in-person care is needed. Telemedicine is convenient and reduces exposure to illnesses, but it cannot replace physical exams or urgent tests when serious symptoms are present.

Red Flags That Require Immediate In-Person Care

Seek emergency care if your child with palpitations experiences:

These signs may indicate serious heart problems or other emergencies needing urgent evaluation.

When to Schedule a Routine In-Person Visit

Arrange an in-person visit if your child has:

A healthcare provider can perform a physical exam, heart tests like ECG, and other assessments to find the cause.

Preparing for a Telemedicine Visit

Before your tele-visit:

This preparation helps the provider understand your child's condition better.

After the Telemedicine Visit: What to Expect

After your tele-visit, the provider may:

Follow the provider's advice closely and schedule follow-up visits as recommended to keep your child safe.

How to prepare for your tele-visit

• Write down when palpitations occur and how long they last.
• Note any other symptoms like chest pain, dizziness, or shortness of breath.
• List your child's medications and medical history.
• Find a quiet, well-lit place with good internet connection for the tele-visit.
• Prepare questions or concerns to discuss with the healthcare provider.

After your tele-visit

• Monitor and record any new or worsening symptoms as advised.
• Follow lifestyle recommendations such as hydration and avoiding stimulants.
• Schedule and attend any recommended in-person visits or tests.
• Seek emergency care if red flag symptoms develop.
• Keep in touch with your healthcare provider for follow-up and guidance.

FAQs

What causes palpitations in children?

Palpitations in children can be caused by many things including stress, fever, dehydration, caffeine intake, vigorous activity, or sometimes heart rhythm problems. Most are harmless, but persistent or severe palpitations should be evaluated by a healthcare provider.

Can telemedicine diagnose heart problems causing palpitations?

Telemedicine can help assess your child's symptoms and decide if further testing is needed, but it cannot perform physical exams or diagnostic tests like ECGs. In-person visits are often necessary for diagnosis.

When should I take my child to the emergency room for palpitations?

Go to the emergency room immediately if your child has palpitations with chest pain, fainting, severe dizziness, difficulty breathing, or bluish lips or face. These may be signs of serious heart issues.

How can I help my child during palpitations?

Encourage your child to rest and stay calm. Make sure they are hydrated and avoid caffeine or stimulants. Keep track of symptoms and share this information with your healthcare provider.

Are palpitations common in children?

Yes, palpitations are quite common in children and are often not serious. They frequently occur with excitement, exercise, or stress and usually resolve without treatment.

Sources

1. Palpitations in Children — MedlinePlus | U.S. National Library of Medicine / National Institutes of Health.
2. Heart Palpitations — Mayo Clinic.
3. When to Seek Emergency Care for Heart Symptoms — Centers for Disease Control and Prevention (CDC).
4. Pediatric Arrhythmias — American Academy of Pediatrics (AAP).

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for in-person medical evaluation, diagnosis, or treatment. If your child has serious or worsening symptoms, seek emergency or in-person care promptly.