I've looked and looked, scoured the internet but I really am not finding much on what is considered a normal QTc in an 11-year-old girl. Do the values differ for children versus adults?
My 11-year-old daughter was referred for a second opinion regarding a QTc of 430 (hr was 76). Like I said she is 11 and she has started her period if that makes a difference. She is very athletic and plays basketball 4-5 times a week.
Symptoms that prompted the EKG were dizziness and lightheadedness during and immediately after sports, while shopping and one time during class. She also had two episodes of chest pain during class last week (these were a few days after the EKG). The chest pain was underneath her right breast. She went to the nurse and the nurse sent her back to class with an ice pack which Brooke did not use and said it just went away on its own.
During these episodes she is usually very sweaty (but again usually while playing sports) and her face gets really flushed.
Anyone have any input? I am a nervous wreck over this to the point that I now sit and watch every minute of basketball practice to make sure she is okay. Brooke don't want anyone on her team or her coach to know about this because she is afraid she will be benched. Poor kid!!!
Lisa
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What is a normal QTc in a child?
- By BrookesMom
- Posted October 16, 2009 at 2:13 pm · 5 replies
- In Help desk
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- By kizzie
- Posted October 18, 2009 at 6:44 am
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Lisa,
The normal QTc interval varies from 350 to 450 milliseconds. About 95% of people have a value between 380 and 440 seconds, which is the range doctors generally consider as the ‘normal’ range.
I personally would get a second opinion as your daughter is young and participates in quite a bit of sport. QTc of 430 ms is at the upper end. You need her to see an cardiologist who specialises in rhythm problems (electrophysiologist). Don't be brushed off lightly, she needs a 24 hour ECG monitor with specific monitoring of the QT interval, an echocardiogram and a cardiac MRI. Also an exercise test under supervision may be worthwhile too.
These are routinely requested in the UK in instances where there are concerns with QT intervals.
Hope this helps, please try not to worry too much.
Regards
Kizzie x
- By BrookesMom
- Posted October 18, 2009 at 9:01 am
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She is seeing a Pediatric Cardiologist on Oct. 27. I was told they would review her EKG and order another EKG at the time of that visit and go from there as to what other tests they will order.
They also said should there be any concern for long QT that she would see the Electrophysiologist that works with their Cardiology group.
I really hope the send her home with a 24 hour Holter monitor and order an exercise stress test. I think that would give them a better look at what is going on.
Our appointment is October 27 and hopefully they can get as much testing done that day as possible. This doctor is a 2 hour drive away for us.
- By kizzie
- Posted October 19, 2009 at 7:56 am
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I would advise you to take a list of questions and your concerns with you. I always find that I forget things until afterwards then regret not having asked everything I wanted to. Remember you know your child better than anyone else does. Hopefully they will do as many as the investigations on the day as possible. Gather as much family medical history as you can. The 24 hour tape is a really important, hopefully they can catch an episode while it is on! Keep perservering and don't give in easily. I work in a cardiology department in our local NHS hospital. The C.R.Y site and the SADS sites in the UK are very helpful, check them out. On the C.R.Y. site in the "My Story" section is a tribute to our daughter "Chloe Lauren Leach".
Keep smiling
regards
Kizzie x
- By Timbo
- Posted October 20, 2009 at 5:49 am
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I agree with Kizzie about making sure you take along a list of questions. What may also prove usefull is to keep a diary of any episodes Brooke has, giving an accurate description of her activity levels before symptoms began and what she looked like before, during and after the event, not just what she felt like.
From experience I know that if it is written down it is harder for it to be ignored and you tend not to leave anything out. Any detail, no matter how small may be significant. If the doctor pays no attention to your experience then find another doctor.
Don't get to bogged down with the QTc numbers though. They change all the time in the majority of people and in many cases can appear in the normal range most of the time and only get extreme under certain conditions. The shape of the waves on the ECG are far more significant to the experts than the numbers.
Be prepared for the 'long haul' and don't get tied into the idea that it can only be one particular diagnosis. There are lots of heart conditions that can cause similar symptoms but have very different causes. That is what often makes an accurate diagnosis very difficult for the physicians.
I learnt all this the hard way when my daughter began fainting at the age of 13. Like Brooke my Becky was exceptionally fit (competitive swimming) but unlike Brooke she never had an episode during or after exercise. Becky also stopped breathing on several occasions but by the time medical attention arrived all her stats appeared normal. ECGs showed a high but within the normal range of QTc and her blood preasure and oxygen saturation appeared normal. A 72 hour Holter test caught no episodes and simply showed a very fit and normal heart.
Soon after her 15th birthday she had yet another episode and was seen by a cardiologist who suspected that it may be LQT even though she did not fit any of the normall diagnostic criteria i.e. not exercise associated, no family history of sudden death, QTc within normal etc. practically the only thing he had to go on was that people on my wifes side had much longer than average life spans. (some research has shown that the LQT gene gives a longer than agerage life span which is the upside of the gene) (every cloud has a silver lining as they say)
She was kept in overnight and had an episode while hooked up to a monitor but even that was not conclusive but another three events where her heart was recorded at over 300BPM were enough for her to have an ICD implanted and LQT2 was confirmed much later via genetic testing. She is now paced at 70BPM to prevent her heart rate dropping too low and has not had another episode. For her the ICD is a friend that keeps her alive and makes her feel safer than any of her 'normal' friends. She knows that if she had another episode the ICD would keep her alive.
She has just recently had her 18th Birthday, is still swimming and works part-time as a swimming teacher and pool lifeguard while she is at 6th form college with a very active social life as well.
This link http://news.bbc.co.uk/1/hi/england/nottinghamshire/6307377.stm
should take you through to an Item that was done by the local TV station 6 months after she had her ICD. Though things may look dark at the moment there can be light at the end of the tunnel.
- By BrookesMom
- Posted October 20, 2009 at 6:37 am
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Very interesting about the longer lifespan. Brooke has a great-great grandmother who is alive and really quite active at the age of 97. Her other great-great grandmother died at age 85 with breast cancer which they opted not to treat because of her severe Alzheimers. Her great-grandparents are alive and extremely healthy and active for their ages of 73 and 75. No signs of health problems whatsoever. Her grandparents are ages 55 and 59. Grandma is perfectly healthy but Pap has a severe degenerative neurologic disorder that has yet to be diagnosed.
All of these grandparents, great-grandparents and great-great grandparents are on my side of the family.
On Brooke's dad's side of the family none of the grandparents lived even close to seeing 70. In fact grandfather died in his 50s of heart disease. Both grandparents were extremely heavy smokers and grandmother died with heart disease and emphysema.
Interesting information about the life span.
Lisa
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