My Daughter's Test Results

She does have a small PFO confirmed by echo with bubble study, we have been advised to consider having this closed prior to her having children (early 20s).

June Ekg results (read by a pediatric cardiologist)

Vent rate 67 BPM

PR interval 130 ms

QRS duratin 84 ms

QT/QTc 416/439 ms

P-R-T axes 257 73 64

Analysis:  Irregular left atrial rhythm, clinical correlation is necessary.  Compared to Ekg from 01/09/03, significant difference.  Unsure about lead placement vs. true ectopic atrial rhythm.

I don't know what any of this means.

She then underwent a 24-hr holter which was interpretted by an adult cardiologist (pediatric cardiologist in our area was out of the country):

The quality of this recording was very good.

There was sinus rhythm noted.

There was intermittent sustained and nonsustained junctional rhythm noted.

Atrial ectopic activity consisted of rare APCs.  There were no episodes of SVT, atrial fibrillation or atrial flutter.

There was intermittent sinus bradycardia with a minimum heart rate of 48 BPM.

There were no episodes of AV block or sinus arrest.

There was intermittent sinus arrhythmia.

There was intermittent sinus tachycardia with a maximum heart rate of 169 BPM.

Ventricular ectopic activity consisted of 7 PVCs.  There were no ventricular couplets or episodes of ventricular tachycardia.

There were no significant ST segment or T wave changes documented.

Documented symptoms correlate at times with junctional rhythm, PACs (at times bigeminal), and sinus arrhythmia.

Narrative Summary:

Monitoring started at 10:00 AM and continued for 23 hr 59 min.  The average heart rate was 84 BPM.  The minimum heart rate was 48 BPM, occuring at 9:24:53 AM.  The maximum heart rate was 169 BPM, occuring at 11:25:53 AM.

Ventricular ectopic activity consisted of 7 beats, of which, 7 were in single PVCs.

The patient's rhythm included episodes of both sustained and nonsustained junctional rhythm.

The patient's rhythm included 40 min 22 sec of bradycardia.  The slowest single episode of bradycardia occurred at 9:24:45 AM, lasting 23 sec, with minimum heart rate of 48 BPM.

The patient's rhythm included 1 hr 37 min 14 sec of tachycardia.  The fastest single episode of tachycardia accurred at 11:25:31 AM, lasting 1 min 55 sec, with maximum heart rate of 169 BPM.

Supraventricular ectopic activity consisted of 508 beats, of which, 1 was late beat, 364 were single PACs, 106 were in bigeminy, 37 were in trigeminy.  The longest R-R interval was 1.3 seconds occurring at 9:24:50 AM.  The longest N-N interval was 1.3 seconds occurring at 9:24:50 AM.

She is currently on a 30-day holter event monitor.  Symptoms she has complained about for several years are heart pounding, racing, weak spells - all of which we have ignored telling her that everyone feels this way sometimes because she had a normal echo and Ekg 3 to 4 years ago after being diagnosed with PSRA.  She has never fainted, but now and then has "weak" spells where she gets very pale and she drops down saying she can't walk and she is very tired.

Are above test results normal for a 13-yr old girl.  Maternal side no heart problems, paternal side numerous heart problems - father-in-law has an internal diffibrilator due to sudden death that he survived due to quick EMS response and use of external diffibrilators within 5 minutes of collapse).

Any thoughts?

Thank you for taking the time to reply.  My daughter, Katie, going through the recent heart testing is my youngest of three girls.  My family is typically very healthy and we never go to the doctor's office except for Katie.  It seems like since she was born there has always been something going on with her.  She gets migraines when she is involved in a lot of physical activity, the weak spells come and go, her palpatations are strong enough to wake her up in the middle of the night.  She gets chest pains while doing physical activity and when she is just sitting quietly.

She has terrible anxiety and has been on Buspar for a couple of years now.

I'll be glad when the 30-day monitor is done and hopefully we'll find out for certain whether her arrhythmias are innocent or not.

I guess I wish I'd pushed for the same pediatric cardiologist to read all of her tests when her pediatrician heard the murmur he was concerned about at the beginning of the summer, hind-sight is 20/20.

Her echo and ekg in 2003 were read by a pediatric cardiologist and were both normal.

Her echo and ekg in June 2006 were read by the same pediatric cardiologist from 2003, echo indicated the possible PFO and ekg was abnormal so he recommended a bubble study and 24-hr holter.

Her bubble study was read by an adult cardiologist (because the pediatric cardiologist from our area was out of the country) and the PFO was confirmed.

Her 24-hr holter was read by a different adult cardiologist than the one who read the bubble study and he considered the 24-hr readings normal.

She was then referred to a pediatric cardiologist from Riley (Indianapolis).  When she saw him a new ekg was performed and he said that he didn't see any problems with it and that he thought the murmur was probably innocent.

I told him that I'm concerned about her intermittent symptoms so he ordered the 30-day monitor.  When I transmit via phone the highest I've seen Katie's heart rate was 238 and the lowest was 50 - I guess that would make me feel pretty strange sometimes too!!

I just don't want something overlooked by so many tests being read by so many doctors.

Again, thanks for taking the time to reply.