When a child exerts themselves during sporting activities, it is common for them to experience their heart racing. Parents are often alarmed when their kids clutch their hearts after a sprint or complain that their hearts are beating too fast while at a sports event. But in most cases, it is not as serious as it sounds, believes cardiologist Dr Pankaj Bajpai.
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“In my experience, most such episodes are harmless. But there are specific things parents should check before deciding whether it needs a doctor’s attention,” he shared with HT Lifestyle. The list of things to be checked is presented as follows.
Check 1: Did the racing heart build up gradually, or did it switch on suddenly?
A heart rate that climbs gradually during play and settles within a few minutes of rest is normal – it signals that the heart is working harder to meet the increased oxygen demand.
“What should worry parents is a sudden, unprovoked switch – the child says their heart suddenly started ‘racing’ or ‘pounding’ almost instantly, without a gradual build-up,” cautioned the cardiologist.
“If this is paired with dizziness, chest pain, sudden paleness, or breathlessness that seems out of proportion, it can mean arrhythmia – an electrical rhythm disturbance. This needs a cardiac evaluation,” he shared.
Check 2: Did the fainting happen while playing, or while standing around?
Fainting is often a cause for more serious concern. But even that depends on the circumstances surrounding the event, pointed out Dr Bajpai.
According to him, fainting after standing too long in assembly, or after standing up too quickly, is usually a benign drop in blood pressure.
However, fainting during active play or sport – at the peak of exertion, not while resting – is different.
“It can mean the heart’s rhythm has become unstable under strain, or, less commonly, point to a structural issue such as a thickened heart muscle (hypertrophic cardiomyopathy) or an abnormal coronary artery origin, which often only shows up when the heart is pushed hard,” he stated.
If this happens, Dr Bajpai suggested stopping further sports immediately and getting the child evaluated before they return to play.
Check 3: What tests actually confirm whether it is a cardiac issue?
If a child experiences a sudden racing heart or faints during exertion, Dr Bajpai suggested parents consult a cardiologist with a detailed history – when the episode happened, how long it lasted, and what the child felt.
It is usually followed by a resting ECG or echocardiogram to rule out structural issues, and for episodes that come and go, an exercise stress test that reproduces the trigger under medical supervision.
“Not every child needs all of these, but once red flags appear, this is the sequence to work through,” noted the cardiologist.
Check 4: Has the family history been flagged to the doctor?
When going for a medical check-up, parents should proactively share family history, stressed Dr Bajpai. This includes any unexplained sudden death in a first-degree relative before age 50, congenital heart disease, a relative needing a heart transplant, or conditions like long QT syndrome or Marfan syndrome.
“These are often left out simply because parents don’t know they’re relevant,” he noted.
“My advice to parents is simple,” shared the cardiologist. “Don’t self-diagnose based on how frightening an episode looked. Run through these checks, write down what triggered it and what the child felt, and get a cardiac opinion rather than waiting for it to happen again.”
Caught early, he assured that most cardiac causes of these symptoms in children are entirely manageable – but they need to be identified first.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
Dr Pankaj Bajpai is the Associate Director of Clinical and Preventive Cardiology, Paediatric Cardiology, and Cardiac Care at Medanta, Gurugram. He has over 28 years of clinical experience.
