Children may describe palpitations as a racing heart, pounding, fluttering, “beeping,” or a feeling that the heart skipped a beat. Most childhood palpitations are not caused by dangerous heart disease, but the child’s age, activity, symptoms and family history help determine when further evaluation is important.
Heart palpitations are fairly common in children and adolescents, and many episodes are caused by normal increases in heart rate, stress, exercise, fever, dehydration, caffeine, medicines or occasional premature beats. A child’s normal heart rate also changes with age, so an infant normally has a faster pulse than a teenager. Palpitations deserve more urgent attention when they occur with fainting, near-fainting, chest pain, unexplained shortness of breath, collapse or during exercise, particularly when there is known heart disease or a family history of sudden unexplained death or an inherited rhythm condition.
When a Child’s Palpitations Need Urgent Attention
Seek urgent or emergency medical care if a child has palpitations together with:
- fainting or loss of consciousness;
- collapse;
- severe shortness of breath;
- significant chest pain or pressure;
- severe dizziness or near-fainting;
- blue or gray lips or skin;
- a sustained very rapid heartbeat while the child appears seriously unwell;
- confusion, extreme lethargy or signs of poor circulation;
- an unexplained seizure-like episode associated with exercise; or
- rapidly worsening symptoms.
Palpitations associated with fainting during exercise are particularly important and should not be dismissed as dehydration or anxiety without appropriate medical evaluation.
What Do Heart Palpitations Feel Like to a Child?
Adults often use terms such as fluttering or skipped beats, but children may not have the vocabulary to explain the sensation clearly.
A child may say:
- “my heart is racing”;
- “my heart is beating really hard”;
- “my chest is jumping”;
- “my heart skipped”;
- “my heart is beeping”;
- “something is fluttering in my chest”; or
- simply that the chest feels strange.
Some younger children may point to the chest without being able to describe the feeling at all.
A child can feel a pounding heartbeat during a normal sinus rhythm, during fever or exercise, from a premature beat or during a genuine arrhythmia. An ECG or rhythm monitor is sometimes needed to know which one is occurring.
A Child’s Normal Heart Rate Is Not the Same as an Adult’s
One of the most important things for parents to understand is that normal heart rate changes substantially with age.
Babies normally have much faster heart rates than school-age children, while adolescents gradually approach adult resting rates.
A child’s pulse also changes naturally with:
- exercise;
- sleep;
- crying;
- excitement;
- fear;
- pain;
- fever; and
- hydration status.
Do Not Use an Adult Heart-Rate Cutoff for a Young Child
A pulse that would seem very fast in an adult may be normal for an infant, particularly during crying or activity.
The child’s age, whether they are awake or sleeping, what they were doing at the time and whether the rhythm is sustained or symptomatic are all important when interpreting heart rate.
Some Irregular Heartbeats Are Normal in Children
Parents may become concerned when a child’s pulse seems to speed up and slow down while breathing.
This may represent respiratory sinus arrhythmia, a normal pattern in which the heartbeat speeds slightly during inhalation and slows during exhalation.
Despite the word “arrhythmia,” this is a normal physiological variation and is especially common in healthy children.
What about skipped beats?
Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) can also occur in otherwise healthy children.
A premature beat may be followed by a brief pause and then a stronger heartbeat, which can create the sensation that the heart “skipped.”
Occasional premature beats are often benign, although frequent or symptomatic premature beats may need additional evaluation.
What Commonly Causes Heart Palpitations in Children?
Exercise and physical activity
Running and playing normally increase the heart rate because muscles need more oxygen.
The heart should gradually slow during recovery. A sudden racing heartbeat that continues unexpectedly after exercise deserves more attention.
Stress, fear and excitement
Adrenaline increases heart rate when children are frightened, excited, nervous or emotionally stressed.
Older children and teenagers may describe the resulting heartbeat as pounding or racing.
Fever
Fever commonly increases heart rate. A child with an infection may therefore notice a faster heartbeat along with fatigue, coughing, sore throat or other illness symptoms.
Dehydration
Poor fluid intake, vomiting, diarrhea, heavy exercise or hot weather can reduce circulating fluid volume and increase heart rate.
Caffeine and energy drinks
Coffee, strong tea, colas, pre-workout products and energy drinks can cause a faster or more noticeable heartbeat, particularly in adolescents.
Nicotine and vaping
Nicotine stimulates the cardiovascular system. Cigarettes, vaping devices and other nicotine products may cause a faster pulse or palpitations in adolescents.
Cold, allergy and asthma medicines
Decongestants and some bronchodilator medicines can increase heart rate or make the heartbeat more noticeable.
Do not stop a prescribed medicine without discussing it with the child’s healthcare professional.
Anemia
When the blood carries less oxygen than normal, the heart may beat faster to compensate. Fatigue, weakness, pallor, dizziness or breathlessness may occur as well.
Thyroid disease
Excess thyroid hormone can increase heart rate and occasionally contribute to rhythm disturbances, although thyroid disease is a less common cause of childhood palpitations.
Poor physical conditioning
A child who is not accustomed to physical activity may notice a fast heartbeat and breathlessness sooner during exertion than a well-conditioned child.
Can Children Have Real Heart Arrhythmias?
Yes. Children can develop abnormal fast, slow or irregular heart rhythms, although most childhood palpitation complaints do not turn out to represent a dangerous rhythm disorder.
Supraventricular tachycardia (SVT)
SVT is the most common clinically important abnormal fast rhythm in infants and children.
In older children, an SVT episode may feel like:
- a heartbeat that suddenly begins racing;
- a very fast but often regular rhythm;
- pounding in the chest;
- dizziness;
- shortness of breath;
- chest discomfort; or
- fatigue.
A useful clue is that SVT often begins and ends abruptly rather than gradually speeding up and slowing down like the heart usually does with exercise.
Depending on the child’s age, episode frequency and type of SVT, treatment may include observation, medication or catheter ablation. Children with diagnosed SVT may also be taught age-appropriate vagal maneuvers by their pediatric cardiology team.
Wolff-Parkinson-White syndrome
Some children are born with an additional electrical pathway in the heart. Wolff-Parkinson-White syndrome can allow episodes of rapid tachycardia.
Long QT syndrome
Long QT syndrome is an electrical disorder that can predispose a child to potentially serious ventricular arrhythmias.
Fainting during exercise, swimming, emotional stress or sudden startling can sometimes be an important clue, particularly when there is a family history of sudden unexplained death.
Ventricular tachycardia
Ventricular tachycardia is uncommon in children but can be serious. A child with a sustained rapid rhythm and collapse, fainting or signs of poor circulation needs emergency medical attention.
Are Heart Palpitations During Exercise More Concerning in Children?
A fast heartbeat during exercise is normally expected.
More concerning features include:
- a sudden racing rhythm that feels different from normal exertion;
- palpitations followed by fainting or near-fainting;
- exercise-related chest pain or pressure;
- unexplained excessive shortness of breath;
- a substantial unexplained decline in exercise ability;
- palpitations continuing unusually long after activity stops; or
- a concerning family history.
Fainting During Exercise Is an Important Red Flag
Fainting after standing for a long time or after seeing blood is often vasovagal in adolescents.
Fainting during active exercise — particularly when preceded by palpitations or chest pain — deserves cardiovascular evaluation before strenuous competitive activity is resumed.
For general information about exercise-related symptoms, see heart palpitations after exercise .
Why Family History Matters in a Child With Palpitations
Family history can provide important clues to inherited electrical or structural heart conditions.
Tell your child’s healthcare professional about:
- unexplained sudden death in a relative at a young age;
- unexpected drowning or unexplained single-vehicle crashes in relatives;
- hypertrophic or other inherited cardiomyopathy;
- long QT syndrome;
- Brugada syndrome;
- catecholaminergic polymorphic ventricular tachycardia;
- other known inherited rhythm disorders;
- a close relative with an implantable defibrillator; or
- a pacemaker implanted unusually early in life.
A Concerning Family History Does Not Mean the Child Has the Same Disease
It means the threshold for cardiovascular evaluation may be lower, particularly when the child also has exercise-related palpitations, fainting, unexplained breathlessness or chest pain.
How Can You Recognize a Fast Heart Rhythm in a Baby?
Babies cannot tell parents that their heart is racing, so an arrhythmia may present differently.
Possible signs during a prolonged episode can include:
- unusual fussiness or irritability;
- poor feeding;
- stopping frequently during feeding;
- rapid breathing;
- excessive sweating, particularly during feeds;
- vomiting;
- pale appearance;
- unusual sleepiness;
- reduced activity; or
- signs of poor circulation when the episode is severe.
SVT is an important arrhythmia in infancy, and a prolonged untreated episode can eventually affect the baby’s ability to feed and maintain adequate circulation.
A Sick-Looking Infant With a Very Fast Heartbeat Needs Medical Assessment
Seek urgent care if a baby with a suspected very fast rhythm has difficulty breathing, poor feeding, marked lethargy, pale or blue-gray coloring, reduced responsiveness or signs of poor circulation.
What Should Parents Record When a Child Reports Palpitations?
If the child otherwise appears well, keeping a simple symptom log can make the medical visit much more useful.
Record:
- the child’s age;
- when the episode started;
- how long it lasted;
- whether it started and stopped suddenly;
- what the child was doing;
- whether the pulse felt regular or irregular;
- whether fever or illness was present;
- recent caffeine or energy-drink intake;
- medicines, inhalers or decongestants used that day;
- whether chest pain, dizziness or breathlessness occurred;
- whether the child nearly fainted or actually fainted; and
- whether similar episodes have happened before.
If a wearable device can safely record the heart rate or an ECG during an episode, the information may be useful to the child’s clinician. A consumer device should not delay urgent medical care when serious symptoms are present.
How Are Heart Palpitations Evaluated in Children?
The goal is to determine whether the child is experiencing a normal physiological response, premature beats or a clinically important arrhythmia.
Medical and family history
History is especially important in children. The clinician will want details about exercise, fainting, associated symptoms, medications and inherited cardiovascular conditions in the family.
Physical examination
Heart rate, blood pressure, pulses and examination of the heart and lungs may provide useful clues.
12-lead ECG
An electrocardiogram is usually the first cardiac test when a rhythm disorder is suspected.
It can identify many electrical abnormalities, including pre-excitation, conduction abnormalities or prolonged QT.
A child with intermittent SVT may have a completely normal ECG after the racing episode has ended. A Holter, patch or event monitor can help capture episodes that come and go.
Holter or event monitor
Ambulatory ECG monitoring can compare the child’s symptoms with the electrical rhythm over a longer period.
Exercise testing
If symptoms occur mainly during sports or physical activity, an exercise ECG test may be considered.
Blood tests
Depending on the history, testing may include:
- a complete blood count for anemia;
- thyroid function;
- electrolytes; or
- other tests directed by the clinical situation.
Echocardiogram
Not every child with palpitations needs an echocardiogram. Heart ultrasound may be appropriate when the history, examination or ECG suggests structural heart disease.
Pediatric cardiology referral
Referral may be appropriate when:
- an ECG is abnormal;
- an arrhythmia is documented;
- palpitations are associated with exercise-related fainting;
- there is concerning chest pain or unexplained breathlessness;
- the child has known congenital or structural heart disease;
- episodes are frequent or sustained; or
- family history suggests an inherited cardiac condition.
How Are Heart Palpitations in Children Treated?
Treatment depends entirely on the cause.
Normal sinus tachycardia
When the heart is appropriately fast because of exercise, fever, dehydration or emotional stress, treatment generally focuses on the trigger rather than trying to slow the heart directly.
Premature beats
Occasional PACs or PVCs in an otherwise healthy child often require reassurance and observation rather than medication.
Medication or stimulant effects
The child’s doctor may review caffeine, energy drinks, decongestants, asthma treatment, ADHD medicines and other substances.
Parents should not abruptly stop a prescribed medicine solely because palpitations occurred.
Supraventricular tachycardia
Depending on age and episode pattern, SVT treatment may involve observation, clinician-taught vagal maneuvers, medication or catheter ablation.
Other arrhythmias
Long QT syndrome, ventricular arrhythmias, heart block and other electrical disorders require diagnosis-specific treatment and pediatric cardiology or electrophysiology follow-up.
Do Not Give a Child Someone Else’s Heart Medicine
Beta-blockers, rhythm medicines, potassium, magnesium and other supplements should not be used to treat an unexplained racing or irregular heartbeat in a child without appropriate medical guidance.
Dr. Albana’s Note
When a parent tells me, “My child’s heart suddenly races,” the first thing I want to understand is what the child was doing at the time. A fast pulse during fever, crying or running is very different from a rhythm that suddenly starts while the child is sitting quietly and then suddenly stops several minutes later. I also ask specifically about dizziness, fainting, chest discomfort, difficulty breathing and whether the episode occurred during exercise. Family history matters more in children than many parents realize, so I also ask about unexplained sudden deaths and inherited heart conditions. Most childhood palpitations are not dangerous, but those details help us identify the children who need more careful rhythm evaluation.
When Should Parents Make a Doctor’s Appointment?
Contact your child’s pediatrician if:
- palpitations keep returning;
- episodes are becoming more frequent;
- the heart suddenly races while the child is resting;
- episodes last for several minutes or longer;
- the child reports dizziness or lightheadedness;
- there is unexplained shortness of breath;
- there is recurrent chest discomfort;
- symptoms occur during exercise;
- palpitations began after a medicine or stimulant exposure;
- the child has congenital or other known heart disease;
- the child has had unexplained fainting; or
- there is a concerning family history of sudden death or inherited heart disease.
If the child has shortness of breath with the episodes, see heart palpitations and shortness of breath .
Urgent Warning Signs in Children
Seek urgent or emergency medical care for palpitations accompanied by:
- fainting, especially during exercise;
- collapse;
- significant chest pain or pressure;
- severe shortness of breath;
- blue or gray lips or skin;
- severe dizziness or near-fainting;
- a very rapid sustained heartbeat with a child who appears unwell;
- confusion or markedly reduced responsiveness;
- an unexplained seizure-like event associated with activity; or
- rapidly worsening symptoms.
If serious symptoms are occurring now, do not wait to see whether the heartbeat settles on its own.
Most Asked Questions
Are heart palpitations common in children?
Yes. Children and adolescents commonly notice fast, pounding or skipped heartbeats, and most episodes do not turn out to represent dangerous heart disease. Recurrent or symptomatic episodes still deserve evaluation.
Why does my child’s heart beat so fast?
Children’s hearts naturally beat faster than adult hearts, especially in younger children. Exercise, fever, crying, fear, dehydration and excitement can increase the rate further. A sudden sustained racing heartbeat at rest may need rhythm evaluation.
Can anxiety cause heart palpitations in a child?
Yes. Fear, emotional stress and anxiety release adrenaline and can make the heart beat faster or harder. However, recurrent symptoms should not automatically be attributed to anxiety, particularly when fainting, exercise-related symptoms or other warning signs are present.
Can dehydration cause palpitations in children?
Yes. Dehydration from poor fluid intake, vomiting, diarrhea, exercise or hot weather can increase heart rate. Persistent palpitations after hydration or symptoms accompanied by other warning signs need evaluation.
Can energy drinks cause heart palpitations in teenagers?
Caffeine and other stimulants in energy or pre-workout drinks can increase heart rate and may trigger palpitations in susceptible teenagers. Recurrent symptoms are a good reason to stop the stimulant exposure and discuss the episodes with a healthcare professional.
Are skipped beats normal in children?
Occasional PACs or PVCs can occur in healthy children and are often benign. Frequent skipped beats, symptoms during exercise or episodes associated with dizziness or fainting deserve further assessment.
What is SVT in a child?
Supraventricular tachycardia is an abnormally fast rhythm that starts above the ventricles. It often begins and stops suddenly and can cause racing palpitations, dizziness, breathlessness, fatigue or chest discomfort. It is one of the most common clinically important tachyarrhythmias in children.
How do I know if my child’s racing heart is SVT?
You cannot confirm SVT from symptoms alone. A rhythm that begins and ends very suddenly while the child is otherwise at rest can raise suspicion, but an ECG recorded during the episode is the best way to establish the diagnosis.
Should I worry if my child has palpitations during sports?
A faster heart rate during sports is normal. More concerning features include a sudden abnormal racing sensation, fainting or near-fainting, chest pain or unexplained excessive breathlessness during exercise.
Why is fainting during exercise concerning?
Most fainting in adolescents is benign, but fainting during active exercise can occasionally be a sign of an arrhythmia or structural heart condition. It deserves cardiovascular assessment, particularly when palpitations or chest pain occur first.
Can a normal ECG rule out an arrhythmia in my child?
No. If the abnormal rhythm is intermittent, a short ECG performed between episodes may be normal. A Holter, patch or event monitor may be needed to capture the rhythm when symptoms occur.
When should a child see a pediatric cardiologist?
Referral may be appropriate for an abnormal ECG, documented arrhythmia, exercise-related fainting or concerning palpitations, known heart disease, frequent sustained episodes or a family history suggesting an inherited cardiac disorder.
Related Heart Palpitation Guides
Medical References
- American Academy of Pediatrics. Fast, Slow and Irregular Heartbeats (Arrhythmia). HealthyChildren.org. HealthyChildren.org .
- Children’s Hospital of Philadelphia. Heart Palpitations. Reviewed January 29, 2025. Children’s Hospital of Philadelphia .
- American Heart Association. Types of Arrhythmia in Children. American Heart Association .
- Children’s Hospital of Philadelphia. Supraventricular Tachycardia (SVT) in Children. Reviewed October 23, 2024. Children’s Hospital of Philadelphia .
- American Heart Association. Treating Arrhythmias in Children. American Heart Association .
- American Academy of Pediatrics. Sudden Death in the Young: Information for the Primary Care Provider. Pediatrics. 2021.
- American Academy of Pediatrics. Cardiac Arrhythmias. Signs & Symptoms in Pediatrics, 2nd Edition. 2025.
- American Heart Association / American Academy of Pediatrics. 2025 Pediatric Tachyarrhythmia With a Pulse Algorithm.
About the Medical Team
Dr. Albana Greca, MBBS, MMedSc
Family Physician / General Practitioner
Dr. Albana Greca has more than 20 years of experience in primary care, general medicine, chronic disease management, prevention, patient education and digital health.
Dr. Benard Shehu, MBBS, MS
Cardiologist
Dr. Benard Shehu has more than 19 years of cardiovascular experience, including clinical experience relevant to arrhythmias and cardiovascular disease.