Preventing Sudden Cardiac Death in Children: 4 Questions Can Help


It’s incredibly rare for a child to die suddenly from a heart problem, but it’s a horrific tragedy when it does, especially because it often could have been avoided – if someone had just asked. good question.

We tend to think of sudden deaths like this in athletes because we often hear about it on the playing field – and because most prevention efforts have been aimed at athletes. But they absolutely can occur in children and adolescents who are not athletes, as a new policy statement from the American Academy of Pediatrics notes. The advice it offers will help primary care pediatricians better screen their patients for heart problems that can lead to sudden death. Here’s what parents need to understand and do.

What could cause sudden cardiac arrest or death in children?

There are several heart conditions that can lead to a risk of sudden death. They include

  • Cardiomyopathies. These are problems with the muscle of the heart. There are several different types, but the type most likely to lead to sudden death is hypertrophic cardiomyopathy, in which the heart muscle becomes unusually thick.
  • A problem with a coronary artery. The coronary arteries carry oxygenated blood to the heart muscle. If there is a problem with one or both arteries, the heart muscle may not be receiving the necessary blood supply. Called abnormal coronary artery, it is the second leading cause of sudden death after hypertrophic cardiomyopathy.
  • Problems with the electrical conduction system of the heart. This is the system that causes the heart to contract and move blood around the body. Problems with this conduction system can lead to arrhythmia – and the heart may not be able to circulate blood properly or not at all.
  • Congenital heart disease. When children are born with a heart defect, it puts them at a higher risk of arrhythmia, either because of the defect itself or because of the surgery that was done to treat it.
  • Aortopathies. It is the medical term for a problem with the aorta that could cause it to bloat (aneurysm) and open. (The aorta is the main blood vessel leading from the heart to the rest of the body.) Marfan syndrome is one condition that can cause it, but there are others as well.

Four Important Screening Questions Can Help Identify Heart Risk

Many of these conditions can go unnoticed for years. However, the AAP says these four questions can help identify which children may be at risk:

  1. Have you ever passed out, passed out, or had an unexplained seizure suddenly and without warning, especially while exercising or in response to sudden loud noises such as doorbells, alarm clocks or ringing phones?
  2. Have you ever had chest pain or shortness of breath from exercise? Most of the time, it is simply a strained muscle or asthma. But it can be related to the heart, especially if the pain feels like pressure; radiates to the neck or arm; is associated with sweating, nausea or fainting; or occurs with exercise, exertion or stress.
  3. Did anyone in your immediate family (parents, grandparents, siblings) or other more distant relatives (aunts, uncles, cousins) die of heart problems or had an unexpected sudden death before the age 50? (This includes unexpected drowning, unexplained car crashes in which the parent was driving, and Sudden Infant Death Syndrome, or SIDS.)
  4. Are you related to someone with hypertrophic cardiomyopathy, obstructive hypertrophic cardiomyopathy, Marfan syndrome, arrhythmogenic cardiomyopathy, long QT syndrome, short QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia (CPVT ), or anyone under the age of 50 with a pacemaker or implantable defibrillator?

The last question emphasizes the importance of knowing the details of your family history. We don’t always like to be indiscreet, but knowing the details can be crucial for the health of other family members. So don’t be afraid to ask your family members the exact diagnosis they were given by a doctor and then share that diagnosis with your doctor. This is true for all health concerns, not just heart problems. Of course, some people may not have access to their family’s health information.

How often should this screening be done?

Ideally, according to the AAP, your child’s doctor should ask these questions during routine checkups at least once every three years, or upon entering college or college and entering high school. If the answer is yes to any of the questions, the child should be referred to a cardiologist (or a cardiologist specializing in arrhythmias) for further evaluation. Until they are allowed, they should not participate in sports.

However, families don’t have to wait for a pediatrician to ask the questions. If the answer to any of these is yes, or could be yes, talk to your child’s doctor right away. You could literally save your child’s life.

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of the last revision or update of all articles. Nothing on this site, regardless of date, should ever be used as a substitute for direct medical advice from your physician or other qualified clinician.


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