The sudden death of a child, adolescent, or adult due to a heart condition is extremely rare. But when it happens, it’s an awful tragedy because it could often have been avoided if the right questions had been asked.
Since we hear so much about sudden death in sports, and since most prevention measures are aimed at athletes, we tend to focus on them. According to the 2021 Policy Statement of the American Academy of Pediatrics, sudden deaths can occur in children and teenagers who are not athletes. It offers guidance to primary care pediatricians on how to better screen patients for heart problems, which can lead to sudden death. What parents should know and do.
What could cause sudden cardiac death or arrest in children or teenagers?
Several heart conditions can increase the risk of sudden deaths. These include
- Cardiomyopathies. These problems are with the heart muscle. Hypertrophic cardiomyopathy is the most common type, where the heart muscle thickens abnormally.
- A coronary artery problem. Coronary arteries deliver oxygenated blood to the heart muscle. The heart muscle cannot receive the blood it needs if there is a problem in one or both of these arteries. This is called an anomalous heart artery, and it’s the second most common cause of sudden death after hypertrophic cardiac myopathy.
- A problem with the electrical system of the blood. The system is responsible for the contraction and movement of blood in the body. This conduction system may be affected by an arrhythmia, and the heart might not be able to move blood at all or well.
- Congenital Heart Disease. Children born with heart defects are at a higher risk for arrhythmias, whether the defect is present or not, and this may be due to the surgery performed on them.
- Aortopathies. It is a medical term that describes a condition where the aorta can balloon (aneurysm) and then split open. The aorta, which is the main vessel that leads from the heart to other parts of the body, can cause this condition. Marfan’s Syndrome is one of the conditions that can cause it, but others are also possible.
Four screening questions that can identify cardiac risk
These conditions are often not recognized for many years. The AAP states that these four questions may help identify children who are at risk.
- Have you ever passed out or fainted suddenly, without warning? This is especially true during exercise or when loud noises like doorbells, alarms, or telephone rings are heard.
- Have you ever experienced chest pains or shortness of breath after exercising? A pulled or asthmatic muscle usually causes this. It may also be related to your heart, especially when the pain is like a pressure, radiates down the arm or neck, and occurs with nausea, sweating, or fainting.
- Have any of your relatives, whether they are close (parents or grandparents) or distant (aunts or uncles or cousins), died suddenly or unexpectedly before the age of 50? This includes sudden drownings and car accidents where the relative was driving.
- You may be related to someone with hypertrophic heart disease, Marfan Syndrome, or arrhythmogenic cardiomyopathy. Short QT Syndrome is also a possibility.
The last question highlights the importance of knowing your family history. Knowing the details of your family history is important for everyone’s health. Don’t hesitate to ask your family about the diagnosis that they received from a doctor. Then, share this diagnosis with your physician. It is not only heart disease that can be affected by this. Some people, however, may not be able to access their family’s health information.
How often should the screening be performed?
According to the American Academy of Pediatrics, your child’s physician should ask these questions during routine checkups, at least every three years, or at entry into middle or junior high and high school. If your child answers yes to any question, they should be referred to an arrhythmia specialist or a cardiologist who specializes in cardiopathies for further evaluation. They shouldn’t play sports until they have been cleared.
But families don’t have to wait until a pediatrician asks the questions. Talk to your child’s physician immediately if you think the answer is or could be yes. You could save the life of your child.
