In a nutshell, Sudden Cardiac Arrest (SCA) means a person ceases to have an effective heartbeat. While a heart attack is a “plumbing” problem more common to adults, an SCA in pediatric or young adult patients is more likely to be “electrical.”
Most people don’t think of kids as having heart problems at all, but there is a long list of pediatric cardiac disorders that could lead to SCA. Most are very rare, and some are inherited. Once diagnosed, any of these cardiac conditions should be closely monitored to prevent SCA.
“When a child has SCA, it’s common that people will describe the child as having been perfectly healthy,” said Robert Campbell, MD, pediatric cardiologist at Sibley Heart Center Cardiology. “However, they were not perfectly healthy, just undiagnosed.”
Dr. Campbell said the incidence of pediatric/young adult sudden cardiac death is not known but is estimated to be about 1-4,000 per year in the U.S. Not all cases of SCA result in death because people are resuscitated or the SCA can self-terminate.
“Of course, we want to prevent all sudden cardiac death,” Dr. Campbell said. “Although it is a pretty small number, it’s a high-profile event when it happens, especially to children. Our focus should be diagnosing kids and families with conditions that could lead to SCA so we can prevent it.”
There are four key warning signs of which people should be aware. Some disorders are inherited, and cascade testing through the family tree may be recommended.
- A family history of sudden, unexpected or unexplained death in anyone before age 50.
- A history of exercise/emotion/startle-induced seizures or passing out (syncope).
- Unusual or unexpected exercise-induced extreme shortness of breath, shoulder or chest pain.
- A family history of known genetic disorders than can lead to SCA.
“Providing a complete and correct family history is very important,” Dr. Campbell said. “To ensure this, I advise people to talk to anyone in the family who has experienced these warning signs. It’s easy to disregard these conditions and details. A lot of our efforts are focused on training healthcare providers to be suspicious if they hear certain stories.”
Dr. Campbell said there is primary and secondary prevention of SCA. Primary prevention, which focuses on awareness and education, involves finding and treating people who are at risk for SCA. Secondary prevention, which focuses on education and practice, refers to saving someone who is suffering from SCA. Successful rescue includes recognizing cardiac arrest, calling 911, performing CPR and using an automated external defibrillator (AED) to restart the heart.
“Nothing takes the place of practiced emergency planning,” Dr. Campbell said. “This is something that’s not unique to pediatrics. Anybody can save anybody else’s life, if they know what to do. Getting this life-saving awareness education and technology into places where we congregate makes everyone safer.”
The following resources focus on both primary and secondary prevention of SCA.
Children’s Healthcare of Atlanta’s Project S.A.V.E.
Children’s Healthcare of Atlanta’s Pediatric Cardiac Risk Assessment Form
American Academy of Pediatrics pre-participation form for student athletes
For more information about Sibley Heart Center Cardiology and our pediatric cardiology specialists, click here.