Pediatricians should recognize symptoms of sudden cardiac arrest, AAP says

March 29, 2012

Pediatric care providers should be familiar with the warning signs and symptoms of pediatric sudden cardiac arrest and ensure that those at risk are referred to a pediatric cardiac center for evaluation, according to a new policy statement from the American Academy of Pediatrics. Learn why a comprehensive family history is critical in identifying individuals at risk.

Pediatric care providers should be familiar with the warning signs and symptoms of pediatric sudden cardiac arrest (SCA) and ensure that those at risk are referred to a pediatric cardiac center for evaluation, according to a new policy statement from the American Academy of Pediatrics (AAP).

The Centers for Disease Control and Prevention estimates that approximately 2,000 persons younger than 25 years die each year in the United States as a result of SCA, defined as the abrupt and unexpected loss of heart function. For patients with underlying cardiovascular disease, participation in sports increases the risk of SCA.

Cardiac disorders predisposing youth to SCA are broadly categorized as structural-functional, primary electrical, and other, including use of illicit and some prescription drugs. Because many of these disorders are genetic, a detailed, comprehensive family history and pedigree is critical to identify individuals at risk for SCA.

Warning symptoms such as dizziness, chest pain, and syncope are common in patients with structural-functional or primary electrical cardiac disorders but are frequently overlooked or misinterpreted by both family members and medical personnel. Misdirecting the initial evaluation to a noncardiac specialist can delay correct diagnosis.

Identified patients and families with known or suspected cardiac disorders should be referred to a pediatric cardiac center for evaluation and management. Treatment options include medical therapy, use of a pacemaker or other device, restriction of activity, avoidance of certain medications, and family emergency preparedness.

For children participating in athletics, use of a standardized preparticipation physical evaluation form, such as the one endorsed by the AAP and other agencies, is recommended. Routine electrocardiographic screening to prevent SCA is not advised.

Bystander cardiopulmonary resuscitation (CPR) more than doubles survival rates after SCA, and the AAP urges support for CPR education, appropriate use of automatic external defibrillators, and school emergency response programs.

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