Author + information
- Victoria L. Vetter,
- Noreen P. Dugan,
- Danielle M. Haley,
- Ramesh Iyer,
- Martha Lopez-Anderson and
- Jonathan Drezner
Specific triggers for sudden cardiac arrest (SCA) in youth are unclear.
Parent Heart Watch members with children who had SCA were surveyed. Questions included 1) occurrence 2) prior symptoms: evaluation, diagnoses 3) family history 4) medications, other triggers 5) activity 6) circumstances.
Responses from 53 of 88 members (60%) included 7 with surviving children. The SCA mean age was 15.9 (4.6) yrs, median 15.5 yrs; Male, 73.5%; Caucasian, 89.9%; Hispanic ethnicity 11.5%. At least one prior cardiovascular symptom was reported in 98%: fatigue 37%; chest pain 20%; palpitations 18%; fainting 20% (half >once); shortness of breath 18%; emotional upset 14%; and seizure 2%. Family history of SCA was noted in 28%. Medical evaluation after symptoms occurred in 15 (31%) with cardiology consult 8; ECG 12; echocardiogram 7; Holter 2; MRI 1. Cardiac diagnoses were made prior to SCA in 4 (7.5%), and after SCA in 29 (54.7%). Cause of death is known in only 62.3%. SCA was activity related in 58%. A recent flu-like illness was present in 16 (32%). Medications, caffeine, energy drinks, supplements, alcohol, tobacco and recreational drugs were used prior to SCA in 26 (53%). SCA was witnessed in 73.4% with 60% receiving CPR. Only 13% of deaths occurred in a location with a defibrillator (AED) on site. Emergency Services arrived in <5 minutes in 21% and in >6 minutes in 54%.
Prior symptoms may be common but misinterpreted, leading to infrequent medical evaluation, identification or treatment of concerning conditions. Intercurrent illnesses and substance use were reported as prevalent at the time of SCA and may represent triggers for SCA in children with an undiagnosed cardiac disorder. The cause often remains unknown and surviving family members may not have appropriate evaluations. Deaths are often witnessed and CPR provided, but AEDs are not common onsite. Improved primary prevention (diagnosis and treatment) and secondary prevention (AED and emergency response) are critically needed. Potential triggers may include activity, intercurrent illnesses, medications and substances with more research needed to confirm these impressions. A comprehensive registry of SCA in youth is needed.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias: SCD in Children and Adults
Abstract Category: 6. Arrhythmias: Other
Presentation Number: 1280-53
- 2013 American College of Cardiology Foundation