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Sudden cardiac death in infants, children, and adolescents
S Berger1, A Dhala, D Z Friedberg
1Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, USA.
Insights
Sudden cardiac death (SCD) in young people often has underlying cardiac conditions. Early screening with detailed history and physical exams can identify at-risk individuals for further cardiac evaluation.
Area of Science:
- Pediatric Cardiology
- Sudden Cardiac Death Etiology
- Cardiovascular Screening
Background:
- Sudden cardiac death (SCD) in infants, children, and adolescents, while uncommon, carries a profound psychosocial impact.
- Many SCD cases involve identifiable cardiac diseases, but some arise from undiagnosed conditions like hypertrophic cardiomyopathy or long QT syndrome.
Purpose of the Study:
- To review potential causes of SCD in pediatric populations.
- To emphasize the role of early screening in identifying at-risk individuals for sudden cardiac death.
Main Methods:
- Comprehensive review of existing literature on SCD causes in pediatric patients.
- Analysis of diagnostic approaches including detailed patient and family history, review of systems, and physical examinations.
- Recommendation for further cardiac evaluation (ECG, echocardiogram) based on initial screening findings.
Main Results:
- Identifiable cardiac diseases are often present in pediatric SCD cases.
- Undiagnosed conditions such as hypertrophic cardiomyopathy and long QT syndrome can present as the first manifestation of SCD.
- Thorough clinical assessment can detect many at-risk pediatric patients.
Conclusions:
- A detailed history and physical examination are crucial for screening pediatric patients for conditions associated with SCD.
- Patients with positive findings on screening should undergo further cardiac investigations like ECG and echocardiography.
- These diagnostic tools can detect most cardiac abnormalities linked to SCD in the pediatric population.
Abstract:
Although SCD is relatively uncommon, its psychosocial impact is devastating. This article has reviewed the potential causes of SCD in infants, children, and adolescents. Many patients who die from SCD have identifiable cardiac disease and are known to have been at risk; however, the existence of other cardiac abnormalities, such as hypertrophic cardiomyopathy or long QT syndrome, may not be known, and SCD may be the first symptom. The authors' contention is that many of the patients in this latter group (e.g., patients who have hypertrophic cardiomyopathy or LQLTS but who have no symptoms) can be screened with a careful, accurate, and detailed history, including family history and review of systems, and physical examination. Any patient with a positive family history, positive review of systems, or positive physical examination should receive further in-depth evaluation, such as an ECG and echocardiogram. These studies permit the detection of most, if not all, of the entities potentially associated with SCD in the pediatric population.
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