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Wednesday, September 6, 2023

Are Adolescents at Risk of Cardiac Arrest?

Posted By: Advancing Care

Cardiac arrest is not exclusive to adults — it can occur in children and teenagers, too. According to the Centers for Disease Control and Prevention (CDC), more than 2,000 children and adolescents in the United States succumb to sudden cardiac arrest every year.

Christa Miliaresis, MD, a pediatric cardiologist at WMCHealth’s Maria Fareri Children’s Hospital, sheds light on the risk factors, screening approaches and preventive measures parents and young people can take to reduce the risk of cardiac arrest.

Causes and Cues

“The causes of cardiac arrest can be anatomical in nature, meaning they stem from structural abnormalities in the heart’s chambers, valves or blood vessels, or they can be the result of electrical issues that disrupt the heart’s natural rhythm,” explains Dr. Miliaresis.

In addition to congenital issues, sudden cardiac arrest can result from inherited cardiogenetic disease. “Hypertrophic cardiomyopathy is the most commonly inherited cardiogenetic disease, and it is the number one reason why athletes experience sudden cardiac arrest on the field or court,” says Dr. Miliaresis. Another common cause is blunt force trauma, such as a heavy blow to the chest.

It’s important to note that some congenital anomalies or conditions don’t always present symptoms. In instances when warning signs are present, they often include:

  • Palpitations
  • Rapid heart rate
  • Chest pain
  • Shortness of breath
  • Fainting during exercise

Recognizing the warning signs of cardiac arrest in children and teens is crucial for early intervention and potentially saving lives.

The Issue of Early Detection

How and when to approach early detection is a topic of debate among medical professionals. Experts are divided into two camps—those in favor of extensive screening, and those who align with the slightly more conservative guidelines established by the American Academy of Pediatrics (AAP) and the American Heart Association (AHA). These organizations recommend physical exams and family history screening, but don’t generally recommend preemptive electrocardiogram (ECG) or echocardiogram tests until symptoms arise.

For student athletes, a 14-element pre-participation evaluation plays a pivotal role in detecting potential risks. Historical questions and physical examination findings provide valuable insight, flagging abnormalities that require further assessment by a pediatric cardiologist.

Knowing your family history is critical and can sometimes lead to the use of genetic testing, which is becoming increasingly helpful as a prevention tool. “Genetic testing provides an in-depth look into a child’s predisposition to cardiac problems, which is key information for medical professionals to have.”

Diagnosis and Treatment

Diagnosing and treating cardiac problems in children involves an initial evaluation that typically includes medical history, physical exams and often an ECG (or EKG) or echocardiogram. If red flags are raised, further tests like exercise stress tests may be conducted.

Treatment options range from lifestyle adjustments and medication to surgeries or interventions, depending on the specific condition and severity. A collaborative approach among pediatricians, cardiologists and other specialists helps to ensure the best possible outcome.

Christa Miliaresis, MD

A Proactive Approach for Parents and Caregivers

When it comes to cardiac health, diet and exercise make a world of difference.

Instilling healthy habits early—embracing whole foods and regular physical activity—can lay the foundation for a lifetime of cardiac wellness. Having a thorough understanding of family history can also help physicians uncover hidden issues before they result in full-blown cardiac arrest.

In schools and communities, the significance of being prepared for sudden cardiac events cannot be emphasized enough.

“Initiatives like Project ADAM, which Maria Fareri Children’s Hospital participates in, collaborate with educational institutions and recreation centers to enhance emergency response protocols, ensuring that cardiac emergencies are met with effective action,” says Dr. Miliaresis. This includes ensuring that automated external defibrillators (AEDs) are accessible and that school staff and communities are trained in CPR and AED use to respond to cardiac emergencies.

Although cardiac arrest is sudden and unpredictable, there are steps physicians, parents, caregivers, schools and community centers can take to reduce the risk in children and teens.

To learn more about Maria Fareri Children’s Hospital and its comprehensive pediatric cardiology care, call 914.493.8372 or visit our website today.