Sudden Cardiac Death in Children and Adolescents

Abstract

Sudden cardiac death (SCD) in children and adolescents is not a common event but when it does occur it is horribly devastating. It is important to explore strategies to prevent sudden cardiac arrest (SCA) by optimizing our screening and detection methods. Furthermore, it is important to prevent SCD if an SCA does occur. Survival after out-of-hospital cardiac arrest (OHCA) can most likely be achieved by a strategy that involves early recognition of cardiac arrest followed by early intervention. Screening is not likely to identify all children and adolescents who are at risk for SCA. This is true because a subset of children and adolescents who have SCA have no antecedent symptoms and have a noncontributory family history. On the other hand, warning signs and symptoms prior to SCA may include syncope, especially associated with exercise, chest pain, or palpitations/arrhythmias. Although it is true that the majority of children and adolescents with these signs and symptoms do not have an underlying life-threatening cardiac condition, a small subset may have symptoms that indicate an ensuing SCA event. Which of these symptoms are important and a strategy for investigation of these signs and symptoms is important for the generalist taking care of children and adolescents to understand. In this issue of Pediatric Annals, we discuss these issues and highlight the importance of gathering a complete patient history, family history, and physical examination to uncover a potentially life-threatening cardiac event. Although additional screening with a 12-lead electrocardiogram (ECG) is a potential screening strategy, we will not cover its nuances in this issue. It is