UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Sudden cardiac arrest and death in children

Author
Stuart Berger, MD
Section Editors
John K Triedman, MD
Martin I Lorin, MD
Deputy Editor
Carrie Armsby, MD, MPH

INTRODUCTION

Sudden cardiac arrest (SCA) and sudden cardiac death (SCD) in children and adolescents are relatively rare. However, because these are unexpected, devastating conditions, concerted efforts have been made to continue to find evidence-based strategies that will prevent these events in a cost-effective manner.

The incidence, etiology, and prodromal signs of SCA/SCD in children and adolescents will be reviewed here. In addition, the role of screening to prevent pediatric SCA/SCD and the approach to evaluating survivors of SCA and victims of SCD will also be discussed.

The management of children with cardiopulmonary arrest is discussed separately. (See "Pediatric advanced life support (PALS)" and "Defibrillation and cardioversion in children (including automated external defibrillation)".)

EPIDEMIOLOGY

The reported incidence of SCA/SCD in children and young adults ranges from 0.5 to 2.5 per 100,000 person-years [1-8]. In the United States, the Centers for Disease Control and Prevention estimates that approximately 1500 people under 25 years of age die each year of SCD [9]. Most studies have shown a bimodal age distribution with higher incidence rates in infancy and adolescence/young adulthood [6,8,10].

In a population-based study from the state of Washington (1980 to 2009), the overall incidence of SCA among people aged 0 to 35 years was 2.28 per 100,000 person-years [8]. Incidence rates and survival rates varied according to age:

                     
To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Nov 2017. | This topic last updated: Sep 27, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
References
Top
  1. Van Camp SP, Bloor CM, Mueller FO, et al. Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc 1995; 27:641.
  2. Maron BJ, Gohman TE, Aeppli D. Prevalence of sudden cardiac death during competitive sports activities in Minnesota high school athletes. J Am Coll Cardiol 1998; 32:1881.
  3. Atkins DL, Everson-Stewart S, Sears GK, et al. Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. Circulation 2009; 119:1484.
  4. Harmon KG, Asif IM, Klossner D, Drezner JA. Incidence of sudden cardiac death in National Collegiate Athletic Association athletes. Circulation 2011; 123:1594.
  5. Maron BJ, Doerer JJ, Haas TS, et al. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation 2009; 119:1085.
  6. Bagnall RD, Weintraub RG, Ingles J, et al. A Prospective Study of Sudden Cardiac Death among Children and Young Adults. N Engl J Med 2016; 374:2441.
  7. Winkel BG, Risgaard B, Sadjadieh G, et al. Sudden cardiac death in children (1-18 years): symptoms and causes of death in a nationwide setting. Eur Heart J 2014; 35:868.
  8. Meyer L, Stubbs B, Fahrenbruch C, et al. Incidence, causes, and survival trends from cardiovascular-related sudden cardiac arrest in children and young adults 0 to 35 years of age: a 30-year review. Circulation 2012; 126:1363.
  9. Kochanek KD, Murphy SL, Xu J, Tejada-Vera B. Deaths: Final Data for 2014. Natl Vital Stat Rep 2016; 65:1.
  10. Vetter VL, Dugan NP, Haley DM, et al. Development of a data set of national cardiovascular deaths in the young. Am Heart J 2014; 168:568.
  11. Corrado D, Basso C, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden cardiac death? J Cardiovasc Med (Hagerstown) 2006; 7:228.
  12. Liberthson RR. Sudden death from cardiac causes in children and young adults. N Engl J Med 1996; 334:1039.
  13. Drezner JA, Fudge J, Harmon KG, et al. Warning symptoms and family history in children and young adults with sudden cardiac arrest. J Am Board Fam Med 2012; 25:408.
  14. Uberoi A, Stein R, Perez MV, et al. Interpretation of the electrocardiogram of young athletes. Circulation 2011; 124:746.
  15. Fish FA, Kannankeril PJ. Diagnosis and management of sudden death in children. Curr Opin Pediatr 2012; 24:592.
  16. Section on Cardiology and Cardiac Surgery. Pediatric sudden cardiac arrest. Pediatrics 2012; 129:e1094.
  17. Angoff GH, Kane DA, Giddins N, et al. Regional implementation of a pediatric cardiology chest pain guideline using SCAMPs methodology. Pediatrics 2013; 132:e1010.
  18. Mahle WT, Sable CA, Matherne PG, et al. Key concepts in the evaluation of screening approaches for heart disease in children and adolescents: a science advisory from the American Heart Association. Circulation 2012; 125:2796.
  19. Kaltman JR, Thompson PD, Lantos J, et al. Screening for sudden cardiac death in the young: report from a national heart, lung, and blood institute working group. Circulation 2011; 123:1911.
  20. Maron BJ, Thompson PD, Puffer JC, et al. Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee (clinical cardiology) and Congenital Cardiac Defects Committee (cardiovascular disease in the young), American Heart Association. Circulation 1996; 94:850.
  21. Maron BJ, Thompson PD, Ackerman MJ, et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation 2007; 115:1643.
  22. Vetter VL. Electrocardiographic screening of all infants, children, and teenagers should be performed. Circulation 2014; 130:688.
  23. Friedman RA. Electrocardiographic screening should not be implemented for children and adolescents between ages 1 and 19 in the United States. Circulation 2014; 130:698.
  24. Chandra N, Bastiaenen R, Papadakis M, et al. Prevalence of electrocardiographic anomalies in young individuals: relevance to a nationwide cardiac screening program. J Am Coll Cardiol 2014; 63:2028.
  25. Schoenbaum M, Denchev P, Vitiello B, Kaltman JR. Economic evaluation of strategies to reduce sudden cardiac death in young athletes. Pediatrics 2012; 130:e380.
  26. Leslie LK, Cohen JT, Newburger JW, et al. Costs and benefits of targeted screening for causes of sudden cardiac death in children and adolescents. Circulation 2012; 125:2621.
  27. Drezner JA, Rao AL, Heistand J, et al. Effectiveness of emergency response planning for sudden cardiac arrest in United States high schools with automated external defibrillators. Circulation 2009; 120:518.
  28. Ackerman MJ, Priori SG, Willems S, et al. HRS/EHRA expert consensus statement on the state of genetic testing for the channelopathies and cardiomyopathies this document was developed as a partnership between the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA). Heart Rhythm 2011; 8:1308.
  29. Miles CJ, Behr ER. The role of genetic testing in unexplained sudden death. Transl Res 2016; 168:59.
  30. Kauferstein S, Kiehne N, Jenewein T, et al. Genetic analysis of sudden unexplained death: a multidisciplinary approach. Forensic Sci Int 2013; 229:122.
  31. Tester DJ, Ackerman MJ. The molecular autopsy: should the evaluation continue after the funeral? Pediatr Cardiol 2012; 33:461.
  32. Ackerman MJ. State of postmortem genetic testing known as the cardiac channel molecular autopsy in the forensic evaluation of unexplained sudden cardiac death in the young. Pacing Clin Electrophysiol 2009; 32 Suppl 2:S86.
  33. Santori M, Blanco-Verea A, Gil R, et al. Broad-based molecular autopsy: a potential tool to investigate the involvement of subtle cardiac conditions in sudden unexpected death in infancy and early childhood. Arch Dis Child 2015; 100:952.