Sudden cardiac arrest and death in children
- Stuart Berger, MD
Stuart Berger, MD
- Executive Director, Pediatric Heart Center at Lurie Children's Hospital
- Vice Chair, Clinical Affairs Pediatrics at Lurie Children's Hospital
- Professor of Pediatrics, Northwestern University
- Section Editors
- John K Triedman, MD
John K Triedman, MD
- Section Editor — Pediatric Cardiology
- Professor of Pediatrics
- Harvard Medical School
- Martin I Lorin, MD
Martin I Lorin, MD
- Section Editor — General Pediatrics
- Professor of Pediatrics
- Baylor College of Medicine
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 in children and adolescents will be reviewed here. In addition, the role of screening to prevent pediatric SCA and the management of individuals with SCA will also be discussed.
The management of children with cardiopulmonary arrest is discussed separately. (See "Defibrillation and cardioversion in children (including automated external defibrillation)".)
The reported incidence of sudden cardiac arrest (SCA) for adolescent and young adults ranges from 0.5 to 20 per 100,000 person-years [1-5]. A retrospective study from the state of Washington using population-based data from a county emergency medical service (EMS) reported an overall incidence of SCA of 2.28 per 100,000 person-years for individuals between 0 to 35 years of age from 1980 to 2009 . In this series of 361 SCA cases, reported age-based incidences for individuals between 0 to 2 years, 3 to 13 years, and 14 to 25 years were 2.1, 0.61, and 1.44 cases per 100,000 person-years, respectively. Survival rates following SCA also varied by age with rates of 27, 40, and 37 percent for patients between 0 to 2 years, 3 to 13 years, and 14 to 25 years, respectively. Survival increased over the course of the study from 13 percent between 1980 and 1989 to 40 percent between 2000 and 2009. The authors attributed the rise in survival during the study period to improvements in the community-based EMS and changes in resuscitation protocols.
In the above study, cases of sudden infant death syndrome (SIDS) were excluded because a cardiac cause could not be confirmed . However, in several case series of SIDS, about 10 percent of deaths were reported to be caused by cardiac channel defects resulting in arrhythmias. As a result, the incidences of SCA and sudden cardiac death (SCD) in children less than two years of age were likely to be underestimated in this study. (See "Sudden infant death syndrome: Risk factors and risk reduction strategies", section on 'Genetic factors'.)
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- Genetic disorders
- WARNING SIGNS AND SYMPTOMS
- Electrocardiographic findings
- DIFFERENTIAL DIAGNOSIS
- PREVENTIVE STRATEGIES
- Primary prevention (screening)
- - Overview
- - Universal versus selective screening
- - Age of screening
- - Method of screening
- - Societal recommendations
- Secondary prevention
- OUR APPROACH
- - Newborn
- - Routine healthcare visits
- - Preparticipation sports assessment
- - Further evaluation and referral
- Survivors of SCA
- Victims of SCD
- Secondary prevention
- SUMMARY AND RECOMMENDATIONS
- Epidemiology, etiology, and prodromal symptoms
- Prevention of SCD