All children should be screened for conditions that may put them at risk for cardiac arrest or death, a new American Academy of Pediatrics (AAP) policy statement recommends.
The screening should be done whether or not kids play sports, and it is particularly important as they begin middle school or junior high, the statement says.
It updates 2012 guidelines and was published online June 21 in the journal Pediatrics.
“We tended to focus on athletes in the past when parents brought their children and teens in for a sports physical, or pre-participation exam,” said Dr. Christopher Erickson, lead author of the revised statement. “We know today that all children and teens benefit from a simple screening to help identify any potential problem that warrants follow-up with a cardiac specialist.”
About 2,000 people under age 25 suffer sudden cardiac death in each year in the U.S. Many had structural heart anomalies, research shows, but the causes for up to 40% of such deaths are unexplained.
The policy statement recommends doctors ask whether a child has ever fainted, had an unexplained seizure, or experienced chest pain or shortness of breath. Doctors are also urged to ask if family members have a history of heart conditions or death before age 50.
“Ideally, this screening is incorporated into a child’s regular exam at least every two to three years,” said statement co-author Dr. Jack Salerno. “The pediatrician is in an ideal position to check on a child’s development into the teenage years and is aware of family history that may raise a red flag for potential heart related issues.”
The AAP recommends that pediatricians and other primary care providers evaluate whether a child’s personal or family history and physical exam suggest a risk for sudden cardiac arrest or death.
If there is a concern, an electrocardiogram should be the first test, and it should be interpreted by a doctor trained to recognize electrical heart disease. The doctor should factor in a patient’s clinical history and consider referral to a specialist, the statement recommends.
“No single screening strategy will detect every possible heart issue, and so it’s important that we raise awareness and education not only in pediatric offices but within the community,” Erickson said. “We encourage parents and pediatricians to be alert for any concerning signs or family history.”
The Children’s Hospital of Philadelphia has more on sudden cardiac arrest.
SOURCE: American Academy of Pediatrics, news release, June 21, 2021