Introduction
Sudden cardiac arrest (SCA) is a rare but devastating event in which the heart suddenly stops beating, leading to loss of consciousness and, if not treated immediately, death. While SCA is uncommon in children and adolescents, it can occur, especially during or after intense physical activity. Awareness, early recognition, and prompt action are crucial for saving lives.
Causes
In young athletes, SCA is most often caused by underlying heart conditions that may not have been previously diagnosed. Common causes include inherited heart diseases such as hypertrophic cardiomyopathy, congenital long QT syndrome, arrhythmogenic right ventricular cardiomyopathy, and structural heart defects. Other causes can include myocarditis (inflammation of the heart muscle), abnormal heart rhythms (arrhythmias), and, rarely, trauma to the chest (commotio cordis).
Symptoms
SCA often occurs without warning, but some children may experience warning signs such as chest pain, palpitations, fainting (especially during exercise), shortness of breath, or unexplained seizures. In many cases, the first symptom is sudden collapse and loss of consciousness. The person will not be breathing normally and will have no pulse.
Diagnosis
Diagnosis of the underlying cause is made after emergency treatment and may involve a detailed medical and family history, physical examination, electrocardiogram (ECG), echocardiogram, cardiac MRI, and genetic testing. Pre-participation screening for athletes, including a thorough history and physical exam, can help identify those at risk. If a child or adolescent experiences fainting, chest pain, or palpitations during exercise, consult a doctor or cardiologist for evaluation.
Treatment Options
Immediate treatment of SCA involves calling emergency services, starting cardiopulmonary resuscitation (CPR), and using an automated external defibrillator (AED) if available. Survival rates are highest when CPR and defibrillation are started within minutes. After emergency care, treatment focuses on identifying and managing the underlying heart condition, which may include medications, lifestyle changes, or the implantation of a cardioverter-defibrillator (ICD).
Simple measures such as ensuring access to AEDs at sports facilities, training staff and students in CPR, and regular screening for at-risk athletes can help prevent tragic outcomes. If new symptoms develop or there is a family history of sudden cardiac death, consult a doctor promptly.
Prevention
While not all cases of SCA can be prevented, regular screening of young athletes, awareness of warning signs, and prompt emergency response can save lives. Families with a history of inherited heart conditions should seek genetic counseling and screening.
Takeaway
Sudden cardiac arrest in athletic children and adolescents is rare but serious. Early recognition, immediate action, and proper screening are essential for prevention and survival. If you notice warning signs or have a family history of heart disease, consult a doctor for assessment and guidance.