Sudden Death in the Young: Information for the Primary Care Provider

Abstract

There are multiple conditions that can make children prone to having a sudden cardiac arrest (SCA) or sudden cardiac death (SCD). Efforts have been made by multiple organizations to screen children for cardiac conditions, but the emphasis has been on screening before athletic competition. This article is an update of the previous American Academy of Pediatrics policy statement of 2012 that addresses prevention of SCA and SCD. This update includes a comprehensive review of conditions that should prompt more attention and cardiology evaluation. The role of the primary care provider is of paramount importance in the evaluation of children, particularly as they enter middle school or junior high. There is discussion about whether screening should find any cardiac condition or just those that are associated with SCA and SCD. This update reviews the 4 main screening questions that are recommended, not just for athletes, but for all children. There is also discussion about how to handle post-SCA and SCD situations as well as discussion about genetic testing. It is the goal of this policy statement update to provide the primary care provider more assistance in how to screen for life-threatening conditions, regardless of athletic status.

Workup for Suspected Brugada Syndrome: Two Case Reports for the General Practitioner

“…Primary care providers (PCPs) serve a vital role in the prevention of cardiac disease. In both the adult and pediatric domains, it is recommended that PCPs focus cardiac screening on risk factors and family history of any cardiac abnormalities [6,12,13]. The American Academy of Pediatrics specifically recommends screening for family history of sudden cardiac death or sudden cardiac arrest for primary prevention [6].…”

“…In both the adult and pediatric domains, it is recommended that PCPs focus cardiac screening on risk factors and family history of any cardiac abnormalities [6,12,13]. The American Academy of Pediatrics specifically recommends screening for family history of sudden cardiac death or sudden cardiac arrest for primary prevention [6]. In particular, the PCP is especially critical in the context of Brugada syndrome, as multiple family members within their patient panels may be affected.…”

“…ST-segment elevation on EKG can increase suspicion for myocardial infarction (MI), but other causes may include pericarditis, early repolarization, left ventricular hypertrophy, left bundle branch block, ventricular aneurysm, or takotsubo cardiomyopathy [1,2]. One additional cause of ST-segment elevation is Brugada syndrome, which is associated with ventricular arrhythmia and sudden cardiac death [3][4][5][6]. EKGs in patients with Brugada syndrome have a characteristic ST-segment elevation in the anterolateral leads (V1 to V3) [4,[6][7][8].…”

“…One additional cause of ST-segment elevation is Brugada syndrome, which is associated with ventricular arrhythmia and sudden cardiac death [3][4][5][6]. EKGs in patients with Brugada syndrome have a characteristic ST-segment elevation in the anterolateral leads (V1 to V3) [4,[6][7][8]. It poses a challenge to primary care clinicians to assess the risks of sudden cardiac death in such patients.…”

COVID Vaccination in Athletes and Updated Interim Guidance on the Preparticipation Physical Examination During the SARS-Cov-2 Pandemic

“…Anaphylaxis with mRNA vaccines 27,31,36,37 2. Thrombotic events with thrombocytopenia [32][33][34]37,38,40,44 c Although rare, pericarditis and myocarditis have been reported among recipients of mRNA vaccines. The chance of developing this heart condition is 6 times greater after infection compared with side effect of vaccination.…”