Sudden Cardiac Arrest In Children

Sudden cardiac arrest means the heart stops beating unexpectedly. It’s not something that you might expect to happen in children, but it can... It kills approximately 2,000 children of all ages each year in the United States. Sudden cardiac arrest is responsible for up to five percent of all deaths in children ranging from five to 19 years old. 

Awareness is the key to a better understanding of this heart problem that can happen to anyone at any age. The more you know about sudden cardiac arrest in children, the better. 

What is pediatric cardiac arrest?

With sudden cardiac arrest, the heart stops beating abruptly and unexpectedly. When the heart isn’t beating, blood is not circulating to major organs, including the brain. 

The lack of blood flow causes the child to collapse. Restarting the heart needs to be quick; otherwise, there may be damage and eventually death. 

Is pediatric cardiac arrest similar to a heart attack?

Although both a heart attack and sudden cardiac arrest affect the heart, the cause is different. A heart attack means there is a blockage keeping blood from going to the heart. Typically, the blockage is due to fat, cholesterol, or other substances closing off one or more arteries to the heart.

What causes cardiac arrest in children? 

The direct cause is loss of electrical heart function due to ventricular fibrillation (VF). VF means the heart ventricles begin to quiver rapidly and with an irregular pattern. 

The indirect cause is more elusive. Often it is due to a pre-existing problem with the heart, but different conditions than you see in adults.

Some common causes of cardiac arrest in children include:

  • Congenital heart problems such as structural abnormalities or Marfan syndrome
  • Postoperative cardiac repairs
  • Primary electrical diseases, which are abnormalities of the electrical system that controls the heart, for example, Wolff-Parkinson-White syndrome or Long QT Syndrome
  • Abnormalities with the heart muscle structure or functioning such as hypertrophic cardiomyopathy or dilated cardiomyopathy
  • Acquired heart disease like myocarditis, which is an infection
  • Chest trauma
  • Drug use

The exact cause is not always clear.

Who is most at risk among our youth? 

Sudden cardiac arrest can happen to any child. Certain groups seem to experience it more often, though. Those at most risk have a pre-existing heart problem that may or may not be diagnosed. 

There may also be medical problems like a recent viral infection, a history of fainting, or high blood pressure that can put children at risk. A history of unexplained seizures or seizure-like activity such as involuntary twitching of body stiffness can also be a warning sign.

Family history is a risk factor, too. If someone in the family has had sudden cardiac arrest, there may be a genetic problem to consider. 

Not every child who experienced sudden cardiac arrest falls into a risk category, or they do and don’t know it. Educating parents on what to look for is one way to prevent cardiac arrest in children.

What are signs of cardiac arrest in children? 

Despite the name, about 30 to 50 percent of children do exhibit warning signs before they arrest. Often, people don’t understand them, so they ignore them. 

Some common warning signs include:

  • Chest pain or discomfort during exercise
  • Fainting or extreme dizziness during or just after an athletic activity
  • Racing heart or palpitations 
  • Unexplained shortness of breath during exercise
  • Excessive fatigue during exercise
  • Change in exercise tolerance

Not everyone exhibits all of these symptoms. They may have just one or two of them. At least 50 percent of children who die from sudden cardiac arrest have no symptoms before the event.

A child who experiences any of these potential warning signs should see a doctor immediately. Evaluation by a pediatric cardiologist may allow parents to develop a plan in case SCA happens. Planned emergency response is the best chance a child has of survival. 

What to do in case of a sudden cardiac arrest?

The chain of survival concept consists of five steps that must occur as quickly as possible to increase the chance of survival from sudden cardiac arrest: 

  1. Initiate EMS by calling 911 or making sure someone calls for you.
  2. Do cardiopulmonary resuscitation (CPR) focusing primarily on chest compressions. Hands-only CPR is the most effective immediately after the collapse. CPR pumps blood throughout the body until the restoration of the heartbeat. Continue the CPR until the heart starts again either spontaneously or with the help of an automated external defibrillator (AED) or EMS arrives.
  3. Rapid defibrillation with an AED to restore normal heart rhythm. If there is no AED available, you should continue CPR until help arrives. 
  4. Advanced life support from EMS
  5. Post-cardiac arrest care at a hospital

These five steps are the most effective response because they keep blood flow going to the brain. If there is no AED available, you should continue CPR until help arrives. 

Are there ways to help prevent pediatric cardiac arrest?

There are steps parents can take to determine if the child is at risk for SCA. That starts with regular well-child visits. Wellness visits screen for many conditions that might put your child at risk, such as undiagnosed heart problems. 

Pre-participation exams, or sports physicals, are also important tools to prevent SCA. A physical exam before playing organized sports, taking gym class, or signing up for a recreational activity that involves plenty of exercise -- like going to camp, for example -- can save lives. 

Many communities have heart screenings that are free of charge. Heart screenings can identify structural and electrical problems that might put a child at risk. A healthcare professional will take a family history, do a physical exam, and an electrocardiogram to check the heart’s rhythm during a screening. Some screenings may also include an echocardiogram to rule out a structural problem.

Genetic testing can offer insight, too. It may pinpoint a family history of Long QT Syndrome, a genetic condition that can cause SCA, for instance. 

Any child who has warning signs or falls into a risk category should be evaluated with tests such as an EKG and an echocardiogram. Identifying an underlying heart condition or another risk factor means stopping sudden cardiac arrest before it happens.

Early intervention can include medication and lifestyle changes. Specialists may recommend the implantation of a cardioverter-defibrillator -- a small, computerized device that can recognize an abnormal heart rhythm and correct it with an electrical shock. 

How to support our cause and save more kids!

Simon’s Heart is the legacy of Simon, a little boy who died way too soon due to sudden cardiac arrest. Today, we work tirelessly to raise awareness and provide information and initiatives to prevent more kids from dying. 

You can support this worthy cause in so many ways. Students can become ambassadors to raise awareness in their schools. Parents can go online to give money. They can host a fundraising drive and petition companies in the area to match the donation or ask them to host a heart screening. You can even list Simon’s Heart as your charity on Amazon Smiles. That will mean proceeds from your Amazon purchases will come to Simon’s Heart. 

Businesses can sponsor one of our annual events, partner with us, or even get an AED. It all helps. 

Sudden cardiac arrest has taken too many lives. Let’s change that together.