4 questions to ask to help prevent sudden heart death in children

It's extremely rare for a child to die suddenly from cardiac disease, but when it occurs, it's a terrible tragedy, especially because many times it could have been avoided if someone had simply asked the correct question.

We tend to associate abrupt fatalities like this with sports because we frequently hear about them occurring on a playing field — and because players have received the majority of the preventative efforts.

They can, however, occur in adolescents and teenagers who aren't sports, according to a recent policy statement from the American Academy of Pediatrics. Primary care physicians will be able to better screen their patients for heart abnormalities that can lead to sudden death as a result of the advice provided.

Here is what parents should know and do.

What could trigger a child's sudden cardiac arrest or death?

There are a number of cardiac diseases that can put you at risk of dying suddenly. They include the following:

Congenital heart disease (CHD) is a type of congenital cardiac defect When children are born with a heart abnormality, they are more likely to develop arrhythmia as a result of the defect or the surgery used to correct it.

Cardiomyopathies. These are issues with the heart's muscles. There are several types, but hypertrophic cardiomyopathy, in which the heart muscle thickens abnormally, is the most likely to cause sudden death.

Aortopathies. This is the medical term for a problem with the aorta that could cause it to inflate (aneurysm) and rupture. (The primary blood channel connecting the heart to the rest of the body is the aorta.) One disorder that might cause this is Marfan's syndrome, although there are others as well.

Problems with the heart's electrical conduction system. The system that causes the heart to contract and circulate blood throughout the body is known as the circulatory system. An arrhythmia can result from problems with this conduction pathway, and the heart may not be able to move blood well or at all.

Stenosis of a coronary artery. The coronary arteries give oxygenated blood to the heart muscle. If one or both arteries are blocked, the heart muscle may not receive the blood it requires. After hypertrophic cardiomyopathy, an aberrant coronary artery is the second largest cause of sudden death.

Four key screening questions can aid in the detection of heart risk.

Many of these illnesses can and do go unnoticed for years. According to the American Academy of Pediatrics, the following four questions can assist identify which children are at risk:

1. Has anyone in your close family (parents, grandparents, siblings) or other distant relatives (aunts, uncles, cousins) died of heart disease or sudden death before the age of 50? (This includes unintentional drownings, mysterious vehicle accidents in which a relative was the driver, and SIDS, or sudden infant death syndrome.)

2. Have you ever fainted, passed out, or had an unprovoked seizure, particularly during exercise or in response to unexpected loud noises like doorbells, alarm clocks, or ringing telephones?

3. Have you ever experienced chest pain or shortness of breath when exercising? Usually, this is caused by a torn muscle or asthma. However, it could be related to the heart of the discomfort is pressure-like, extends to the neck or arm, is accompanied by perspiration, nausea, or fainting, or occurs with exercise, straining, or stress.

4. Are you related to someone who has hypertrophic cardiomyopathy, hypertrophic obstructive cardiomyopathy, Marfan syndrome, arrhythmogenic cardiomyopathy, long QT syndrome, short QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia (CPVT), or a pacemaker or implantable defibrillator?

The last question emphasizes the necessity of understanding your family's history in detail. We don't always like to probe, yet understanding the specifics can be critical for the wellness of other family members. So don't be hesitant to ask family members about the specific diagnosis they received from a doctor — and then tell your doctor about it. This applies to all health issues, not just cardiac issues. Naturally, some people may not have access to their family's medical records.

When should this screening be performed?

According to the American Academy of Pediatrics, your child's doctor should ask these questions at least once every three years, or at the time of entry into the middle or junior high school, and at the time of enrollment into high school. If the child's answer to any of the questions is yes, he or she should be referred to a cardiologist (or an arrhythmia specialist) for additional evaluation. They should not participate in sports until they have been cleared. Families, on the other hand, do not have to wait for a paediatrician to ask the questions. If any of them is yes, or maybe yes, speak with your child's doctor straight away. It's possible that you'll be able to save your child's life.