AAP: Screen all children for potential heart-related issues
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In a new policy statement, the AAP said all children — particularly those entering middle school — should be screened for conditions that can lead to cardiac arrest or death, regardless of their athletic status.
Christopher C. Erickson, MD, FAAP, professor of cardiology at the University of Nebraska Medical Center, and colleagues provided guidance to assist pediatricians in identifying children at risk for heart-related issues.
The updated guidance contains a comprehensive review of conditions that should prompt more attention and cardiology evaluation, the AAP said.
The recommendations include:
- Clinicians should evaluate if a patient’s clinical history, family history and physical examination suggest a risk for sudden cardiac arrest or sudden cardiac death.
- If there is concern, an electrocardiogram should be the first test administered, then interpreted by a physician trained to recognize heart disease. The doctor should factor in a patient’s clinical history and consider referral to a specialist.
- Clinicians should advocate for emergency action plans and CPR training with the community. The use of automated external defibrillators is effective, in cases of sudden cardiac arrest.
- The screening consists of four questions that ask if a child or teen has ever fainted or had an unexplained seizure or has experienced chest pain or shortness of breath, or if a family member has a history of cardiac conditions or death before the age of 50 years.
“We tended to focus on athletes in the past when parents brought their children and teens in for a sports physical, or preparticipation exam,” Erickson said in a 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.”
According to the AAP, about 2,000 individuals aged younger than 25 years die annually of sudden cardiac death in the United States. Although autopsy studies show that most patients have structural heart anomalies, the causes for 6% to 40% of deaths remain unexplained, AAP stated.
References:
Erickson CC, et al. Pediatrics. 2021;doi:10.1542/peds.2021-052044.
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AAP. American Academy of Pediatrics: All children should be screened for potential heart-related issues. https://services.aap.org/en/news-room/news-releases/aap/2021/american-academy-of-pediatrics-all-children-should-be-screened-for-potential-heart-related-issues/. Accessed June 22, 2021.
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