You’ve heard about the teenager who collapses on the basketball court or the football field and never recovers — a kid who had shown no signs of a heart condition and seemed in perfectly good health. And you’ve probably wondered whether you should worry about your own children.

female athleteSudden cardiac arrest (SCA), which is often to blame for these deaths, is rare in children and adolescents. Still, it can affect anyone, even those who are young and physically fit. Each year, SCA claims the lives of over 2,000 children and adolescents in the U.S. and accounts for approximately 3-5 percent of all deaths in children aged 5-19 years.

Fortunately, you can help prevent sudden cardiac arrest by understanding what it is, learning how to recognize the signs of SCA and understanding how you can help a child who is in trouble.

What is sudden cardiac arrest?

Sudden cardiac arrest occurs when the heart suddenly and unexpectedly stops beating effectively and blood flow to the body and vital organs stops. It is usually caused by the loss of normal heart rhythm, usually from an irregular and rapid quivering of the ventricles (called ventricular fibrillation). The result: A person suddenly collapses without a pulse or spontaneous breathing.

Rarely, these abnormal heart rhythms resolve on their own. More often, early emergency treatment with cardiopulmonary resuscitation (CPR) or an automated external defibrillator (AED) is needed to help convert an abnormal heart rhythm into normal rhythm, and regulate the heartbeat. Both of these methods can help prevent sudden cardiac death (SCD).

Who is at risk?

Sudden cardiac arrest occurs more frequently in males than females, and, in children, most often occurs between 10-19 years of age. Other risk factors include:

  • Athletic activity: Two-thirds of the deaths occur during exercise or activity, making SCA the leading cause of death in young athletes.
  • Congenital heart disease or structural heart abnormalities.
  • Known abnormal heart rhythms.
  • Obesity and hypertension.
  • Exposure to drugs, medications, toxins and infectious agents, including cocaine, inhalants, recreational or club drugs, and some prescription medications.
  • Sudden blow to the chest directly over the heart.
  • Family history of heart problems, fainting spells, and/or sudden death before 50 years of age.

Recognizing worrisome symptoms

Young people are often unaware that they can have serious heart problems before adulthood. They also may not tell adults when they experience worrisome symptoms, because they’re frightened, embarrassed or simply unaware that what they’re feeling could indicate a potentially fatal problem.

It’s important to encourage older children and teenagers to talk with you, their teachers and their coaches about how they’re feeling and make sure they know about the potential dangers of certain heart symptoms. 

If your child experiences any of the following symptoms, be sure to speak with your pediatrician: 

  • Exercise-related chest pain or discomfort
  • Dizziness or lightheadedness with activity
  • Unexplained fainting (syncope) or near fainting, especially during or just after activity
  • Repeated episodes of unexplained fainting or unusual seizures, especially during or just after activity
  • Racing heart and palpitations, especially with activity
  • Excessive fatigue or unexplained shortness of breath while exercising
  • Recent viral infection with chest pain or change in exercise tolerance

If your child suddenly collapses and does not immediately awaken, call 911, check for a pulse and breathing and start CPR. If an AED is available, it should be applied if there is no pulse. The best chance of survival is prompt recognition and a planned emergency response with CPR and AED use.

The Children’s Hospital of Philadelphia’s Youth Heart Watch Program has a School AED Program committed to making AEDs available to all children and adolescents. To learn more about SCA and how the Youth Heart Watch Program can train students and staff at your child’s school to operate AEDs, visit http://www.chop.edu/centers-programs/youth-heart-watch.