Monday, March 7, 2011

Sudden Cardiac Arrest in Children and Teens

Our Daniel

This week, a sixteen year old young man named Wes Leonard, who had just made the winning basket in his team's final game of the perfect season, went into cardiac arrest, and was later pronounced dead at a Michigan hospital. Today, the ABC affiliate in Fort Collins, Colorado was telling us about a seventeen year old named Matthew Hammerdorfer who took a blow to the chest during a school rugby game(Commotio cordis). He subsequently experienced a cardiac arrest, and was also later pronounced dead after being airlifted to a hospital.
Coroners claim that these young athletes must have had a congenital predisposition to a heart rhythm disturbance which caused their deaths.(This is not the same as what is commonly known as a "heart attack" or more correctly, a myocardial infarction. A heart attack involves clots and constrictions in the arteries that feed the heart, and cellular death occurs to the organ. "Heart attacks" are the result of coronary artery disease and normally are an issue for adults or older people. Daniel's coronary arteries on autopsy, for example were as "clean as a whistle".) For the purpose of this discussion, we are speaking about spontaneous heart rhythm disturbances which occur in young people, independently of any coronary artery disease.
Of course, I cried when I heard about each, because when I hear about another family's loss, I am immediately transported to the day that Daniel, on a perfect morning the day after Thanksgiving,two years ago, walked into the bathroom, collapsed and died. He was only 12 1/2 years old, and despite immediate CPR, and epinephrine, we never got him back. The medical staff on the Med-Evac helicopter worked for hours before pronouncing him dead on the oak floors in the hallway outside our main bathroom. The devastation of these families will never disappear. The loss of their child from Earth will remain both permanent and in some ways, forever emotionally inexplicable.
When Daniel died, I had to try to make sense of what had happened. I needed to explain this to myself in the language a college professor and critical care RN would understand. I did a great deal of research, and even contacted Dr. Brugada, in Barcelona, for whom one of the often fatal arrhythmic disorders associated with sudden death is named. I learned that in both Italy and Spain, all children, particularly boys, are screened with an EKG, looking for these uncommon, yet potentially deadly undiagnosed potential cardiac rhythm disorders. Apparently, many of these young people who go on to experience sudden arrhythmic death are as asymptomatic as Daniel was. In Italy and Spain, a routine EKG is certainly done before anyone is permitted to play athletics. In the US, health practitioners decline this, because our physicians believe that too few cardiac conduction disorders will be found to justify the expense for all children of 12, or even just all boys. The reality is, is that sudden cardiac death in teens and children is not as rare as many physicians would have us believe. No uniform records of exactly how many child or teen sudden cardiac deaths occur, but they are estimated to be 7,000 a year, in the US. I have met several parents in my own area who have lost children to this very issue, and I am located in a very rural part of Virginia. The fact is, that if we spare even one family from losing a precious child with no notice, then a screening EKG would be worth the hundred dollars paid.
My husband and I, and our three other biological children, will never attend Daniel's high school, or college graduations. He will be absent from our other children's weddings and also from his own. There will be no grandchildren someday visiting us along with a grown Daniel and his wife. His many friends remain devastated. If something could have been done to prevent his loss, then it should have been.
In addition,in the US, there is no standardization of autopsies for children or teens who are afflicted by sudden death. There is broad variation in the amount of work which may be done following sudden death. In fact, if we had not aggressively obtained our own immediate autopsy at a major medical center, doing one at all, was declined by our local medical examiner. Daniel had no prior medical history other than some food allergies as a small child, which according to his allergist, had been outgrown. His death was completely unexpected. An autopsy was a reasonable course of action, and he deserved an automatic investigation into what happened to him. Had we actively pursued and had we not agreed to pay for one in another jurisdiction entirely, one would never have been done. Daniel was failed by a medical system which considers the loss of " a few boys" annually, an acceptable loss. He was failed by an American Academy of Pediatrics which does not consider Sudden Death Arrythmic Disorders an important focus for pediatricians. He was failed again by a system which in my locality would have blocked an autopsy for anyone but a wealthy family. In our case, because no cause of death was found, Daniel's case was made a teaching case, and consequently, we were never billed for the autopsy.

Other things you may wish to research or
read about:

Long QT Syndrome
Wolff-Parkinson-White Syndrome
Brugada Syndrome
SADS (Sudden Arrhythmic Death Syndrome)



This is supplemental information from Dr. Mehmet Oz, a cardiac surgeon, and medical television personality, as reported by his fan base.

#1 Sudden Killer In Children – Death By Sudden Cardiac Arrest

By DrOzFans on April 22, 2010

Doctor Oz did an episode on the number one sudden killer in children- Sudden Cardiac Arrest, which causes the sudden death in children. Cardiac Arrest in children is almost always fatal. What causes these kids to die? What are the warning signs of Sudden Cardiac Arrest? If you have children, you must read this and send it to all of your friends and family members with kids! sudden cardiac arrest

Dr Oz was joined by Dr G, Medical Examiner on Discovery Health, to teach us about sudden cardiac arrest – the number one sudden killer in children. One moment your kid can be full of energy and running around and then suddenly his or her heart can stop beating and stop pumping blood to the brain or other body parts. There are often no symptoms or warnings right before the Sudden Cardiac Arrest attacks. Sudden Cardiac Arrest is not the same thing as a heart attack. There are over a dozen heart disorders that can cause Sudden Cardiac Arrest. Of the 7000 children that go into Sudden Cardiac Arrest each year, only 5% survive. Death is preventable though if you know that your child has a heart condition. These are not kids that look sick or chronically ill.

Sudden Cardiac Arrest Causes:

1. Enlarged Heart

A normal heart for a child is 300 grams, but their heart can get 2 to 4 times as large and as the muscle get enlarged, it can cause your child to die. Overtime, if it is a congenital problem, the muscle wall in the heart will thicken and want more blood supply, which makes the thickened muscle very angry and irritable if it does not get what it needs.
2. Arrhythmic Heart or Electrical Heart Problem

Arrhythmia, or an inconsistent heart beat, is an electrical heart problem that is often genetic, but an autopsy can’t find this problem.

Doctor Oz told the story of a young girl named Sarah who was 12 and turning 13 in a few weeks. Sarah was on her summer vacation and was taking a junior lifeguard course, when she asked her mom if she could play at the waterpark afterwards. Shortly after that, Sarah’s friend called and said that Sarah had collapsed. Sarah ended up dying of Sudden Cardiac Arrest, and her mother is just left with a locket of Sarah’s hair and her old swimsuit.

Sarah had some signs of Sudden Cardiac Arrest, because she told her mom that her chest hurt and she felt a tightness in her chest when she played sports that involved running. Her mother took her to the doctor, but he listened to her heart and just dismissed it.

Dr. Asif Ali did a test on a group of 6th graders and found that by doing some simple tests such as an echocardiogram, he was able to find 7 children with heart conditions, and 2 kids who needed medical intervention.
Sudden Cardiac Arrest Signs & Symptoms
1. Family History

You must be proactive and know the genetic risk factors and family history.
2. Fatigue
3. Heart Palpitations
4. Tightness of the Chest

How to Prevent Death by Sudden Cardiac Arrest
1. Know Symptoms Above
2. AED (Automated External Defibrillator)

Make sure you have an automated external defibrillator at your child’s school. Sarah’s parents got the government in Texas to pass a law making all schools have automated external defibrillators and recently 2 children in Texas were saved with the AED’s.

Also, if anyone in your family under 60 dies, you must have an autopsy done so that you can determine the cause of death, because it can dramatically help future generations and your kids to know their risks.

Please share this information.

Daniel had no clear symptoms. He had no clear heart abnormalities on autopsy. The conclusion that a heart rhythm disturbance was responsible for his sudden death was concluded by pathologists based on
a.) a clean autopsy b.) a failure to respond to immediate CPR and 2 spaced injections of epinephrine. c.) grandparental history of heart rhythm disturbances. (Although most grandparents died at very advanced ages) d.) He had played soccer the day before his death. e.) He had a viral syndrome (flu) about a month before his death, when his grandfather passed, but he was very nearly completely recovered when he experienced sudden cardiac death.

This is an excellent source of additional information:


  1. This comment has been removed by a blog administrator.

    1. Amelia, Thank you for posting. I am glad it was helpful and that you had an opportunity to convey the available heart hospitals for those in India. Best wishes.


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