Christopher C. Erickson, MD: Screening for Risk of Cardiac Arrest in Children

Back in June, the American Academy of Pediatrics released an updated policy statement for information for a primary care provider on screening children prone to sudden cardiac arrest (SCA) or sudden cardiac death (SCD).

The primary author of the statement, Christopher C. Erickson, MD, The Criss Heart Center, Children's Hospital & Medical Center Omaha, spoke with HCPLive® on the larger implications of the statement in primary care.

Erickson recently presented a talk entitled "Sudden Death in the Young" at the 2021 American Academy of Pediatrics Virtual Meeting.

Foremost, he explained that these cardiac events can really happen at any age in pediatric patients, regardless of demographics, as it is dependent more on the entity of disease they have that might cause one of these cardiac events. Notably, he mentioned genetics as an important factor in the consideration of a patient who may be prone to cardiac arrest.

He discussed the comorbidities of channelopathies and cardiomyopathies and ultimately discussed the policy statement recommendations of screening for conditions that may be related to SCD and SCA, rather than each cardiac defect.

The main questions for screening included:

• Have you ever faded, passed out or had an unexplained seizure suddenly and without warning, especially during exercise, or in response to loud sudden noises such as doorbells, alarm clocks, and ringing telephones?
• Have you ever had exercise related chest pain or shortness of breath?
• Has anyone in your immediate family, parents, grandparents or siblings, or other more distant relatives, aunts, uncles and cousins died of heart problems, or had an unexpected sudden death before the age of 50?
• Are you related to anyone with hypertrophic cardiomyopathy or hypertrophic obstructive cardiomyopathy, Marfan syndrome, arrhythmogenic, cardiomyopathy, Long QT syndrome, short QT syndrome, regardless syndrome, or catecholaminergic, polymorphic, ventricular tachycardia, or anyone younger than 50 years of age with a pacemaker or implantable defibrillator.

Erickson went on to highlight other important aspects of the paper, particularly the role of a clinician or caretaker in the event of both prevention before a cardiac event and communication and assessment post-event.

“It emphasizes that the role of the primary care physician is that pediatricians and other primary care physicians do have a role in both prevention of sudden death and the evaluation after a sudden cardiac arrest occurs,” Erickson said. “In other words, how to deal with family, how do we evaluate survivors?”