Sudden Cardiac Arrest in the Young

Each year thousands of children, teens and young adults suffer Sudden Cardiac Arrest (SCA). SCA is a medical emergency. If not treated within minutes it usually causes death.

SCA is not the same as a heart attack. SCA is a condition in which the heart suddenly and unexpectedly stops beating, usually due to irregular heartbeats called arrhythmias that stop the flowing of blood to the brain and other vital organs. SCA can happen in people who appear healthy and have no known heart disease or other risk factors. The leading causes of SCA in the young are undetected heart abnormalities, including Hypertrophic Cardiomyopathy (HCM), coronary artery abnormalities, Myocarditis, Long Q-T Syndrome (LQTS) and Wolff-Parkinson-White Syndrome, among others. Commotio Cordis (a blow to the chest) can also cause SCA.

SCA victims can survive if they receive immediate CPR and are treated rapidly with Automated External Defibrillators (AEDs). An AED is a device that sends an electric shock to the heart to restore its normal rhythm. To be effective, this treatment must be delivered ideally within three to five minutes after collapse.

Top 10 Facts Everyone Should Know About SCA

  1. SCA is a leading cause of death in the United States. It kills more people each year than breast cancer, prostate cancer, colorectal cancer, AIDS, traffic accidents, house fires and gunshot wounds combined.
  2. Around 360,000 people die each year from SCA (1,000 per day or one person every two minutes).  About 3,000 people die each year from fire-related deaths. That means you are over 100 times more likely to need an AED before you will ever need a fire extinguisher.
  3. Among children and young adults it is estimated that SCA affects several thousands per year. In this group SCA most often occurs between the ages of 10 and 19. It strikes boys four times more often than girls and occurs during exercise 60 percent of the time.
  4. SCA is a time-critical medical emergency. If not treated within 10 minutes from collapse SCA will likely result in death or irreversible brain damage. Brain death begins approximately 5 minutes after blood circulation stops. The survival rate declines by about 10 percent for each minute without blood circulation. Beyond 10 minutes from collapse, the survival rate is only 5 percent.
  5. When accessed quickly by calling 911, emergency medical services (EMS) have been shown to improve survival rates from SCA by providing early defibrillation. However, most EMS systems cannot deliver defibrillation within the time frame required to significantly increase survival. As a result, the national survival rate for SCA is around a dismal 5%.
  6. The only effective treatment to reverse the heart to a normal rhythm is defibrillation (an electric shock to the heart) using an AED. However, defibrillation must be provided immediately. When both CPR and AED are used within the first 3-5 minutes from collapse, the survival rate is close to 75%.
  7. AEDs are affordable, easy to use and maintain. Studies show that a person as young as 10 can learn to use and operate an AED effectively.
  8. The “Good Samaritan” law in Connecticut protects AED users from liability.
  9. Most occurrences of SCA in the youth occur in public places and during exercise. The availability of publicly accessible AEDs in schools and athletic fields dramatically increases survival rates. 
  10. Children and young adults are not routinely or adequately screened for heart conditions. Most youth who suffer SCA have an undetected heart condition. A thorough family history and physical examination that includes an electrocardiogram as a baseline test can help detect approximately 60% of the heart conditions that may lead to SCA. Approximately 2% of youth that are heart-screened are diagnosed with a heart abnormality or concern.

How you can save a life

What to do:

Learn the Chain of Survival 

This is a four-step intervention process developed by the American Heart Association.

  • Recognize the SCA emergency: Sudden collapse; loss of consciousness; cessation of normal breathing; loss of pulse and blood pressure
  • Call 911 immediately
  • Give CPR (chest compressions): This is the critical link that buys time between the first link (Call 911) and the third link (Use the AED)
  • Use the AED: Use defibrillation to restore the heart to a normal beat

What not to do:

The worst thing for an SCA victim is that bystanders do nothing. Sometimes people hesitate to help because they are afraid they might do the wrong thing and hurt the victim. But the SCA victim is already clinically dead and cannot get worse. Your actions can only help.

Warning Signs

The warning signs and symptoms of a heart condition in children and young adults frequently go undetected or are misdiagnosed. Those who live and work with youth must be aware of these signs and symptoms and if any exist they should be reported to the child’s physician immediately. 

Medical professionals must be more acutely aware of the warning signs and symptoms of a heart condition. 

These symptoms include:

  • Fainting or seizure during or after physical activity
  • Fainting or seizure resulting from emotional excitement, emotional distress or startle, or unexplained
  • Family history of unexpected sudden death during physical activity or during a seizure, or any other unexplained sudden death of an otherwise healthy family member under age 50
  • Chest pain or discomfort / racing heartbeat
  • Family history of heart disease
  • Unusual shortness of breath
  • Unusual fatigue / tiredness
  • Dizziness / lightheadedness during or after physical activity

To lean more about SCA:

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