Restrictive cardiomyopathy: normal to thickened ventricular walls and normal ventricular size with impaired diastolic function and often with dilated atria.Īrrhythmogenic cardiomyopathy (includes arrhythmogenic right ventricular cardiomyopathy ): enlarged, dilated right ventricle with orwithout decreased systolic function often associated with frequent arrhythmias (can be seen in the leftventricle as well).
HCM is reported as the most common cause of SCA and SCD in young athletes. Hypertrophic cardiomyopathy (HCM): abnormally thickened ventricular myocardium without cause (eg, hypertension, coarctation, aortic stenosis, etc). 14ĭilated cardiomyopathy: enlarged, dilated left and/or right ventricle with or without decreased systolic function. 2– 4, 12, 13 Currently, several groups are studying the question of the use of preparticipation ECG to date, none have published conclusive data on its overall effectiveness, practicality of implementation, or cost. 6– 11 There have been numerous studies addressing preparticipation screening, including whether electrocardiography (ECG) or other noninvasive tests should be added. SCA and SCD in young people have been addressed in several articles that have focused efforts toward disease recognition as well as prevention. In today’s society, the nonathlete is much less visible because of the great attention paid to athletics in the lay press, which creates the perception that only athletes have an increased risk of sudden cardiac events. However, the sudden death of a young nonathlete is no less tragic. 1– 5 The sudden death of a young athlete is always tragic for the family and community. There is a growing movement to identify pediatric and young adult athletes who may be at risk for sudden cardiac arrest (SCA) or sudden cardiac death (SCD) during sports participation.
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It is the goal of this policy statement update to provide the primary care provider more assistance in how to screen for life-threatening conditions, regardless of athletic status. There is also discussion about how to handle post-SCA and SCD situations as well as discussion about genetic testing.
This update reviews the 4 main screening questions that are recommended, not just for athletes, but for all children. There is discussion about whether screening should find any cardiac condition or just those that are associated with SCA and SCD. The role of the primary care provider is of paramount importance in the evaluation of children, particularly as they enter middle school or junior high. This update includes a comprehensive review of conditions that should prompt more attention and cardiology evaluation. This article is an update of the previous American Academy of Pediatrics policy statement of 2012 that addresses prevention of SCA and SCD. Efforts have been made by multiple organizations to screen children for cardiac conditions, but the emphasis has been on screening before athletic competition. There are multiple conditions that can make children prone to having a sudden cardiac arrest (SCA) or sudden cardiac death (SCD).
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