0A-S1-2

SUDDEN CARDIAC DEATH IN CHILDREN AND ADOLESCENTS

Stuart Berger¹

¹ Medical College of Wisconsin, Children’s Hospital of Wisconsin, USA

Sudden cardiac death (SCD) in the pediatric and adolescent population is relatively rare though some reports suggest that the frequency is increasing. The incidence of SCD in the student-athlete population is reported to be anywhere from 1 in 100,000 to 1 in 300,000. The causes associated with SCD in children and adolescents are usually congenital and include hypertrophic cardiomyopathy, long QT syndrome, congenital coronary artery abnormalities, right ventricular dysplasia, WPW as well as other known congenital heart defects. Because many children who suffer SCD are unknown and asymptomatic prior to the episode of SCD one of the challenges in preventing SCD is in the attempts to identify these patients with adequate screening, prior to the episode of SCD. Screening therefore involves elicitation of a careful history, family history, and physical examination to uncover any potential clues. Screening ECG and echocardiography has been advocated, but is not widely performed. The author contends that even with “optimal” screening many children who are at risk for SCD will not be discovered. Project ADAM has been launched in order to educate caretakers, students, teachers, et al about screening, symptoms,etc with regard to children and adolescents at risk if SCD. In addition, the goals of Project ADAM include teaching CPR to every high school student in the state of Wisconsin prior to graduation as well as the placement of automatic external defibrillator (AED) in each of the high schools in the state. The latter will allow for the opportunity for rapid intervention in the student (or adult) that cannot be detected with screening and suffers an episode of SCD with ventricular fibrillation. A cost-effectiveness analysis of Project ADAM will be presented.