FRIDAY, March 9 (HealthDay News) -- Each year, between one and
six of every 100,000 U.S. children are a victim of sudden cardiac
death. In many of these cases, underlying, undiagnosed heart
trouble is responsible, and a new study suggests that routine mass
electrocardiogram (EKG) screening could help identify these
problems earlier, and potentially save children's lives.
Although EKG exams, which record electrical activity in the
heart, could help identify these heart problems, many questions
remain about how and when to use them.
Researchers from Tufts Medical Center, Harvard Medical School
and Children's Hospital Boston analyzed data from 30 studies, which
examined subgroups of children such as newborns and high school
athletes. The results appear online and in the April issue of
Pediatrics.
The goal of the study was to see how accurate EKG was at
identifying three of the most common disorders associated with
sudden cardiac death: hypertrophic cardiomyopathy (a thickened
heart muscle), long QT syndrome (a rare congenital disorder) and
Wolff-Parkinson-White syndrome (a condition that can lead to very
rapid heart rate).
By and large, EKGs were accurate at identifying these three
conditions, but there was a risk of false positives in some
cases.
"EKG is going to find disease; this is undisputed. But we will never find all the diseases that we worry about because not all things are detectable on EKG," said study author Angie Mae Rodday of Tufts Medical Center in Boston. "Some of these heart problems are very age dependent, so even if you are going to develop it as you get older, an EKG may not have any findings."
Study co-author Dr. Laurel Leslie, an associate professor of
pediatrics and medicine at Tufts University, agreed. "There are,
unfortunately, [heart problems] that aren't identified by any of
these approaches, which is tragic, but thankfully quite rare," she
said.
Rodday's advice for concerned parents is to "work with [your]
pediatrician and be aware of family history."
"A number of these disorders are genetic," she said. "Family history is not your Uncle Fred who had a heart attack at age 75. We are talking about disorders where someone died of a cardiac problem before the age of 50."
Dr. Rubin Cooper, chief of pediatric cardiology at Cohen
Children's Medical Center in New Hyde Park, N.Y., said the proper
timing of an EKG as a screening test is an issue. EKG readings
change in the first few weeks and years of life.
"We are between a rock and a hard place because we don't want to give people a false sense of security," Cooper said. "A normal EKG reading may not mean they are not at risk for sudden cardiac death in the future."
It is too soon to offer blanket screenings for all kids, Cooper
said. "We need some sort of filter, such as a pediatrician or
family practitioner, to identify the family history very accurately
and conduct a physical exam," he said.
Children who develop chest pain or shortness of breath during
exertion, however, may need further evaluation by EKG, Leslie
said.
More information
Learn more about
sudden cardiac death at the U.S. National Heart,
Lung, and Blood Institute.