All kids should be screened for heart issues, says AAP

Baystateparent Magazine
Heart screenings recommended for all children.

The American Academy of Pediatrics is calling for all children to be screened for heart-related conditions that could lead to cardiac arrest or death. 

The group's new policy, issued this summer, updates previous recommendations which called for screenings for athletes. Now, the group says all children should be screened, regardless of their athletic status, and particularly as they enter middle school or junior high school.

About 2,000 individuals younger than age 25 die each year of sudden cardiac death in the United States, excluding sudden infant deaths. While autopsy studies show that most patients had structural heart anomalies, the causes for 6%-40% of deaths remain unexplained.

“We tended to focus on athletes in the past when parents brought their children and teens in for a sports physical, or preparticipation exam,” said Christopher C. Erickson, MD, FAAP, lead author of the statement. “We know today that all children and teens benefit from a simple screening to help identify any potential problem that warrants follow-up with a cardiac specialist.”

The AAP’s new guidance should help pediatricians identify children at risk for heart-related problems. The screening itself consists of four questions that ask if a child or teen has ever fainted, had an unexplained seizure, experienced chest pain or shortness of breath, as well as if family members have a history of cardiac conditions or death before age 50.

The screening should be incorporated into a child’s regular exam at least every two to three years, the group says. If there is a concern, an electrocardiogram should be the first test administered, and it should be interpreted by a physician trained to recognize electrical heart disease. The doctor should factor in a patient’s clinical history and consider referral to a specialist.

The AAP also says pediatricians should advocate for emergency action plans and CPR training within the community. The use of automated external defibrillators is effective, as well, in cases of sudden cardiac arrest.

“No single screening strategy will detect every possible heart issue, and so it’s important that we raise awareness and education not only in pediatric offices but within the community,” Dr. Erickson said. “We encourage parents and pediatricians to be alert for any concerning signs or family history.”