Published online August 1, 2006
PEDIATRICS Vol. 118 No. 2 August 2006, pp. 802-804 (doi:10.1542/peds.2006-0564)
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COMMENTARY

Preventing Pediatric Sudden Cardiac Death: Where Do We Start?

Robert M. Campbell, MDa and Stuart Berger, MDb

a Children's Healthcare of Atlanta Sibley Heart Center, Emory University School of Medicine, Atlanta, Georgia
b Children's Hospital of Wisconsin-Herma Heart Center, Milwaukee, Wisconsin

Abbreviations: SCD, sudden cardiac death

The first 20% of the full text of this article appears below.

First steps first. Good medical practice begins with good history. The details of a disciplined, comprehensive patient and family history may provide the first clues to a patient-specific medical diagnosis that directs a patient-specific medical treatment. Patient and family history is critical for diagnosing diseases that cause pediatric sudden cardiac death (SCD).

Pediatric SCD is uncommon. It is estimated that 500 to 1000 pediatric patients <21 years old will suffer SCD each year in the United States.1 However, each event is absolutely devastating to parents, families, neighbors, communities, and health care providers. Could the death have been prevented? Could the diagnosis have been made before the fatal event?

The differential diagnosis for causes of pediatric SCD includes anatomic and structural abnormalities of the heart (eg, hypertrophic cardiomyopathy, single right coronary artery with anomalous course of the left coronary between the aorta and pulmonary artery, arrhythmogenic right ventricular cardiomyopathy, etc), primary electrical cardiac disorders (including long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, short QT syndrome), stimulant use (eg, cocaine, ephedra), and trauma (commotio cordis). Importantly, because many of these disorders are genetic, the identification of a first-affected family member may unravel extensive family involvement.

The impact of genetic evaluation was detailed recently in 2 publications. Tan et al2 reported . . . [Full Text of this Article]

Address correspondence to Robert M. Campbell, MD, Sibley Heart Center Cardiology, 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341. E-mail: campbellr@kidsheart.com


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