Annotated abstract☆

Article Outline

• 1. Berger, S., Kugler, J.D., Thomas, J.A., & Friedberg, D.Z. (2004). Sudden cardiac death in children and adolescents: introduction and overview. Pediatric Clinics of North America, 51, 1201-1209
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1. Berger, S., Kugler, J.D., Thomas, J.A., & Friedberg, D.Z. (2004). Sudden cardiac death in children and adolescents: introduction and overview. Pediatric Clinics of North America, 51, 1201-1209 

This article is one of many interesting papers in this edition of Pediatric Clinics of North America. Berger et al. review current thinking related to sudden cardiac death (SCD) in children and adolescents. The incidence of SCD, as discussed by Berger et al., is estimated to be anywhere from 0.8 to 6.2 cases/100,000 population per year. However, the true numbers are not definitively known because of the lack of an established national registry with mandatory reporting of unexpected SCD cases in children and adolescents. Reporting issues are problematic; thus, the authors urge the establishment of a national registry. Studying all cases of SCD is key to identifying major and subtle antecedent signs and symptoms that may be present prior to the event and, thus, alert health care providers to potential problems.

Berger et al. discuss sport preparticipation screening questionnaires that were developed to identify children with key preexisting symptoms and at risk familial factors. Although there is no perfect screening tool, the use of such questionnaires is nonetheless a useful component in primary prevention. Problems in their use are associated with the emphasis and completeness of various questionnaires as well as patient's accuracy in answering questions. Unfortunately, not all victims of SCD have known preexisting symptoms nor are knowledgeable about their family medical history. Thus, researchers continue to search for ways to diagnose underlying pathology associated with SCD and continue to refine screening tools that will allow providers to identify at risk children and adolescents in a cost-effective and accurate manner. Pilot studies now underway that add other routine screening tools such as ECG and echocardiography were briefly addressed. Berger et al. also addressed the benefits of secondary prevention programs in school- and community-based AED programs noting that the reported incidence of ventricular fibrillation in children and adolescents may be underestimated.