Electrocardiographic Screening of All Infants, Children, and Teenagers Should Be Performed
If we had the requisite wisdom or irrefutable evidence to answer the existing questions about screening and the prevention of sudden cardiac death (SCD) in youth, perhaps the perpetual screening debate would be resolved. Without that seemingly inaccessible goal, we continue to discuss and debate the best practices to identify those with conditions that predispose to SCD.1–4
Response by Friedman p 697
This article will attempt to discuss many of the unanswered questions surrounding screening and to present a cogent rationale for the use of the ECG in screening for heart conditions in the young. Only focusing on the How precludes an understanding of the broad focus that is necessary for effective screening for these somewhat elusive conditions in an age group that is changing on a daily basis.
The issues to be discussed in this article will focus on screening data that currently exist, both in the United States and in other countries. A more expansive view of screening of all infants, children, and adolescents, not just athletes, will be proposed along with the advantages and disadvantages of ECG screening.
Why Is Screening Needed?
Many of the condition responsible for SCD are subtle and not evident. SCD is not a disease or medical condition but an outcome of a broad spectrum of diseases or conditions. To prevent SCD, a predisposing disease condition must be identified and early intervention provided. Disease-specific prevention must be applied with ongoing surveillance by the individual’s physician.
Why Screen Children?
Sudden cardiac arrest (SCA) is not well recognized as an event that occurs in neonates and all children because there is no current registry that documents all childhood SCDs or all childhood cardiovascular deaths. Sudden infant death syndrome (SIDS) may be associated with SCA from a channelopathy or with critical congenital heart disease. Many children are extremely active, sometimes …