Healthy Living

Routine ECG test could save kids with heart problems

Friday, June 08, 2012

An electrocardiogram, called an EKG or ECG, checks for electrical problems in your heart. The heart is a muscular pump powered by a natural electrical system. The EKG records wavy lines measuring the electrical activity in the different chambers of the heart.

Thousands of seemingly healthy American kids die suddenly every year when this electrical system fails. Now a group of researchers believes this routine adult test could be used to save kids' lives.

Eleven-year-old Lena Felix is in constant motion. It's hard to imagine that for half her life, she lived with a potentially deadly heart defect called atrial septal defect (ASD).

"Basically a hole in your heart, and it was quite a large hole," said Lena's mother, Michelle Borelli.

Lena never showed any symptoms of heart trouble. Doctors discovered the defect by chance. Michelle Borelli had heard about a children's heart health study, and enrolled her kids on a whim.

Pediatric cardiologist Dr. Victoria Vetter is studying how measuring the electrical activity of the heart with an ECG could save kids' lives.

"These children may have the cardiac arrest as their very first symptom," said Vetter. "So by identifying them early and providing treatment and care, we can often prevent the cardiac arrest from occurring."

In the heart health screening study of 2,500 school-aged students, researchers found undetected abnormalities in 5 percent of kids. Lena was among the 1 percent who had a life-threatening condition.

But the ECG isn't foolproof. Critics say false positives could lead to more expensive tests and high anxiety for parents.

Still, Lena's mother believes it's worth it. Lena had surgery to fix her heart defect before it became life-threatening.

"My daughter is proof that this is something that should be mandated," said mother Michelle.

Vetter says research shows the ECG is three times as effective in picking up abnormalities as a personal history and traditional physical exam. She says improvements in ECG standards will lower false positives, reducing the number of tests needed. Vetter says she would eventually like to see e-c-g widely available at pediatrician's offices.

BACKGROUND: Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs. SCA usually causes death if it's not treated within minutes. Sudden cardiac arrest (SCA) is a primary cause of death in adults (there are about 300,000 sudden cardiac deaths each year in the United States alone), it's quite rare in the young people but it can happen. It's estimated that 6-8,000 deaths result from SCA in the young on an annual basis. (SOURCE: National Heart and Lung Blood Institute)

CAUSES AND SIGNS: The causes of SCA and death in young people vary. However, what all SCA episodes have in common is the final common pathway that leads to death. For a variety of reasons, something causes the heart to degenerate into a chaotic and abnormal electrical rhythm and the heart beats out of control. This abnormal heart rhythm is known as ventricular fibrillation. Many times death occur with no advance warning. However, there are a couple of signs that can indicate trouble. The first is sudden and unexplained fainting that occurs during physical exertion. This is known as syncope. In addition to syncope, seizures can also occur. The other major warning sign is a family history of unexplained deaths before the age of 50. (SOURCE: Sudden Cardiac Arrest Foundation)

NEW GENERATION OF TESTS: A pilot study in healthy children and adolescents shows that it is feasible to screen for undiagnosed heart conditions that increase the risk of sudden cardiac arrest (SCA). Adding a 10-minute electrocardiogram (EKG or ECG) to a history and physical examination identified unsuspected cases of potentially serious heart conditions.

The study team identified previously undiagnosed cardiac abnormalities in 23 subjects, and hypertension in an additional 20. Ten of the 400 subjects (about 2.5 percent) had potentially serious cardiac conditions. Of those 10 subjects, only one had experienced symptoms, and those had previously been dismissed. None of the 10 subjects had a family history of SCA.

The study showed using ECG, outperformed the history and physical examination and found previously unidentified potentially serious abnormalities that would not have been identified by history and physical examination alone. (SOURCE: The Children's Hospital of Philadelphia)

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