Warning Symptoms and Family History in Children and Young Adults with Sudden Cardiac Arrest

BACKGROUND The association between a positive family history (PFH) of premature cardiovascular disease (PCVD) and atherosclerosis has been explored in numerous studies. In adults, various studies have confirmed a significant positive correlation between a PFH and PCVD. Scant literature however, focuses on young individuals. Nevertheless, it is important to understand the impact that a PFH has in young people because the foundations of atherosclerosis and adverse cardiac behaviors develop in youth. In this paper, we aimed to systematically review the evidence linking a PFH of PCVD to indirect markers of subclinical atherosclerosis. METHODS The search was conducted on Medline, Web of Science and Embase. ‘Family history’, ‘children/young adults’ and ‘subclinical atherosclerosis’ were the three main concepts used. Increase in mean carotid IMT (cIMT), endothelial dysfunction and vascular inflammation were used as indirect measures of subclinical atherosclerosis. RESULTS 1191 articles were identified in the initial search. 24 papers with 5400 participants were included in the final review. There were five cohort studies and nineteen case control studies from twelve countries. Mean cIMT was found to be significantly increased in those with a PFH by eleven of the fourteen papers reviewed. Endothelial dysfunction, measured by flow mediated dilatation (FMD), was found to be significantly increased in five of the seven included studies. The evidence on vascular inflammation was somewhat inconsistent with only ten of the nineteen studies demonstrating significance. The results tend to suggest that an elevated mean cIMT, as well as a greater degree of endothelial dysfunction are seen in children and young adults with a PFH of PCVD. Moreover, these differences exist in asymptomatic children as young as 8-9 years (4 studies) in the absence of any other cardiac risk factor. DISCUSSION Individuals with a PFH of PCVD have evidence of subclinical atherosclerosis in their youth demonstrating an accelerated tendency to acquire cardiovascular disease. Some of this risk may be attributable to behavioral risk clustering in families. However, a significant proportion of this elevated risk is related solely to a positive family history and needs attention.

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Low rates of immediate coronary angiography among young adults resuscitated from sudden cardiac arrest

Resuscitation ◽

10.1016/j.resuscitation.2019.12.005 ◽

2020 ◽

Vol 147 ◽

pp. 34-42

Author(s):

Victor Waldmann ◽

Nicole Karam ◽

Julien Rischard ◽

Wulfran Bougouin ◽

Ardalan Sharifzadehgan ◽

...

Keyword(s):

Young Adults ◽

Cardiac Arrest ◽

Coronary Angiography ◽

Sudden Cardiac Arrest

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Familial clustering of cardiac conditions in patients with anomalous aortic origin of a coronary artery and myocardial bridges

Cardiology in the Young ◽

10.1017/s1047951118000835 ◽

2018 ◽

Vol 28 (9) ◽

pp. 1099-1105 ◽

Cited By ~ 1

Author(s):

Hitesh Agrawal ◽

Carlos M. Mery ◽

S. Kristen Sexson Tejtel ◽

Charles D. Fraser ◽

E. Dean McKenzie ◽

...

Keyword(s):

Coronary Artery Disease ◽

Cardiac Arrest ◽

Coronary Artery ◽

Family History ◽

Positive Family History ◽

Sudden Cardiac Arrest ◽

Coronary Anomalies ◽

Myocardial Bridge ◽

Familial Clustering ◽

Artery Disease

AbstractBackgroundAnomalous aortic origin of a coronary artery is the second leading cause of sudden cardiac arrest/death in young athletes in the United States of America. Limited data are available regarding family history in this patient population.MethodsPatients were evaluated prospectively from 12/2012 to 02/2017 in the Coronary Anomalies Program at Texas Children’s Hospital. Relevant family history included the presence of CHD, sudden cardiac arrest/death, arrhythmia/pacemaker use, cardiomyopathy, and atherosclerotic coronary artery disease before the age of 50 years. The presence of one or more of these in 1st- or 2nd-degree relatives was considered significant.ResultsOf 168 unrelated probands (171 patients total) included, 36 (21%) had significant family history involving 19 (53%) 1st-degree and 17 (47%) 2nd-degree relatives. Positive family history led to cardiology referral in nine (5%) patients and the presence of abnormal tests/symptoms in the remaining patients. Coronary anomalies in probands with positive family history were anomalous right (27), anomalous left (five), single right coronary artery (two), myocardial bridge (one), and anomalous circumflex coronary artery (one). Conditions present in their family members included sudden cardiac arrest/death (15, 42%), atherosclerotic coronary artery disease (14, 39%), cardiomyopathy (12, 33%), CHD (11, 31%), coronary anomalies (3, 8%), myocardial bridge (1, 3%), long-QT syndrome (2, 6%), and Wolff–Parkinson–White (1, 3%).ConclusionIn patients with anomalous aortic origin of a coronary artery and/or myocardial bridges, there appears to be familial clustering of cardiac diseases in approximately 20% of patients, half of these with early occurrence of sudden cardiac arrest/death in the family.

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Aborted cardiac arrest during sport activity in a teenager diagnosed with short QT syndrome

Cardiology in the Young ◽

10.1017/s1047951120001055 ◽

2020 ◽

Vol 30 (6) ◽

pp. 886-889

Author(s):

Mehmet G. Ramoğlu ◽

Selen Karagözlü ◽

Tayfun Uçar ◽

Ercan Tutar

Keyword(s):

Cardiac Arrest ◽

Family History ◽

Male Patient ◽

Sport Activity ◽

Sudden Cardiac Arrest ◽

Short Qt Syndrome ◽

Negative Family History ◽

Qt Intervals ◽

Qt Syndrome

AbstractShort QT syndrome is a malignant repolarisation disorder characterised by short QT intervals. We present a previously asymptomatic 14-year-old male patient with negative family history, who suffered a sudden cardiac arrest while playing basketball and diagnosed with short QT syndrome to make emphasis on the fact that although very rare patients with this syndrome may experience cardiac arrest during exercise.

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Family history of cancer in children and young adults with colorectal cancer

Medical and Pediatric Oncology ◽

10.1002/(sici)1096-911x(199911)33:5<470::aid-mpo6>3.0.co;2-a ◽

1999 ◽

Vol 33 (5) ◽

pp. 470-475 ◽

Cited By ~ 12

Author(s):

Smita Bhatia ◽

Charles B. Pratt ◽

Gerald B. Sharp ◽

Leslie L. Robison

Keyword(s):

Colorectal Cancer ◽

Young Adults ◽

Family History ◽

Family History Of Cancer ◽

History Of ◽

Children And Young Adults ◽

Cancer In Children ◽

History Of Cancer

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Predictors of sudden cardiac arrest in adolescents with mitral valve prolapse: an analysis of the nationwide inpatient sample

European Heart Journal ◽

10.1093/ehjci/ehaa946.2007 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

B Narasimhan ◽

L Wu ◽

C.H Lucas ◽

K Bhatia ◽

A Shah ◽

...

Keyword(s):

Cardiac Arrest ◽

Family History ◽

Sudden Cardiac Death ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Mitral Valve Prolapse ◽

Cardiac Death ◽

Sudden Cardiac Arrest ◽

Adolescent Patients ◽

History Of

Abstract Background Mitral valve prolapse (MVP) is the most commonly encountered valvular pathology seen in 2–3% of the general population. Though traditionally regarded as a benign pathology, recent literature suggests that sudden cardiac death is significantly more common in these patients with estimates of 0.2–0.4%/year. The exact underlying mechanism of these higher rates of SCD remain poorly understood. In this study, we aim to identify predictors of sudden cardiac arrest (SCA) in an adolescent population. Methods We conducted a retrospective study using the AHRQ-HCUP National Inpatient Sample 2016-2017 for the years 2016-17. All patients (≤18 years) admitted with Mitral valve prolapse were identified using ICD-10 codes and further sub stratified based on presence or absence of sudden cardiac arrest (SCA). Baseline characteristics were obtained and multivariate regression analysis was utilized to identify potential predictors of SCA. Independent risk factors for in-hospital mortality were identified using a proportional hazards model. Complications were defined as per the Agency for Health Care Research and Quality guideline. Results We screened a total of 71,473,874 admissions in the NIS database to identify a total of 1,372 adolescent patients admitted with MVP in the years 2016–17. These patients were then sub-categorized based on presence or absence of SCA during the hospitalization. Our findings revealed that patients with SCA were generally slightly older (15y vs 13y, p=0.036, OR-1.1, p=0.007) and more likely female (83.3% vs 13%, p=0.227, OR – 3.55, p=0.57)). Interestingly, patients in the SCA cohort were noted to have almost 4 fold higher rates of Mitral regurgitation (66.6% vs 18.35%, p=0.008, OR-8.89, p=0.005) as well as family history of SCD (16.7% vs 4.1%, p=0.145, OR-4.65, p=0.14). Conclusions Presence of Mitral regurgitation and a family history of sudden cardiac death are associated with significantly higher rates of SCA in adolescent patients with mitral valve prolapse. Predictors of SCA in Adolescent MVP Funding Acknowledgement Type of funding source: None

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Cardiac Arrest in Children and Young Adults

Circulation ◽

10.1161/circulationaha.112.129148 ◽

2012 ◽

Vol 126 (11) ◽

pp. 1325-1327 ◽

Cited By ~ 5

Author(s):

Dianne L. Atkins

Keyword(s):

Young Adults ◽

Cardiac Arrest ◽

Children And Young Adults

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