Keep the Beat, Protect Kids' Hearts

It can make your own heart skip a beat:  Hearing news of a young athlete dying after the physical exertion of a high school or college sporting event.The American Heart Association estimates that nearly 360,000 out-of-hospital sudden cardiac arrests occur each year in the United States and 92 percent of those result in death.  The Centers for Disease Control and Prevention reports that 1 percent of those arrests happen to people under the age of 35.That seemingly small percentage represents too large a number for cardiologist John Dylewski, M.D., medical director of cardiac electrophysiology at South Miami Heart Center, who championed the placement of automatic external defibrillators, or AEDs, at all Miami-Dade County public schools in 2007 and 2008.“We equate youth with health, especially in athletes,” Dr. Dylewski said.  “The good news is these deaths are likely preventable, if we use the diagnostic tools we have at our disposal and pay close attention to the tell-tale signs of potential problems.”Dr. Dylewski recommends student athletes have annual electrocardiograms, or EKGs, which can show abnormalities in the heart’s electrical system – a common cause of sudden cardiac arrest, according to the Sudden Arrhythmia Death Syndromes Foundation.Electrical ProblemsSome electrical abnormalities detected by EKGs, Dr. Dylewski says, include:Long QT Syndrome – the time interval between contractions and relaxation in the lower chambers, or ventricles, of the heart is prolonged.  When someone with this abnormality exercises or is startled, electrical activity in the ventricles may be disrupted, causing dangerous arrhythmias, or irregular heartbeats, known as ventricular fibrillation.Wolff-Parkinson-White Syndrome – an extra electrical circuit in the heart can cause periods of rapid heart beats, or tachycardia. A normal adult heart rate is between 60-100 beats per minute and less than 150 beats per minute in newborns, infants and small children.  Someone experiencing tachycardia may have a heart rate up to 300 beats per minute.Dr. Dylewski warns, however, that a normal EKG doesn’t necessarily mean a normal heart, as other factors, such as the heart’s anatomy, may also lead to sudden cardiac arrest.  Abnormalities in the structure of the heart may also cause electrical problems in the heart, but are usually best detected using an ultrasound, or ECHO, of the heart which shows what the heart looks like inside the body.Structural ProblemsMadeleen Mas, M.D., medical director of Baptist Children’s Hospital Pediatric Cardiology, says that the leading cause of sudden cardiac arrest related to the heart’s anatomy is a structural defect known as cardiomyopathy, or an enlarged heart.  Dr. Mas explains that the extra mass of the heart, which can be caused by increased muscle, in most cases, or by fat or scar tissue, can disrupt the path of electrical signals in the heart and lead to irregular heartbeats and death.Abnormalities in the coronary arteries leading to the heart may also cause heart rhythm problems that could potentially lead to sudden cardiac arrest.  Dr. Dylewski explains that if these arteries are located in unusual areas of the heart, they can be squeezed with every beat, causing chest pain.Dr. Mas points to illness as another source of sudden cardiac arrest linked to the structure of the heart.  Myocarditis occurs after a cold or flu virus causes the body’s immune system to attack the heart.“Few people realize that viral symptoms should subside four to five days after the onset,” Dr. Mas said.  “If fatigue, shortness of breath and lightheadedness persist, insist on getting your heart checked.  Treatment for myocarditis requires no sports for at least six months.”Watch for SignsBoth Dr. Mas and Dr. Dylewski recommend that parents pay close attention to their kids’ ability to participate in activity and certain words kids may use to describe symptoms.•    Children may describe a “flipping” or “fluttering” in their chests or pain in their throats.•    They may experience shortness of breath and not be able to keep up with their friends.•    Dizziness or fainting also indicate a potential problem.•    Paleness, especially after activity, may be a sign.Family History“If there’s a family history of sudden cardiac arrest, unexplained death at a young age or heart rhythm problems, there’s a very good chance a child has the same issues,” Dr. Dylewski said.  While grandparents, aunts and uncles factor in to family history, the strongest correlation exists with parents and siblings.Dr. Dylewski advises parents of children with a family history or symptoms to talk to their primary doctor about seeing a cardiologist and getting an EKG.“The educated parent is the best to prevent problems,” Dr. Mas said.As the official sports medicine provider for Miami-Dade County Public School athletics, Doctors Hospital Center for Orthopedics & Sports Medicine provides free physicals to student athletes in Miami-Dade County Public Schools.  Beginning November 1, those athletes also will be able to get a free EKG at select Baptist Medical Plazas in Miami-Dade County.Schedule a free EKG for your student athlete weekdays, between 9 a.m. and 4 p.m., at Baptist Medical Plazas at Brickell, Coral Gables, Miami Lakes, Palmetto Bay, or Country Walk in Miami-Dade County.

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