Though rare, sudden cardiac arrest can be due to a range of underlying cardiac conditions, a CHOC Children’s cardiologist tells “American Health Journal.”
This can occur at anytime, but more often during sports activities, Dr. Anjan Batra says. Early indicators may be rapid heart rates, palpitations or chest pain during exercise. Dr. Batra recommends every child undergo a physical exam that includes cardiac screening.
Learn more about sudden cardiac arrest and its prevention in “American Health Journal,” a television program that airs on PBS and other national network affiliates that reach more than 40 million households.
Each 30-minute episode features six segments with a diverse range of medical specialists discussing a full spectrum of health topics. For more information, visit www.discoverhealth.tv.
Anjan Batra, M.D., attended medical school at Ohio State University and completed his internship, residency and fellowship at the Children’s Hospital of Los Angeles.
SUDDEN CARDIAC ARREST
“Sudden cardiac arrest is a condition in which the heart suddenly stops beating. If this happens, the blood pumped from the heart stops flowing to the brain and other vital organs. If it’s not treated in minutes, it leads to death,” says Dr. Batra, medical director of electrophysiology at CHOC Children’s and the division chief of pediatric cardiology at UC Irvine. Sudden cardiac arrest is usually caused by an irregular heartbeat, or a condition called arrhythmia. Depending on the type of arrhythmia, says Dr. Batra, it may or may not be life-threatening. Sudden cardiac arrest is not the same as a heart attack, in which blood flowing to a part of the heart muscle is blocked. In a heart attack, the heart usually doesn’t stop beating.
HEART RISK SYMPTOMS FOR YOUNG ATHLETES
“Young athletes that suffer sudden cardiac arrest usually have an inherited condition that tends to run in families. Often it is not previously diagnosed,” says Dr. Batra. A child’s family should seek medical help sooner rather than later if the child experiences a fast or irregular heartbeat, passes out or has chest pains, especially when active or exercising. Young athletes with a family history of cardiac problems also should be screened for possible heart problems, he says.
SURVIVING SUDDEN CARDIAC ARREST: WHAT TO DO
If someone you are with shows signs of a sudden cardiac arrest (chest pain; discomfort in one or both arms, the back, neck or jaw; or an unexplained shortness of breath), call 911 or ask someone else to call. Start CPR (cardiopulmonary resuscitation) immediately if the person is unconscious and not breathing. CPR will keep the blood circulating to the brain and other organs. Meanwhile, ask someone else to look for an automated external defibrillator (AED) and use it immediately. An AED is a portable device that sends an electric shock through the chest to the heart. The shock can restore a normal rhythm to the heart. AEDs are often kept in public places like schools and anyone can use one. “Every second matters. That’s the difference between life and death,” Dr. Batra says. In Orange County, about three-fourths of the public schools have an AED or are implementing an AED program, Dr. Batra says.
Number of sudden cardiac deaths in Orange County among young athletes, per year: About 5
Number of youths who experience sudden cardiac arrest annually (estimates vary widely): 1,000-9,500
Number of people of all ages in the U.S. who experience non-traumatic sudden cardiac arrest annually; 9 to 10 victims from this group die annually from this group die: 424,000
Dr. Batra is the medical director of electrophysiology at CHOC Children’s and the chair of cardiology at UC Irvine. Dr. Batra is a respected leading researcher in pediatric cardiology, working on several ongoing research projects to help children with heart disease. His research and scientific findings are reflected in over 60 publications in national journals and textbooks. He has been designated as a Certified Cardiac Device Specialist by the International Board of Heart Rhythm Examiners and is certified in
the field of arrhythmia management and device implantation. Dr. Batra completed his internship and residency in pediatrics and a fellowship in cardiology at Children’s Hospital Los Angeles.
Dr. Batra’s philosophy of care: “For me it’s very simple: treat every child like they are your own.”
Ohio State University College of Medicine in Columbus, Ohio
Pediatrics – General
Sudden cardiac arrest, simply put, describes when a per
son’s heart suddenly stops beating and blood stops flowing to the brain and other vital organs. If the person isn’t treated within minutes, death results, a CHOC Children’s cardiologist says
Sudden cardiac arrest is usually caused by an irregular heartbeat, or a condition called arrhythmia, says Dr. Anjan Batra, medical director electrophysiology at CHOC.
During an arrhythmia, the heart can beat too fast, too slow or with an irregular rhythm. Depending on the type of arrhythmia, it can be relatively harmless, serious or life-threatening.
Many of these conditions can be treated and managed, he says.
“The message I would send to parents is to not be scared, but to be proactive,” he says. “There are often things we can do about it.”
Dr. Batra encourages families of young athletes or any young person with a family history of heart problems to contact their pediatrician, who can refer the child to a pediatric heart specialist for screening if necessary.
Families also should take their child to a doctor or the emergency department for care if the child shows symptoms of heart distress, like fainting, a racing heart or chest pains.
There are several causes of sudden cardiac death in young people, says Dr. Batra.
First, hypertrophic cardiomyopathy (HCM) is a hereditary disease in which the heart muscle becomes abnormally thick, making it harder for the heart to pump blood. While usually not fatal in most people, this condition is the leading cause of sudden cardiac death in young athletes in United States. HCM often is previously undetected, he says.
Second, long QT syndrome is another inherited heart rhythm disorder that can cause fast, chaotic heartbeats. The rapid heartbeats may lead to fainting, and can be life-threatening, Dr. Batra says.
Finally, supraventricular tachycardia (SVT) is common and worrisome. In these cases, a person suddenly feels his heart racing or beating very fast, Dr. Batra says.
“The good news is it’s a condition that is very easily treatable with a non-surgical, outpatient procedure called ablation,” he says. “We have a close to 100 percent cure rate. Families should seek care from someone who specializes in arrhythmias.”
When Jaden Rascon started fourth grade earlier this week, she didn’t have to worry any longer about her heartbeat suddenly racing – thanks to an innovative procedure at CHOC Children’s.
“I feel good,” the 9-year-old says. “Before, when my heart would speed up, it was very hard to breathe, and it would give me headaches. But now it’s all gone because I got the procedure.”
Jaden recently underwent an outpatient electrophysiology procedure at CHOC to cure her arrhythmia. The experience was short, non-invasive and – even better – required no radiation.
Her procedure is a landmark achievement that signals a new direction for electrophysiology, a field that has already dramatically changed cardiology. And now, an electrophysiology procedure with no radiation marks an even safer and less invasive cure for a common ailment.
The successful radiation-free electrophysiology procedure is a credit to the skill and expertise of Dr. Anjan Batra, medical director of electrophysiology at the CHOC Children’s Heart Institute, as well as the state-of-the-art cardio mapping equipment inside the hospital’s new Bill Holmes Tower.
“This has really changed our field,” Dr. Batra said. “We can do so much more, and do it better and safer. It’s great to be in a field where we not only treat, but also cure. It’s great to help a patient so that they don’t have to see a doctor for the condition again.”
Dr. Batra performed the procedure using a three-dimensional cardio mapping system. The device uses catheters with locator sensors that transmit signals from inside the heart. This allowed Dr. Batra to visualize the beating heart by using these magnetic sources as reference points, rather than relying on fluoroscopy – an imaging technique that uses X-rays to obtain images of internal organs while they’re in motion – to reveal the catheters’ positions.
Just weeks after her procedure, Jaden’s quality of life has already improved.
Last November, Jaden began complaining of a rapid heartbeat, says her mother, Vera. A normal resting heart rate for children ages 7 to 9 is between 70 and 110 beats per minute, but Jaden experienced a heart rate of 225 beats per minute during one emergency department visit. She was then referred to CHOC, and was subsequently determined to be a good candidate for an electrophysiology procedure.
“I was nervous at first,” Jaden says, “but then I knew that they were studying the heart for a long time so nothing would go wrong.”
Typically, up to three patients are diagnosed with arrhythmias each day at CHOC, Dr. Batra says. About 25 years ago, the only cure for these conditions was open heart surgery, and many patients simply tolerated the condition or relied on medication.
Now, the hospital has used electrophysiology procedures to cure more than 100 children with arrhythmias each year, and that figure is expected to increase as awareness grows among parents and the medical community, says Dr. Batra, one of about 200 pediatric electrophysiologists worldwide.
The Bill Holmes Tower at CHOC Children’s is now open, and as we celebrate our new hospital and its state-of-the-art programs and services, including the Julia and George Argyros Emergency Department at CHOC Children’s – Orange County’s first fully dedicated pediatric ED, we’d also like to take an opportunity to celebrate and recognize just a few of the many doctors making miracles happen every day within the walls at CHOC. Here, we hear from Heather and Curtis Short about the CHOC doctors who saved their son’s life.
Cameron was born with cranial stenosis, or improper fusion of growth plates in his skull. When he was 8 months old, we scheduled corrective surgery at CHOC Children’s.
After his surgery, he was stable in the pediatric intensive care unit (PICU), so we went home to sleep.
But a ringing phone jerked us awake at 6 a.m. Cameron had suffered two heart attacks and a stroke. We raced back to the hospital to find the chaplain waiting to console us. Cameron had coded.
We went into the PICU to say goodbye. In a fog, we watched Dr. Adam Schwarz administer chest compressions. He brought Cameron back to life.
We experienced a miracle in the form of Dr. Adam Schwarz, Dr. Anjan Batra and a superb cardiac emergency team.
Twenty-one days later we left the hospital – the three of us, together. Now we have the friendliest, most enthusiastic 5-year-old in Orange County, if not the world.
But CHOC docs still play a very important role in our lives. Every six months, Cameron visits Dr. Michael Rebolledo for an echocardiogram. Since Cameron’s initial hospital stay, CHOC docs have seen him through a heart catheterization and an aortic valve repair.
In fact, just after Cameron’s fifth birthday, we learned that he would need open-heart surgery for a faulty mitral valve. We were terrified. After all, we came too close to losing Cameron the first time.
Again, we were saved by a CHOC doctor – this time, Dr. Richard Gates. He assured us that cardiac surgery would be less risky than Cameron’s original cranial surgery. As he calmed our fears, Dr. Gates handed Cameron his stethoscope, making everyone in the exam room happier.
We left Dr. Gates saying to ourselves, “We can do this. Cameron needs the surgery. We need to go into it with confidence.”
Today we have confidence. And we have Cameron — both thanks to CHOC doctors.
At 6 years old, Vanessa Avina was more interested in viewing the monitor for her echocardiography (heart ultrasound) than watching a cartoon during her doctor’s visits. Her CHOC pediatric cardiologist ...