Heart Facts

Sudden Cardiac Arrest claims the lives of 250,000 people in the United States every year. Sudden Cardiac Arrest can strike anyone at anytime. This includes people of all ages, with no prior history of heart disease. The most tragic thing about sudden cardiac arrest is the fact that despite the finest cardiologists, hospitals, emergency rooms, and pre-hospital care, the survival rate is less than 5% nationally.
When sudden cardiac arrest occurs, most victims have an abnormal heart rhythm called Ventricular Fibrillation (VF). Ventricular Fibrillation is a treatable rhythm. During this rhythm, electrical energy is present in the heart, but it is chaotic. If the heart is shocked quickly with a defibrillator, a normal heart rhythm can be restored. This is called defibrillation.

The most common means of treating sudden cardiac arrest is with the use of an Automated External Defibrillator. AED’s are about the size of a portable laptop computer and provide brief, but powerful electrical stimulation to a person’s chest, helping to restore the heart’s natural rhythm. The user simply places the AED pads on the victim’s chest and lets the machine do the rest. EKG readings are taken, and a shock to the heart is advised and administered with the push of a button, only if needed.
During Sudden Cardiac Arrest (SCA), the electrical system of the heart short circuits, causing the heart to quiver rather than pump in a normal rhythm. It typically results in the abnormal heart beat know as ventricular fibrillation (VF). It usually happens without warning and the majority of people have no previously recognized symptoms of heart disease. For the best chance of survival from SCA caused by VF, a defibrillator should be used within 5 minutes. Yet, less than 1 in 20 people survive largely because a defibrillator does not arrive in time. Cardiac arrest can be fatal within minutes unless the heart’s electrical pattern is restored spontaneously or with the aid of a defibrillator.
Sudden cardiac arrest claims approximately 460,000 lives annually in the United States. Sudden Cardiac Arrest can strike anyone at anytime. This includes people of all ages, with no prior history of heart disease. The most tragic thing about Sudden Cardiac Arrest is the fact that despite the finest cardiologists, hospitals, emergency rooms, and pre-hospital care, the survival rate is less than 5%.
When Sudden Cardiac Arrest occurs, most victims have an abnormal heart rhythm called Ventricular Fibrillation (VF). Ventricular Fibrillation is a treatable rhythm. During this rhythm, electrical energy is present in the heart, but it is chaotic. If the heart is shocked quickly with a defibrillator, a normal heart rhythm can be restored. This is called defibrillation.
Heart disease is the leading cause of death in the U.S. 340,000 people die each year of coronary heart disease without ever making it to the hospital.

About 1,000 AED’s are already scattered around King County in gyms, office buildings and shopping malls.

Pediatric Cardiac Arrhythmias (electrical disturbances of the heart)

Heart Function

Your heart beats 100,000 times a day to circulate blood throughout your body. To pump blood, your heart’s chambers must contract and relax in a coordinated manner. Contraction and relaxation are controlled by electrical impulses that travel through your heart muscle-like electricity through wires.
Your heart consists of four chambers-two upper chambers (atria) that receive blood and two lower chambers (ventricles) that pump blood. Within the upper-right chamber of your heart is a group of cells called the sinus node. The sinus node produces the electrical impulse that starts each heartbeat.
Many children and teens at risk for SCD do not experience symptoms. The first sign that something is wrong is the SCD itself. Echocardiography (ultrasound) and directed electocardiography (ECG) can identify some high-risk individuals. Even so, there is no test or combination of tests that will identify every child at risk for SCD. Some possible symptoms include:
-Chest pain with exertion
-Dizziness or fainting after vigorous exercise
-Palpitations
-Shortness of breath

Sudden Cardiac Death is an unexpected, sudden cardiac event that leads to death. It is most likely to occur in a patient with an underlying cardiac abnormality, whether known or not, and is usually caused by an abnormal heart rhythm (arrhythmia).
(SCD) occurs when there is a total cessation of the heartbeat, often as a result of ventricular fibrillation. Ventricular fibrillation can result from lack of oxygen (ischemia) to the heart muscle or from a primary electrical disorder (arrhythmia). In either case, ventricular fibrillation leads to an ineffective quivering of the heart. Death quickly ensues if the heart’s electrical impulses are not converted to an effective, blood pumping rhythm.
Sudden Cardiac Death can occur at any age, even in apparently healthy children and adolescents.5, 000 to 7,000 children and another 5,000 to 7,000 infants die each year of SCD. One in every 200,000 to 300,000 children will have an episode of SCD. Children and adolescents have many different causes of SCD, most of which are undetected conditions:

Heart Conditions

Cardiac Arrhythmias:
An arrhythmia is an abnormal heart rhythm. At rest, the heart normally beats with a regular rhythm at 60 to 100 beats per minute. Tachycardia is when the heart beats too fast and bradycardia is when the heart beats too slowly. The arrhythmia can be described further by indicating what part of the heart is starting the abnormal rhythm. If the arrhythmia is coming from the ventricle, it is called a ventricular arrhythmia. There are several types of ventricular arrhythmias. PVCs are premature ventricular contractions, which are the most common type of ventricular arrhythmias, and most people have isolated PVCs and have healthy hearts. PVCs can alternate with the normal rhythm in a regular pattern. If the ratio is one normal beat to one PVC, the rhythm is called bigeminy. If the ratio is two normal beats to one PVC, it is called trigeminy. Ventricular tachycardia (VT) is a run of more than 3 consecutive PVCs. An arrhythmia can be short lasting, called unsustained, or long lasting, called sustained. A sustained rate of over 120 beats per minute will usually require medical treatment.

(“What Are Arrhythmias”) www.americanheart.org/presenter.jhtml?identifier=560
(HOPE- the Heart Of Pediatric Electrophysiology) www.heartbeatsofhope.org (“Children and Arrhythmia”) www.americanheart.org/presenter.jhtml?identifier=2
(“Types of Arrhythmia in Children”) www.americanheart.org/presenter.jhtml?identifier=7
(“Diagnosing Arrhythmias in Children”) www.americanheart.org/presenter.jhtml?identifier=4

Hypertropic Cardiomyopathy (HCM):
Cardiomyopathy occurs when the heart becomes abnormally enlarged, thickened and/or stiffened due to a number of factors. As a result, the enlarged heart is weakened and less able to pump enough blood to meet the body’s oxygen needs.
Ischemic cardiomyopathy occurs as a result of cardiac ischemia. Nonischemic cardiomyopathies include dilated cardiomyopathy (involves increased heart mass), hypertrophic cardiomyopathy (involves abnormal growth of the heart muscle) and restrictive cardiomyopathy (involves heart being unable to relax between contractions).

Congenital Coronary Artery Anomalies:
The term coronary artery anomaly refers to a wide range of congenital abnormalities involving the origin, course, and structure of epicardial coronary arteries. By definition, these abnormalities occur in less than 1% of the general population. In adults, the clinical interest in coronary anomalies relates to their occasional association with sudden death, myocardial ischemia, congestive heart failure, or endocarditis.
Coronary artery anomalies are found in 0.6% to 1.55% of patients who undergo coronary angiography and the increasing use of diagnostic coronary angiography is uncovering even more such abnormalities. Indeed, most coronary anomalies are found incidentally during coronary arteriography. Although these anomalies are present at birth, relatively few manifest symptoms in children. Anomalous origin of a coronary artery does not generally lead to myocardial ischemia.

Arrhythmogenic Right Ventricular Dysplasia (ARVD):
ARVD stands for arrhythmogenic right ventricular dysplasia. Arrhythmogenic means causing an arrhythmia. The right ventricle is the chamber of the heart that is affected and dysplasia means there is an abnormality of the structure. ARVD is a specific type of cardiomyopathy (a disorder of the cardiac muscle). Simply put, ARVD is a genetic, progressive heart condition in which the muscle of the right ventricle is replaced by fat and fibrosis, which causes abnormal heart rhythms. ARVD is estimated to effect one in 5,000 people. Although it is a relatively uncommon cause of sudden cardiac death, it accounts for up to one fifth of sudden cardiac death in people less than 35 years of age.

Dilated Cardiomyopathy:
Dilated cardiomyopathy represents the end result of more than 50 different diseases. Causes of dilated cardiomyopathy include genetic disorders such as Friedreich's ataxia or myotonic dystrophy, myocarditis (a viral infection of the heart muscle), alcoholism, coronary artery disease, valvular heart disease, and others. In many patients, however, a cause cannot be identified, and their cardiomyopathy is considered "idiopathic." Idiopathic cardiomyopathies are likely to be genetically determined.
Dilated cardiomyopathy is the most common of the cardiomyopathies, comprising more than 90% of all cases that are referred to specialized centers.

Long QT syndrome (LQTS) the heart electrically recharges itself too slowly or in a disorganized fashion in preparation for the next heartbeat. When combined with a trigger, such as intense emotion or physical exertion, a long Q-T heart can go out of control and cause cardiac arrest and sudden death. Long Q-T syndrome is sometimes called the perfect killer because it leaves no clues.
LQTS is a hereditary condition which once identified can be addressed by implanting internal defibrillators to prevent premature deaths.

(“Mayo Clinic Research”) www.mayoclinic.org/long-qt-syndrome/research.html
(“Heart Gone Haywire”) www.cardiologyonline.com/journal_articles/Heart_haywire.htm
www.sads.org (The Sudden Arrhythmia Death Syndromes (SADS) Foundation)
www.longqt.org

Marfan Syndrome:
The Marfan syndrome is a heritable condition that affects the connective tissue. The primary purpose of connective tissue is to hold the body together and provide a framework for growth and development. In the Marfan syndrome, the connective tissue is defective and does not act as it should. Because connective tissue is found throughout the body, the Marfan syndrome can affect many body systems, including the skeleton, eyes, heart and blood vessels, nervous system, skin and lungs.

The Marfan syndrome affects men, women and children, and has been found among people of all races and ethnic backgrounds. It is estimated that at least 1 in 5,000 people in the United States have the disorder.

Commotio Cordis (Cardiac concussion/blunt trauma to the chest):
Commotio cordis is arrhythmia or sudden death from low-impact, blunt trauma to the chest without apparent heart injury. Ventricular fibrillation is the most common associated arrhythmia, and heart block, bundle branch block, and ST-segment elevation are also seen. Commotio cordis occurs most commonly in baseball but has also been reported in hockey, softball, and several other sports. Approximately two to four cases are reported each year, but the true incidence is uncertain. Survival is low, even when resuscitation is performed. Preventive measures include education of participants and coaches, chest protection, and softer baseballs. Other considerations include having external automatic defibrillators and trained personnel at youth sporting events.
Commotio cordis (cardiac concussion) refers to blunt, nonpenetrating, precordial chest impact that causes arrhythmia or sudden death without evidence of heart injury at autopsy. Absence of morphologic cardiac injury distinguishes concussion from contusion (contusio cordis) and other more severe injuries such as rupture. Commotio cordis occurs primarily in youth, with the highest incidence in baseball, softball, and ice hockey. Cases have also been described in football, lacrosse, basketball, cricket, martial arts, boxing, fights, and vehicular accidents (table 1) (1-10). Death is usually from ventricular fibrillation.

Coronary Artery Abnormalities:
The term coronary artery anomaly refers to a wide range of congenital abnormalities involving the origin, course, and structure of epicardial coronary arteries. By definition, these abnormalities occur in less than 1% of the general population. In adults, the clinical interest in coronary anomalies relates to their occasional association with sudden death, myocardial ischemia, congestive heart failure, or endocardi.