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A Communication Service for Physicians from CHOC and CHOC at Mission. Please Note: Physician Connection is no longer being printed and is now available electronically. Please visit our blog at http://docs.chocchildrens.org for the latest articles for our physician community. You can also receive our electronic Physician Connection newsletter in your inbox by subscribing to our mailing list: http://www.choc.org/subscribe

“ACE” is the Rx for Sudden Cardiac Death

Young Israeli athletes must undergo an annual EKG, echocardiogram and stress test before participating in sports. Italy has implemented such an aggressive cardiac screening strategy that high school athletes have a lower incidence of sudden cardiac death than non-athletic peers. Closer to home, a program that placed automated external defibrillators (AED) at Milwaukee high schools has saved the lives of students— and even more adults.

Those were some of the international findings presented by Anthony C. Chang, M.D., medical director of the CHOC Children’s Heart Institute, at the second annual Life- Threatening Events Associated With Pediatric Patients in Sports (LEAPS) conference held at the Orange County Department of Education in February.

The conference, organized by Dr. Chang and Anjan Batra, M.D., medical director of electrophysiology of the CHOC Children’s Heart Institute, among other physicians and organizations, was attended by more than 200 Orange County school board members, high school coaches, school nurses, community pediatricians and parents who have been galvanized into action by the incidence of sudden cardiac death in local teenage athletes.

“Hypertrophic cardiomyopathy, the most common cause of sudden cardiac death in young athletes, occurs in 1 out of every 500 people,” Dr. Chang said. “Sudden cardiac death is a public health issue that requires a community-wide response to protect athletes.”

Based on a review of evidence and findings discussed with international experts, Dr. Chang recommends a three-point strategy to minimize risk:

A — Automatic external defibrillator (AED)
C — CPR training
E — EKG screening

He added that implementing “ACE” will undoubtedly yield additional benefits. The siblings and parents of athletes diagnosed with cardiac disease may also be screened and treated as needed.

“This comprehensive effort is similar in concept to the space program,” Dr. Chang said. “That wasn’t just about going to the moon, but about all the dividends that came from a program of that size and scope.”

For more information about LEAPS, contact The CHOC Heart Institute at (714) 532-7576.

EKG screening recommended for sports physicals

The pre-participation sports physical should include:

  • Thorough examination in a quiet environment
  • Complete history and physical, including family history
  • 12-lead EKG screening
  • Echocardiogram for athletes with abnormal EKG or family history of syncope or sudden cardiac death

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Children's Hospital of Orange County is affiliated with UC Irvine Healthcare and UC Irvine School of Medicine

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