Stephen Gaynor School

The consequences of undiagnosed heart conditions in children and adolescents can be catastrophic. A number of conditions such as hypertrophic cardiomyopathy, coronary artery anomalies, long-QT syndrome, and critical congenital heart disease may have sudden cardiac death as an initial presentation. These tragic cases very often gain media attention. Understandably, the community has been seeking better ways of screening for such conditions. These initiatives may be local or even driven at the level of the state legislature. However, despite the best intentions, many of these screening programs may not fully consider the needed infrastructure and staffing, the costs of widespread implementation, or the impact of false-positive or false-negative results. The American Heart Association (AHA) is very often asked to support these extended screening strategies. In accordance with its mission statement, “Building healthier lives, free of cardiovascular diseases and stroke,” the AHA is strongly committed to programs that improve the early detection of life-threatening cardiac conditions in children. The goal of this advisory, therefore, is to review some of the potential screening approaches, to provide a framework for evaluating these strategies, and to understand the elements that would be required for endorsement and broad adoption. There is now awareness that children and adolescents who are otherwise asymptomatic can suffer catastrophic events resulting from previously unrecognized cardiovascular disease. This is most evident in children and teenagers who participate in competitive sports. Sadly, there continue to be reports of school-age children dying suddenly of such conditions as hypertrophic cardiomyopathy and anomalies of the coronary artery.1,2 Because of these devastating events, many in the community and within the health profession are looking for strategies to prevent or at least to reduce the frequency of such events. The AHA has previously considered screening paradigms for young athletes. These strategies were outlined in “Recommendations …