Bengaluru: The recent incidents of two schoolboys in Bengaluru collapsing on campus due to suspected cardiac arrests have left many parents anxious. However, cardiologists emphasise while such events are tragic, they are extremely rare and should serve as a reminder to improve awareness and emergency preparedness rather than trigger panic.Unlike adults, where sudden cardiac arrests are most often caused by blocked arteries, children usually experience these events because of underlying congenital heart defects or inherited electrical abnormalities of the heart that often go undetected until a medical emergency occurs.“Among children, sudden cardiac events are most commonly linked to arrhythmias or genetic channelopathies, which can sometimes be triggered by strenuous physical activity or sports,” said Dr Anand P Subramanian, professor and head of paediatric cardiology at Sri Jayadeva Institute of Cardiovascular Sciences and Research (SJICSR).
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“Other less common causes include congenital abnormalities of coronary arteries, hypertrophic cardiomyopathy, where the heart muscle becomes abnormally thick, and certain valve abnormalities.”According to cardiologists, arrhythmias or abnormal heart rhythms are among the most frequently encountered causes. “Some are exercise-induced, while others may be brought on by certain medications. Unless a child survives the event and undergoes detailed evaluation, it is often difficult to identify what exactly triggered it,” said Dr Atul Surendra Prabhu, consultant, paediatric cardiology, Narayana Health City. The doctor said he sees nearly 20 to 30 children with arrhythmia-related conditions every month.One of the biggest challenges, doctors say, is that many children with these conditions appear completely healthy and may never develop symptoms before a serious event. “In some children, sudden cardiac arrest may unfortunately be the first sign of an underlying heart condition. If there is a family history of sudden cardiac death or unexplained collapse at a young age, it is worthwhile getting other family members evaluated,” Dr Prabhu said.Despite recent incidents, cardiologists stress that parents shouldn’t become overly anxious. “It is certainly tragic when sudden cardiac arrest occurs in children, but fortunately, it is extremely rare, affecting only about one to two per 100,000 every year,” said Dr Ranjan Shetty, lead consultant cardiologist and medical director, Sparsh Hospitals. “These incidents should not create mass hysteria. Instead, they should encourage greater awareness among parents, schools and communities.”Doctors point out there is no single screening test capable of identifying every child at risk. However, adding an electrocardiogram (ECG) as part of routine pre-participation sports or school health screening could help detect some heart abnormalities at a relatively low cost.What can schools do?Set up cardiac emergency response plan. Train teachers, PE staff and administrators in CPR and use of automated external defibrillators every year. CPR and AED within 3 minutes can raise survival rates to over 70%. Conduct regular emergency drills to ensure quick responseDon’t ignore symptomsAlthough many children remain symptom-free, doctors say there are a few warning signs that shouldn’t be ignored. These include chest pain during exercise, unexplained breathlessness while playing, palpitations, repeated fainting spells or dizziness, particularly if these occur during or immediately after physical activity or following emotional stress. “It is crucial that parents, teachers and coaches take any episode of unexplained fainting or dizziness seriously and seek medical evaluation,” said Dr Ranjan Shetty, lead consultant cardiologist and medical director, Sparsh Hospitals.
