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Significance of symptoms and family history as predictors of sudden cardiac arrest

Erik Ekker Solberg on behalf of EACPR Sports Cardiology Section

Warning symptoms and family history in children and young adults with sudden cardiac arrest.
J.A. Drezner et al.
J Am Board Fam Med July-August 2012 vol. 25 no. 4 408-415 2012 Jul;25(4):408-15; doi: 10.3122/jabfm.2012.04.110225


In the debate about screening, ECG has been the primary focus. Additionally, there has been much hope for the future of genetic screening. Even with modern medical advances, it is important not to forget good old fashioned medical tools such as a thorough analysis of symptoms and family history.

In this study, warning symptoms and family history of cardiovascular (CV) disease were retrospectively surveyed in 146 families (response rate, n=87, 60 %) with a child or young adult (mean age 16, range [5–29] years) who had suffered sudden cardiac arrest (SCA):

  • 72 % of SCA victims were reported to have at least one CV symptom before SCA; fatigue (44%) and near-syncope (30%)were the two most common.
  • 24 % of the victims had one or more events of syncope or unexplained seizure that remained undiagnosed as cardiac prior to SCA.
  • Parents reported that CV symptoms first occurred, on average, 30 (range 19-71) months before SCA.
  • A symptom was brought to the attention of the child's physician in 41% of cases.
  • 27% of families reported a family member had experienced sudden cardiac death before age 50 years.

The study was uncontrolled and recall bias must be considered.

Even when taking into account methodological limitations, the study strongly reminds us of the value of a thorough personal and family CV history to prevent SCA.