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Sudden cardiac death in the young: the value of exercise testing

Published online by Cambridge University Press:  13 January 2017

Paul Stephens Jr*
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
*
Correspondence to: P. Stephens Jr, Division of Cardiology, The Children’s Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19027, United States of America. Tel: 215-590-4040; Fax: 215-590-1340; E-mail: STEPHENS@email.chop.edu

Abstract

Paediatric exercise stress testing has historically been used to assess the functional status of patients after repair of CHDs and to assess the efficacy of medical or device therapy in patients with arrhythmias. Exercise stress testing is one of very few hospital- or clinic-based tests that can assess the response of the cardiopulmonary system in an environment that simulates the body’s response to vigorous play and competitive sport. Exercise stress testing is therefore a useful modality in the assessment of child and athletes at risk for sudden cardiac death. The author discusses some cardiovascular maladies that can cause sudden cardiac death by utilising case illustrations as a learning tool.

Type
Original Articles
Copyright
© Cambridge University Press 2017 

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References

1. Corrado, D, Basso, C, Rizzoli, G, Schiavon, M, Thiene, G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003; 42: 19591963.Google Scholar
2. Noakes, T. Sudden death and exercise. Sport Sci 1998; 2: 9804.Google Scholar
3. Maron, BJ. Sudden death in young athletes. N Engl J Med 2003; 349: 10641075.CrossRefGoogle ScholarPubMed
4. Giardini, A, Hager, A, Lammers, AE, et al. Ventilatory efficiency and aerobic capacity predict event-free survival in adults with atrial repair for complete transposition of the great arteries. J Am Coll Cardiol 2009; 53: 15481555.Google Scholar
5. German, LD, Packer, DL, Bardy, GH. Ventricular tachycardia induced by atrial stimulation in patients without symptomatic cardiac disease. Am J Cardiol 1983; 52: 12021207.Google Scholar
6. Coumel, P, Fidelle, J, Lucet, V, et al. Catecholamine-induced severe ventricular arrhythmias with Adams-Stokes syndrome in children: report of four cases. Br Heart J 1978; 40: 2837.Google Scholar
7. Cohen, MI, Triedman, JK, Cannon, BC, et al. PACES/HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW, ventricular preexcitation) electrocardiographic pattern: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology Foundation (SCCF), the American Heart Association (AHA), the American Academy of Pediatrics (AAP), and the Canadian Heart Rhythm Society (CHRS). Heart Rhythm 2012; 9: 10061024.CrossRefGoogle Scholar
8. James, CJ, Bhonsale, A, Tichnell, C, et al. Exercise increases age-related penetrance and arrhythmic risk in arrhythmogenic right ventricular dysplasia/cardiomyopathy-associated desmosomal mutation carriers. J Am Coll Cardiol 2013; 62: 12901297.Google Scholar
9. Brothers, J, Carter, C, McBride, M. Anomalous left coronary origin from the opposite sinus of Valsalva: evidence of intermittent ischemia. J Thorac Cardiovas Surg 2010; 140: e27e29.Google Scholar
10. Kimball, TR. Pediatric stress echocardiography. Pediatr Cardiol 2002; 23: 347357.CrossRefGoogle ScholarPubMed
11. Pelliccia, A, Maron, MS, Maron, BJ. Assessment of left ventricular hypertrophy in a trained athlete: differential diagnosis of physiologic athlete’s heart from pathologic hypertrophy. Prog Cardiovasc Dis 2012; 54: 387396.Google Scholar
12. Maron, MS, Rowin, EJ, Olivotto, I, et al. Contemporary natural history and management of nonobstructive hypertrophic cardiomyopathy. J Am Coll Cardiol 2016; 67: 13991409.Google Scholar
13. Wittlieb-Weber, CA, Cohen, MS, McBride, MG, et al. Elevated left ventricular outflow tract velocities on exercise stress echocardiography may be a normal physiologic response in healthy youth. J Am Soc Echocardiogr 2013; 12: 13721378.CrossRefGoogle Scholar
14. Diller, GP, Dimopoulos, K, Okonko, DO, et al. Exercise intolerance in adult congenital heart disease: comparative severity, correlates, and prognostic implication. Circulation 2005; 112: 828835.CrossRefGoogle ScholarPubMed
15. Dimopoulos, K, Okonko, DO, Diller, GP, et al. Abnormal ventilatory response to exercise in adults with congenital heart disease relates to cyanosis and predicts survival. Circulation 2006; 113: 27962802.Google Scholar