All children should be screened for heart-related issues, AAP says

No single test will detect every possible heart issue, so it's important to screen early and often.

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The American Academy of Pediatrics now says all children should be screened for potential heart-related issues.

Previously, the AAP recommended screenings for sudden cardiac arrest (SCA) or sudden cardiac death (SCD) for children who participate in sports. Now, the group says all children should be screened, regardless of their sports participation.

About 2,000 people younger than age 25 die each year of sudden cardiac death in the in the United States, excluding sudden infant deaths. While autopsies show that many patients had structural heart anomalies, the causes for 6%-40% of deaths remain unexplained.

It sounds scary, mama. But here's what you need to know.


In a policy statement published in the July 2021 Pediatrics, AAP offers new guidance to help pediatricians identify children at risk for heart-related problems.

The screening consists of four questions that should be asked at routine doctor's visits at least every three years, and especially around the time a child begins middle and high school.

The questions are:

  • Have you ever fainted, passed out, or had an unexplained seizure suddenly and without warning, especially during exercise or in response to sudden loud noises, such as doorbells, alarm clocks, and ringing telephones?
  • Have you ever had exercise-related chest pain or shortness of breath?
  • Has anyone in your immediate family (parents, grandparents, siblings) or other, more distant relatives (aunts, uncles, cousins) died of heart problems or had an unexpected sudden death before age 50? This would include unexpected drownings, unexplained auto crashes in which the relative was driving, or SIDS.
  • Are you related to anyone with hypertrophic cardiomyopathy or hypertrophic obstructive cardiomyopathy, Marfan syndrome, arrhythmogenic right ventricular cardiomyopathy, long QT syndrome, short QT syndrome, long QT syndrome, or catecholaminergic polymorphic ventricular tachycardia or anyone younger than 50 years with a pacemaker or implantable defibrillator?

A positive response to any of the four questions should prompt further investigation, which may include an electrocardiogram and referrals to pediatric specialists.

"No single screening strategy will detect every possible heart issue, and so it's important that we raise awareness and education not only in pediatric offices but within the community," said Dr. Christopher C. Erickson, lead author of the statement. "We encourage parents and pediatricians to be alert for any concerning signs or family history."

"Ideally, this screening is incorporated into a child's regular exam at least every two to three years," said Jack C. Salerno, MD, an author of the statement. "The pediatrician is in an ideal position to check on a child's development into the teenage years and is aware of family history that may raise a red flag for potential heart related issues."

So what can you do, mama? Make note of any family history of heart issues or any unexplained fainting spells or chest pains experienced by your child. Talk them over with your family pediatrician—make sure she has all the information needed to properly care for your child.

You got this, mama.

Jamie Orsini is an Emmy Award-winning journalist, military spouse, and a mom to two busy toddlers. In her spare time, Jamie volunteers with the Solar System Ambassador program with NASA/JPL and reads anything she can get her hands on. She’s currently working on her first novel.

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