Jared C. LaCorte M.D., FAAP, FACC Metro Pediatric Cardiology www.DrMDK.com Pediatric Cardiology Fellowship: Children's Hospital of New York-Columbia Presbyterian
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Male 1: I got a comment and a question because of the concern of our kid playing sport. If they play sport and they are active and they suddenly got an increase heart rate and high pulsation or they have some chest pain while doing the event, is that an indication to see a cardiologist? Male 2: Yes, any time a patient has symptoms particularly with physical activity that is a reason to further investigate. Male 1: We have another gimmick, kids complaining of chest pain not doing any activity and most of the time that turns out to be more like a muscle skeletal type of thing and that relates to cardiac, is that true? Male 2: Chest pain in children is extremely common and the vast majority of chest pain in children is not cardiac related. Certain situations much more concerning or managed with physical activity. When the chest pain occurs at rest, it is mild, it is not severe and there is no family history of cardiac issues that child may not necessitate further cardiac evaluation but that needs to be taken by a case by case basis and it is really up to the comfort level of both the primary care physician and parent. Male 1: Most of these cases of cardiac arrests, it may not be anything in the background. It just came out of nowhere and that is the great concern. So, knowing that, would it be wise to have automatic defibrillators in sporting events in gyms, areas where the kids could probably have a trigger mechanism for this sport to bring this particular situation because it seems less than 20% kids have to get CPR and even the rest on a public venue. Would it be wise thing to start pushing the things like that? Male 2: I think so because even with the screening that the American Academy or pediatrics as you stated, many children have no family history and have no symptoms and unfortunately the first presenting sign is a sudden cardiac arrest. With the advent of automated external defibrillators in the community, the prices of these are coming down. They are easy to use and they do not require any previous medical training, I personally believed that sporting events, at least on the high school level, should have one of these present and there are many communities which are now having these in their own private little leagues and start their leagues to provide that extra added level of assurance that if, God forbid, something happens we have a way of trying to treat this unfortunate event. Male 1: And probably every coach in the system and if I would participate in the event would take a course in CPR because God forbid, it does happen and then after created two or three it will be really – Male 2: No question. Athletic trainers, coaches particularly working with middle school and high school children should certainly be trained.