Study of Cardiac Events Due to Hypertrophic Cardiomyopathy under School Management

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is a major cause of sudden death in children at school. However, more children with HCM are being successfully resuscitated after collapse due to the increasing availability and accessibility of basic life support systems. Therefore, the prognosis for children with HCM who experience cardiac events at school may be changing. This present study aimed to determine the outcome of cardiac events arising in children with HCM and the effect of automated external defibrillators (AED) applied under school supervision.
Methods: We retrospectively studied case reports of cardiac events submitted to mutual aid systems for schoolchildren with HCM between 2004 and 2011.
Results: Among 44 children with HCM who experienced sudden cardiac events at school, 29 died and 15 survived after resuscitation. An AED was applied to 14 of the survivors, and one already had an implantable cardioverter defibrillator (ICD). Males predominated among both the deceased and the survivors. Among children with HCM who experienced cardiac events in kindergarten, primary school, junior high school, and high school, only those in junior high school and high school survived. The ratios (％) of the deceased and the survivors that had been diagnosed with HCM before cardiac events occurred were 48％ and 20％, respectively. Cardiac events occurred most frequently during exercise in both the deceased and the survivors.
Conclusions: The number of children with HCM who are resuscitated after cardiac arrest while at school has increased in Japan since 2007. Both AED and ICD are essential in preventing sudden death due to HCM in schoolchildren.