What Are the Common Causes of Cardiac Arrest in Infants and Children?

A common misconception about Sudden Cardiac Arrest (SCA) is that it only affects people of a certain age or demographic. The reality is that SCA can happen to anyone, regardless of age, health, gender, or pre-existing condition. Every year in the United States, over 15,000 pediatric cardiac arrests occur, most of which lead to death. 

The American Heart Association found that the survival rate for pediatric out-of-hospital cardiac arrest is merely 6.4% – there is a documented 3.3% survival rate for infants, 9% for children, and 8.9% for adolescents. It’s important to understand the causes of cardiac arrest in young ones and be prepared to respond in the event of an emergency.

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Common Causes of Cardiac Arrest in Children and Infants

Cardiac arrest can happen to infants and young children for various reasons – ranging from respiratory issues to congenital heart defects. Research shows us, though, that the most common reason for pediatric cardiac arrest is related to heart issues.

Congenital Heart Defects

Congenital heart defects are structural abnormalities of the heart that someone is born with. These abnormalities can affect the heart’s ability to pump blood throughout the body and even lead to cardiac arrest. 

A 30-year review study published by the American Heart Association found that in cardiac arrest patients from 0-13 years old, the most common cause of SCA was due to congenital heart abnormalities. At least 18 unique congenital heart defects exist, but a few of the more common ones are aortic valve stenosis (AVS), atrial septal defect (ASD), and coarctation of the aorta (CoA).

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM), often caused by abnormal genes in the heart muscle, is a chronic disease that is also believed to be a leading cause of cardiac arrest in young athletes in the United States. 

HCM occurs when the walls of the heart become thicker and stiffen, which decreases the amount of blood that can flow through the heart – this structural problem can lead to dangerous arrhythmias and even cause cardiac arrest.

Arrhythmias and Electrical Abnormalities

Irregular heart rhythms and electrical problems cause the heart to beat abnormally, which can trigger a cardiac arrest in patients of all ages. Arrhythmias like ventricular fibrillation (VF) or ventricular tachycardia (VT) are treatable through a shock from an Automated External Defibrillator, or AED. 

Arrhythmias happen when the electrical signals in the heart are delayed or blocked, and they are responsible for a percentage of child and pediatric cardiac arrests.

Myocarditis

Myocarditis is another heart condition that can lead to cardiac arrest, although research shows that this underlying cause is rare for child and pediatric SCAs. Myocarditis impacts the middle muscular layer of the heart wall and leads to inflammation of the heart.

Respiratory Problems

Cardiac arrest in children and infants can stem from various respiratory issues like infections, asthma, and choking. If left untreated, respiratory problems can lead to life threatening situations that require immediate medical attention.
One study that focused solely on in-hospital pediatric cardiac arrest, which is unique from OHCA or out-of-hospital cardiac arrest, found that the most common cause was progressive respiratory failure or shock.

Poisoning, Metabolic Derangements, & Allergic Reactions

While rare, poisoning, metabolic disorders, and allergic reactions can also lead to cardiac arrest in children by disrupting their normal physiological processes, leading to stress or malfunction of the heart’s electrical system.

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Symptoms of Cardiac Arrest in Infants and Children

If someone is unresponsive and not breathing normally, it is best to assume cardiac arrest and take action immediately. Cardiac arrests in infants, children, and adults often happen with little to no warning signs.

However, these are documented symptoms of cardiac arrest in infants and children: 

• Exercise related chest pain or discomfort 
• Excessive fatigue during exercise 
• Unexplained fainting (syncope) 
• Dizziness or lightheadedness

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What to do in Case of Sudden Cardiac Arrest in Children?

If you suspect cardiac arrest, the first thing to do is call 911. Regardless of the age of the patient, starting high-quality CPR and delivering an early shock from an AED will give cardiac arrest patients the best chance of survival.

Perform CPR

Because of the difference in weight and body size, the techniques for performing CPR are different when responding to infants, children, and adults. 

To perform CPR on an infant: use two fingers at the center of the infant’s chest to deliver gentler chest compressions. For a child, both one and two-handed CPR techniques are safe, depending on the size of the child. 

Check out our guide that breaks down the differences between infant, child, and adult CPR.

Use an AED

Contrary to popular belief, AEDs are safe to use on children and adults, although it’s important to understand what may be required of your device to use it safely on children. 

The Avive Connect AED® is one of the only AEDs to have universal electrode pads and an in-rescue Child Mode. When in Child Mode, the AED adjusts the energy of the electric shock to a lower value that is more appropriate for children between the ages of 1 and 8 years old. Child Mode on the Avive Connect AED can be used on children over the age of 1 years old who are under 55 pounds. 

The only way to restore a heart to its normal rhythm and terminate a cardiac arrest is by a shock from an AED, so it is important to include an AED in cardiac arrest response plans for youth.

It is generally accepted that there is not enough data to advocate for or against the use of an AED on infants and patients under 1 year of age.

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How to Prevent Sudden Cardiac Arrest in Children

By definition, Sudden Cardiac Arrest is a sudden and unexpected medical emergency. However, there are a few ways to prepare and take preventative action.

Maintain Regular Check Ups

Arrhythmias and congenital heart defects are leading causes of cardiac arrest in the young, so regular health check ups are essential for early detection of any underlying cardiac issues and ensuring overall well-being.

Pre-Participation Exams or Sports Physicals for Children

Pre-participation exams and sports physicals are typically required for children to participate in school or club sports programs. These physicals often cover a review of the child’s medical history, a physical exam, and sometimes include tests like electrocardiograms (ECGs) or heart screenings. Screening a child for cardiac abnormalities can help prevent sudden cardiac events during sports and better ensure their safety.

Be Prepared with an AED

AEDs are portable medical devices that deliver an electric shock to the heart to restore normal rhythm in case of cardiac arrest. Having access to an AED in public places, schools, sports facilities is crucial for immediate rsponse and increasing the chances of survival.

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