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A nine-year-old girl died after suddenly collapsing inside her classroom at Lovely Heritage School in Mayur Vihar Phase 2, Delhi, on Wednesday morning. The Class 3 student had reportedly returned to the classroom after a games period and collapsed shortly afterwards. CCTV footage showed her walking into the classroom, placing both hands around her waist and then falling to the floor. A teacher rushed to her and attempted to revive her before seeking further help. The school staff took the child to a nearby hospital, which reportedly did not admit her. Following this, she was taken to another hospital in Nirman Vihar where doctors declared her dead.
School authorities said that the child suffered a cardiac arrest while her family has questioned the emergency response. They also alleged that timely CPR was not provided. Police have sent the body for post-mortem and seized the CCTV footage. While the exact cause of death is still unknown, school authorities have said that the child suffered a cardiac arrest.
Cardiac arrest is uncommon in children but it can happen without an obvious warning. Dr Anita Saxena, Executive Director, Paediatric Cardiology, Fortis Hospital Okhla, said, “A sudden cardiac emergency in a nine-year-old is extremely rare, but such incidents remind us that children can sometimes have underlying heart conditions that remain undetected.” Read on to know how common cardiac arrest is in children and the causes of it.
How Common Is Cardiac Arrest In Children?
Sudden cardiac arrest is far less common in children than in adults. It is important to note that paediatric cardiac arrest does not always begin with a problem originating in the heart. The American Heart Association says that in children, cardiac arrest usually happens after severe breathing problems or shock. Dr Gaurav Kumar, Senior Consultant, Pediatric Cardiology and CTVS, Yashoda Medicity, explained that cardiac arrest in children is more commonly associated with respiratory failure, severe infection or shock, while coronary artery blockages are a more common cause of cardiac problems in adults.
However, children with certain heart conditions can have a cardiac arrest. Dr Saxena said that some children may have been born with a heart abnormality, while others may have inherited conditions that cause irregular heartbeats.
When there's a cardiac arrest, the child may suddenly collapse, become unresponsive and stop breathing normally or begin gasping. This is a medical emergency and immediate CPR and access to an automated external defibrillator can improve the chances of survival.
Causes Of Cardiac Events In Young Children
1. Congenital Heart Defects
Some children are born with structural problems that affect the heart. Certain congenital heart defects can impact how the heart pumps blood or how the electrical system works. While a lot of children are detected during infancy or childhood, some may remain undiagnosed until later.
2. Abnormal Heart Rhythms
Electrical problems in the heart can also cause dangerous arrhythmias. Some inherited electrical disorders may cause the heart to beat extremely fast or in an abnormal pattern. This can lead to a sudden cardiac arrest. These conditions can sometimes occur in children who otherwise appear healthy. Dr Kumar said conditions such as long QT syndrome and Wolff-Parkinson-White syndrome can affect the heart's electrical activity and increase the risk of sudden cardiac arrest.
3. Cardiomyopathy
Cardiomyopathy refers to diseases of the heart muscle. The muscle may become abnormally thick, weak or stiff, which eventually affects the heart's ability to pump properly. Some forms can also increase the risk of life-threatening abnormal rhythms. The CDC says that cardiomyopathy is one of the causes of sudden cardiac arrest in children and young people. Dr Kumar added that cardiomyopathies can sometimes be inherited and remain asymptomatic until a serious cardiac event occurs. Hypertrophic cardiomyopathy is one example.
4. Myocarditis
Myocarditis is inflammation of the heart muscle, which is often linked to an infection. In some children, it can affect the heart's pumping ability or trigger abnormal rhythms. In severe cases, this can progress to heart failure or cardiac arrest.
5. Severe Breathing Problems
Children might suffer a cardiac arrest after severe respiratory failure. Conditions such as a serious asthma attack, pneumonia, airway obstruction, choking or drowning can reduce oxygen levels and eventually cause the heart to stop working.
6. Severe Infections And Sepsis
A serious infection can sometimes lead to sepsis and shock. When blood pressure falls severely and vital organs do not receive enough oxygen and blood, the heart can fail. In children, severe infection is therefore an important non-cardiac cause of cardiac arrest.
7. Allergic Reactions
A severe allergic reaction, known as anaphylaxis, can cause sudden breathing difficulty and a fall in blood pressure. Without immediate treatment, it can lead to a cardiac arrest.
8. Physical Trauma
Major injuries can also trigger cardiac or cardiopulmonary arrest. Severe blood loss, chest trauma or other serious injuries can cause shock and prevent the heart and brain from receiving adequate oxygen.
9. Unknown Or Undiagnosed Conditions
In some cases, a child may have an underlying cardiac condition that has not previously been diagnosed. Some inherited heart rhythm disorders and cardiomyopathies may have no obvious symptoms before a major cardiac event. This is why unexplained fainting, chest pain during exertion, unexplained seizures, breathlessness or a family history of sudden cardiac death should be discussed with a doctor.
"In cardiac arrest, every minute matters. Early CPR and timely use of an AED can significantly improve the chances of survival," said Dr Saxena.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.