Paramedic PapersHome Cardiac arrest Paediatric OHCA: half had warning symptoms
Cardiac arrest
Paediatric OHCA: half had warning symptoms
Cardiac warning symptoms in paediatric out-of-hospital ventricular fibrillation cardiac arrest survivors
Open Heart · 2026-07 · Added 6 October 2026
UK single-centre review of 58 consecutive paediatric out-of-hospital VF arrest survivors without a pre-existing diagnosis found 50.9% had reported cardiac symptoms beforehand — syncope in 23.6%, half the arrests during exertion — and of 13 children with prior syncope only three had sought medical attention and none had follow-up arranged, pointing to missed opportunities to diagnose inherited cardiac conditions before arrest.
- Study type
- Case series
- Design
- Single-centre retrospective review of consecutive paediatric OHCA survivors at a UK tertiary referral centre (1996–2025)
- Participants
- 58 survivors of paediatric OHCA aged 0–18
- Main finding
- 50.9% had prior cardiac symptoms (syncope 23.6%); 50% of arrests occurred on exertion; 72.4% were later diagnosed with an inherited cardiac condition, most commonly hypertrophic cardiomyopathy; of 13 children with prior syncope only three sought medical attention and none had follow-up arranged
- Caveat
- Single tertiary centre, survivors only (so no data on children who died at first presentation), and symptom history via retrospective record review
- Bottom line
- Practice prompt
Why it matters in Australia (High relevance). red-flag symptoms in children — exertional syncope in particular — are exactly what paramedics screen for, and this quantifies how often those warning signs slip through before a devastating presentation
Learning goal
Strengthen my recognition of warning symptoms and exertional syncope as red flags for inherited cardiac conditions in children.
More
- Topic: Cardiac arrest
- Daily scan: 6 October 2026
Related papers on Cardiac arrest
-
OHCA outcome variation largest in asystole
Across 616,519 Japanese OHCAs, prefecture-level variation in favourable neurological outcome grew with worse initial rhythm — median ORs of 1.19 for shockable, 1.31 for PEA and 1.65 for asystole.
-
R-EDByUS score validated for OHCA prognostication
External validation of the R-EDByUS score, which predicts poor neurological outcome after cardiogenic OHCA using prehospital variables alone, in 29,345 patients from the JAAM-OHCA registry — it discriminated well (AUC ~0.91), and among patients with predicted probability ≥99% essentially all had poor outcomes.
-
Cancer markedly raises OHCA risk
Swedish matched cohort of ~800,000 cancer patients and 3.7 million controls found cancer carried a 55% higher hazard of out-of-hospital cardiac arrest (aHR 1.55), with the greatest short-term excess in lung and neurological cancers.
-
What actually degrades CPR performance
Qualitative interviews with 21 resuscitation team members in Kermanshah, Iran building a model of how environmental threats, cognitive and motivational barriers, psychological stressors and socio-cultural factors interact to compromise CPR performance.