Sudden death and cardiovascular collapse in children with restrictive cardiomyopathy

Shannon M. Rivenes, Debra L. Kearney, E. O.Brian Smith, Jeffrey Towbin, Susan W. Denfield

Research output: Contribution to journalArticle

133 Citations (Scopus)

Abstract

Background - Restrictive cardiomyopathy (RCM) is rare in children, and the prognosis is poor. In the present study, we evaluated all pediatric patients with RCM who were at our institution during a 31-year period to determine the clinical outcome and cause of death. Those who sustained sudden, unanticipated cardiac arrests were evaluated for risk factors that are predictive of sudden death. Methods and Results - Eighteen consecutive patients were reviewed. Presentation, clinical course, laboratory data, and histopathological evidence of ischemia were compared between patients with and without sudden death events. The results demonstrated that patients who were at risk for sudden death were girls with chest pain, syncope, or both at presentation and without congestive heart failure. Although not statistically significant for sudden death, Holter monitor evidence of ischemia predicted death within months. Histopathological evidence of acute or chronic ischemia was found in the majority of patients, with acute ischemia more common among those who sustained sudden death events. Conclusions - All children with RCM are at risk for ischemia-related complications and death, and some are at risk of sudden death. In the present study, patients at risk of sudden death appeared well and had no evidence of ongoing heart failure but often had signs or symptoms of ischemia characterized by chest pain, syncope, or both. ECGs and Holter monitors may be useful screening tools. The use of β-blockade, the placement of an implantable cardioverter-defibrillator, and preferential status 1A or B listing for cardiac transplantation are proposed for pediatric patients with RCM and evidence of ongoing ischemia.

Original languageEnglish (US)
Pages (from-to)876-882
Number of pages7
JournalCirculation
Volume102
Issue number8
DOIs
StatePublished - Aug 22 2000
Externally publishedYes

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Restrictive Cardiomyopathy
Sudden Death
Ischemia
Syncope
Chest Pain
Heart Failure
Pediatrics
Implantable Defibrillators
Sudden Cardiac Death
Heart Transplantation
Signs and Symptoms
Cause of Death
Electrocardiography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Sudden death and cardiovascular collapse in children with restrictive cardiomyopathy. / Rivenes, Shannon M.; Kearney, Debra L.; Smith, E. O.Brian; Towbin, Jeffrey; Denfield, Susan W.

In: Circulation, Vol. 102, No. 8, 22.08.2000, p. 876-882.

Research output: Contribution to journalArticle

Rivenes, Shannon M. ; Kearney, Debra L. ; Smith, E. O.Brian ; Towbin, Jeffrey ; Denfield, Susan W. / Sudden death and cardiovascular collapse in children with restrictive cardiomyopathy. In: Circulation. 2000 ; Vol. 102, No. 8. pp. 876-882.
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