One in 350 teens is at risk for sudden cardiac arrest; Doug Grosmark, D85, helps save their lives
After Eric Paredes, a 15-year-old high school wrestler and football player, collapsed and died on the kitchen floor in 2009, his parents were shocked to learn he had an undetected heart condition that put him at risk for sudden cardiac arrest. Hector and Rhina Paredes went on to start a foundation that provides free cardiac screenings for teenagers.
Doug Grosmark, D85, was Eric’s dentist and a family friend. He became a founding board member of the Eric Paredes Save A Life Foundation (www.epsavealife.org), which has made it possible for thousands of teens in San Diego County, California, to receive electrocardiograms (EKGs) and echocardiograms at no cost. The group advocates mandatory cardiac screening for all students entering high school and having insurance carriers cover the cost for EKGs administered during well-child exams.
One out of every 350 U.S. teens has an underlying heart condition that puts them at risk for sudden cardiac arrest, according to the foundation, which has screened more than 12,000 young people thus far. Of those, 285 had abnormalities their parents were not aware of, and 125 were determined to be at risk for sudden cardiac arrest. Five of these teens underwent corrective heart surgery.
In sudden cardiac arrest, the heart’s electrical system misfires. “Basically, the heart just turns off,” Grosmark says. There are often no symptoms before a fatal episode, but an initial EKG screening, in addition to an echocardiogram, if necessary, can uncover abnormalities.
“It’s a rewarding thing when you find something these parents didn’t know about,” says Grosmark, who spoke about saving young lives.
Tufts Now: What is the difference between sudden cardiac arrest (SCA) and a heart attack? How can someone be saved?
Doug Grosmark: Unlike a heart attack, which happens when a blocked blood vessel prevents blood from flowing to the heart muscle, sudden cardiac arrest is an electrical event. CPR alone will not save a patient. You have to use an automated external defibrillator [AED] so the heart can be shocked into beating again. After three minutes of cardiac arrest, chances of survival begin to drop 10 percent each minute.
Why screen teens?
A screening can detect an enlarged heart, the most common cause of SCA. The subtle variations in EKG can detect rhythm problems like long QT syndrome, which is what Eric [Paredes] had.
Why aren’t these screenings done as part of routine well-child exams?
There is conflicting discussion within the medical community about this. SCA affects only 1 to 2 percent of the population; therefore, the insurance companies will not routinely cover an EKG. Insurance will cover an EKG if there is a report of symptoms, such as feeling faint or out of breath after exertion. There is also lack of awareness: most parents don’t know that their child’s heart is not being screened, and few parents request it unless they’ve been touched in a personal way or have heard of a local teen who may have died suddenly.
What role can dental professionals play?
As health-care providers who generally see these young people twice a year, we are best capable of alerting parents that they should request their physicians perform screenings. In the dental office, medical histories should not just be reviewed with parents—they should be reviewed with the teens, too. We know some teens don’t tell their parents about symptoms that might keep them from playing sports. But kids will sometimes tell hygienists or dentists about symptoms such as feeling faint when they work out, dizziness or chest discomfort.
My education at Tufts taught me that we’re not just treating teeth; we’re treating the whole patient. Just a few questions included with the health history of a teen could be the impetus that would get them to go to a physician, and that could possibly save a life.
This article first appeared in the Fall 2014 issue of Tufts Dental Medicine magazine.
Helene Ragovin can be reached at helene.ragovin@tufts.edu.
