Hatzolah Medical Rescue has embarked on a potentially one of a kind, life-saving school initiative to prevent sudden cardiac death in adolescents (SCDA).
Sudden cardiac death is defined as death that is abrupt, unexpected, and due to a cardiovascular cause. It’s generally recognised as death that occurs within one hour from the onset of cardiovascular symptoms. However, in young people, it typically occurs within a few minutes of symptom onset.
The condition is extremely rare, but can be fatal and is completely preventable, say experts.
“Over the next three weeks, Hatzolah will be conducting electrocardiograms [ECGs] on all willing adolescents at Johannesburg Jewish schools. It’s hoping to conduct just more than 1 500 ECGs,” said project manager, Avigdor Hack.
Hack said the project was first rolled out about five years ago, and was very successful.
“We conducted more than 1 000 ECGs during our last screening project. There were about 12 adolescents who were flagged for further investigation and four cases were referred to a cardiologist. One adolescent required chronic medication for an arrythmia, and one patient needed to have an ablation,” he said.
Darren Kahn, the executive general manager at Hatzolah, said SCDA was very rare. “We’re undertaking this project as a preventive measure and there’s no reason to be concerned,” he said.
The project, on the cards for some time, was delayed by the COVID-19 pandemic. It’s not related to the recent incident in which Grade 11 pupil Gavi Waksman of King David High School Linksfield collapsed at a recent cross country meeting, Kahn said. It’s unknown whether an ECG would have helped in Waksman’s case, and doctors are still investigating his condition, which is improving.
The idea for the project was sparked several years ago by one of the Hatzolah paramedics, who is also a doctor, at a Johannesburg hospital whose patient, from outside the community, suffered SCDA, which could have been picked up by an ECG.
“I feel strongly about this project because it’s an entirely preventable condition,” Hack said. “It’s wonderful to be able to offer this service.”
“It’s such a tragedy when a young, fit person collapses suddenly from a heart condition that can easily be detected. It’s not like a person’s life has to change if something is picked up, it can require a simple procedure or medication going forward.”
Hack said the project was free of charge for the school and students and was entirely voluntary. If however, an abnormality is picked up, responsibility of future treatment will be up to the legal guardians.
“We have employed two male nurses for male students and two female nurses for female students who will be using our four 12 lead ECG machines. All screenings will be private and confidential,” he said.
The most common causes of SCA in children are structural cardiac abnormalities – congenital heart disease and post-operative repairs and coronary artery anomalies – all of which Hack said could be picked up with an ECG.
“The project relies on a whole team of Hatzolah volunteers and trained nurses. The community is blessed to have so many on board. Huge thanks to all involved,” he said.
An ECG is one of the simplest and fastest tests used to evaluate the heart. Electrodes (small, plastic patches that stick to the skin) are placed at certain spots on the chest, arms, and legs. The electrodes are connected to an ECG machine by lead wires. The electrical activity of the heart is then measured and at a later stage, will be interpreted. No electricity is sent into the body.
Natural electrical impulses co-ordinate contractions of different parts of the heart to keep blood flowing the way it should. An ECG records these impulses to show how fast the heart is beating, the rhythm of the heart beats (steady or irregular), and the strength and timing of the electrical impulses as they move through the different parts of the heart. Changes in an ECG can be a sign of many heart-related conditions.
There will be an opportunity for students at other schools to take part in this project and for those who missed the session to attend catch-up sessions, possibly on weekends. For further information, contact Avigdor Hack at avigdor@hatzolah.co.za
