91 - Community Based Cardiac Screening in Adolescents and Young Adults to Identify Risk of Sudden Cardiac Arrest

Publication Number: 2087.91

Adam C. Gallagher, Cardiology Care for Children, Columbia, PA, United States; Akruthi Puttaparthi, N/A, Downingtown, PA, United States; Cynthia Barbosa-Delgado, Cardiology Care for Children, Lancaster, PA, United States; Julie Walker, Peyton Walker Foundation, Camp Hill, PA, United States; Katrina Timberlake Holmes, Engage Inspire Expose, Lancaster, PA, United States; Nicole L. McCartan, The Peyton Walker Foundation, Camp Hill, PA 17011, PA, United States; Devyani Chowdhury, University of Maryland School of Medicine, Lancaster, PA, United States

Background: Sudden cardiac arrest (SCA) is a leading cause of death in asymptomatic adolescents and young adults. Community screening facilitates early detection of underlying cardiac abnormalities, reducing preventable deaths. Lancaster City, PA, exhibits significant socioeconomic and racial disparities, with high minority and poverty rates. To overcome barriers to preventive care, a no-cost cardiac screening was implemented at an inner-city school for an underserved population.

Objective: To examine the outcomes of a community-based cardiac screening initiative aimed at improving access to preventive cardiac evaluation, detecting subclinical heart disease, and reducing sudden cardiac arrest risk among underserved adolescents in Lancaster City, Pennsylvania.

Design/Methods: The Peyton Walker Foundation, in partnership with Cardiology Care for Children, hosted a cardiac screening for students aged 10–22 years not under routine cardiology care. Participants completed a medical and family history, vital signs, and ECG; echocardiography (ECHO) was performed when indicated by abnormal history, vital signs or ECG. Results were reviewed on-site by a cardiac team and shared with families. Abnormal findings prompted cardiology referral. Participants also received CPR and AED education.

Results: A total of 111 students were screened, with each evaluation lasting 45–60 minutes. Personal and family histories were obtained from 71 participants. 36% reported at least one cardiac-related symptom – most often exertional chest pain, palpitations, dizziness, or shortness of breath. 14% reported a family history of cardiac disease, arrhythmia, or sudden cardiac death before age 40.

Among all participants, 10.8% had abnormal ECGs, most commonly atrial rhythm (41.7%), right ventricular hypertrophy (25%), incomplete right bundle branch block (8.3%), and nonspecific ST/T-wave and QTc prolongation (8.3%). One participant had a prolonged QTc interval (473ms). Echocardiography was performed in 5.4% of cases, identifying one bicuspid aortic valve and one mild left ventricular wall thickening, 66.7% of ECHOs were normal. Students with abnormal findings were referred for cardiology follow-up.

Conclusion(s): This community-based screening model illustrates how equitable outreach can reduce disparities in cardiac care for underserved youth. Through a no-cost nonprofit–cardiology partnership, the program minimized financial and access barriers while providing same-day results and referrals, illustrating a scalable approach to lowering SCA risk in underserved communities.