Item eight: Young hearts
Resolution submitted by the RCN United and Homefirst Branch
That this meeting of RCN Congress demands accessible cardiac screening for young people
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RCN Congress were asked to vote on a resolution demanding accessible cardiac screening for young people. The resolution submitted by the RCN United and Homefirst Branch highlighted that it is estimated that 12 young people in the UK die each week as a result of sudden cardiac death. These deaths are often unexpected, with no warning signs and most commonly affect young males.
Views were heard both for and against this resolution - Mike Travis, paediatric nurse, urged caution saying that these congenital defects are very difficult to deal with and the NHS does not have the budget or staff to deal with screening for all young people, whilst Saffron Brown, nursing student, said that there shouldn't be a price on any son or daughter.
For 156 47.13%
Against 175 52.87%
Abstain 68
Background
It is estimated that eight young people in the UK die each year as a result of sudden cardiac death. Defined as an event that is non-traumatic, non-violent, and resulting from sudden cardiac arrest within six hours of previously witnessed normal health, sudden cardiac death is swift and unexpected. Organisations, such as Cardiac Risk in the Young and the Cormack Trust, believe that the majority of these deaths could be avoided if basic cardiac screening was more widely available.
Sudden cardiac death in those aged 35 years or less is more common in males than females. Premature atherosclerotic disease (hardening and narrowing of arterial blood vessels) is an important cause in young adults, and increased risk is also associated with cocaine abuse. Young people who play sport — especially athletes, who place significant stress on heart or lungs during training and competing — are also considered to be more at risk of sudden cardiac death, as a sporting activity can trigger life threatening arrhythmias or cardiac arrest caused by an underlying and pre-existing congenital cardiac abnormality. Charitable organisations campaigning on this issue prefer not to distinguish between athletes and non-athletes, and instead contend that all young people involved in sport should have access to cardiac screening.
Cost effectiveness is a key consideration in decisions taken by the UK National Screening Committee (NSC), which advises ministers and the NHS in all four UK countries. Similar cost issues inform the recommendations of the National Institute for Health and Clinical Excellence (NICE).
While it might be argued that cardiac screening is not cost effective, the silent suffering of the families that lose a child in this manner has not been evaluated. Any assessment of cost effectiveness undertaken by policy makers would need to consider all evidence — including the full social costs.
References and further reading
Corrado D, Pelliccia A, Bjornstad, H, Vanhees L, Biffi Al, Borjesson M, Panhuyzen-Goedkoop N, Deligiannis A, Solberg E, Dugmore D, Mellwig K, Assanelli D, Delise P, Van-Buuren F, Anastasakis A, Heidbuchel H, Hoffman E, Fagard R, Priori S, Basso C, Arbustini E, Blomstrom-Lundqvist C, McKenna W and Thiene G (2005) Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol, European Heart Journal, 26 (5), March, pp. 516 - 524.
CRY: Cardiac Risk in the Young (2008) from the CRY website.
Goodwin, JF (1997) Sudden cardiac death in the young: a family history of sudden death needs investigation, British Medical Journal, 314 (7084), 22 March, p.843