Screening for warning signs of sudden cardiac death in the young: the SCD-SOS questionnaire.

Introduction: Sudden cardiac death (SCD) is one of the most common causes of death in the young. It may be preceded by "red flags", but screening for these warning signs is not routinely performed. Objective: To test a new questionnaire for fast clinical assessment of possible warning signs of serious heart disease in a young population. Methods: We studied a population of 1472 university students and hospital employees (mean age 22.3±5.9 years; maximum age 40 years; 56.5% women), using a rapid-response questionnaire, evaluating major cardiac symptoms, past pathological and family history and medication: the Sudden Cardiac Death — Screening of Risk Factors (SCD-SOS) questionnaire. Descriptive statistical analysis and comparison of quantitative and nominal variables were performed using SPSS version 16.0. Results: Of the questionnaires, 0.3% were blank and 3.5% had 1 to 3 missing answers (of a total of 8); 42.5% had no previous cardiac complaints, 27.8% had previous syncope and 24.5% chest pain; palpitations were reported by 23.5%, cardiac murmur by 5.9%, epilepsy or antiepileptic drugs by 1.6%, cardiovascular medication by 1.4% and family history of cardiac disease by 3.3%. A history of sudden unexplained or cardiovascular death in first- or second-degree family members was reported by 2.0%. Full analysis of the questionnaires identified 69 participants (4.7%) with at least one warning sign indicating need for cardiological evaluation, among whom 17 had two warning signs and three had three. Conclusions: SCD-SOS detected some cases requiring careful examination by a cardiologist. It could, however, be improved in some respects (characterization of chest pain, palpitations and family history of heart disease), in order to clearly identify possible high-risk patients. Applying this questionnaire together with an ECG may be a better way of risk stratifying this population.