Julia with pediatric cardiologist Dr. Anjan Batra.
Julia Flores, 10, just wanted to play soccer. But late this past summer, two weeks before the start of her recreational league practice, the fifth-grader from Whittier fainted at home. Concerned, her parents took her to see her pediatrician. That's when a series of events began that probably saved Julia's life.
Heart irregularity found
The pediatrician detected a mild irregularity in Julia's heart rhythm and decided she could not clear the young athlete to start soccer practice without further tests. She referred Julia to Dr. Anjan Batra, UCI Health division chief of pediatric cardiology and director of electrophysiology at CHOC Children's hospital, which is affiliated with UCI Health.
Batra also detected the abnormality and asked Julia to undergo an exercise test — walking on a treadmill while her heart function was monitored. She borrowed her mom's sneakers and the test began.
"We have the capability of exercising patients right here when they come to the office," Batra says. "We are leaders in the country in terms of exercise testing."
Springing into action
But when Julia began to exercise, her heart rate soared to 300 beats per minute, three times the normal heart rate of about 100 beats per minute. Batra and his team went into action to prevent full cardiac arrest. They stopped the test, gave Julia oxygen and called paramedics. Julia was rushed to CHOC Children's.
"We were in shock because it happened so fast," says Julia's mother, Sylvia Flores.
Batra is happy the event occurred in his office and not on a soccer field.
"We didn't expect this to happen. But if this would have happened on the field or somewhere, the consequences would have been very different," possibly even life-threatening, he says. "In this case, everyone did the right thing: The family went to the pediatrician. The pediatrician quickly referred the patient to a cardiologist, and we did the treadmill test. It was a series of events that happened."
Troublesome spot identified
In the hospital, tests revealed a tiny, pinpoint spot in Julia's heart that was causing the abnormal rhythm. In the electrophysiology lab, Batra used a catheter threaded through a vein that provided a three-dimensional view of Julia's heart. He then applied radiofrequency energy to the troublesome spot.
"We can actually map where the abnormal rhythm focus is coming from," he says. "We can put radiofrequency in that very small area and get rid of the cells that are causing this abnormal rhythm. It's very sophisticated technology that allows us to do that."
The next day, Julia went home. She had a follow-up treadmill test to verify that her heart rate was normal and the problem was fixed. Julia was so nervous about getting back on the treadmill that she canceled the first test. But during her second appointment, she took a deep breath and bravely stepped on the treadmill.
"I did not want to go on the treadmill again," Julia says. "But now I feel perfectly fine."
Back on the field
She's back on the soccer field and plans to also play volleyball this year. She wants other kids to know that sports physicals and EKGs are important and not all that scary.
"I missed a lot of soccer practices," she says. "But the first game I played in was awesome. I got to have fun."
The family is grateful for the cardiac testing that possibly saved Julia's life.
"It was such a blessing," Sylvia Flores says. "It was a fluke that the abnormality was found. Normally if a child passes out, you can attribute it to heat or something. But afterwards, we were wondering why kids aren't required to get an EKG before playing sports. It makes so much sense."
Value of sports physicals
Most children and teens pass sports physicals with no problem. But these examinations are highly valued and recommended because they can prevent catastrophic events, such as cardiac arrest on the playing field.
UCI Health physicians offer convenient, low-cost sports physicals that include:
- A review of a child's medical history
- A physical exam that includes muscle and joint testing
- Vision and hearing exams
- Review of needed immunizations
- Echocardiograms and EKGs are also available when recommended
Same-day and walk-in appointments are available.
Physicals help find cardiac abnormalities
"More cardiac abnormalities in children are coming to light through sports physicals," Batra says. "There are two aspects to prevention: We can detect the abnormality before something happens or prevent sudden cardiac death after something happens with the use of on-site defibrillators."
UCI Health physicians have worked with Orange County school districts over the past decade to increase the use of defibrillators at sports venues. In the past decade, the rate of county school districts with on-site defibrillators has increased from less than 20 percent to more than 80 percent, he says.
UCI Health, in conjunction with the Orange County Department of Education, also created the LEAPS program (Life-threatening Events Associated with Pediatric Sports) to promote education about pediatric cardiac events, screening EKGs and access to defibrillators.
"That has been really successful," Batra says of the program. "Julia's case is a great example of the importance of getting sports physicals and, if the patient does have an abnormality, getting a timely evaluation."