The treadmill exercise test with the Bruce protocol was performed in three patients with post-myocarditic myocardial hypertrophy (PMH) and ten patients with cardiomyopathy, including three with dilated cardiomyopathy (DCM), five with hypertrophic obstructive cardiomyopathy (HOCM), and two with hypertrophic and nonobstructive cardiomyopathy (HCM). The endurance time was below the normal level in all but one case and was normal or near normal in the three cases with PMH. ST depression was observed in five cases, none of which were of HCM. A marked increase in amplitude of the negative phase of the P wave in V1 was observed in one patient with DCM. The response of blood pressure during the exercise was abnormal in patients with DCM and HCM but was normal in PMH.

Background: Hypertrophic cardiomyopathy (HCM) is a major cause of sudden death in children at school. However, more children with HCM are being successfully resuscitated a er collapse due to the increasing availability and accessibility of basic life support systems. erefore, the prognosis for children with HCM who experience cardiac events at school may be changing. is present study aimed to determine the outcome of cardiac events arising in children with HCM and the e ect of automated external de brillators (AED) applied under school supervision. Methods: We retrospectively studied case reports of cardiac events submitted to mutual aid systems for schoolchildren with HCM between 2004 and 2011. Results: Among 44 children with HCM who experienced sudden cardiac events at school, 29 died and 15 survived a er resuscitation. An AED was applied to 14 of the survivors, and one already had an implantable cardioverter de brillator (ICD). Males predominated among both the deceased and the survivors. Among children with HCM who experienced cardiac events in kindergarten, primary school, junior high school, and high school, only those in junior high school and high school survived. e ratios ( ) of the deceased and the survivors that had been diagnosed with HCM before cardiac events occurred were 48 and 20 , respectively. Cardiac events occurred most frequently during exercise in both the deceased and the survivors. Conclusions: e number of children with HCM who are resuscitated a er cardiac arrest while at school has increased in Japan since 2007. Both AED and ICD are essential in preventing sudden death due to HCM in schoolchildren.

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