Every year, approximately 2,000 seemingly healthy people under the age of 25 die from sudden cardiac arrest (SCA), a tragic statistic that Cook Children's Health Care System is working to change.

In recognition of National Sudden Cardiac Arrest Awareness Month this October, Cook Children's is highlighting its year-round commitment to ensure schools and communities are prepared for such a medical emergency through its Project ADAM program, which provides life-saving training and resources.

Sudden Cardiac Arrest occurs when the heart stops beating, which leads to loss of breath or irregular breathing and prevents blood flow to the brain and other vital organs.

“With the proper training, anyone can do CPR and use an AED, and with enough of us trained and empowered to do so, we have the ability to potentially save someone’s life,” said Sarah Thieroff, Project Adam Program Coordinator.

Project ADAM (Automated Defibrillators in Adam's Memory) is a program named after 17-year-old Adam Lemel. In 1999, while playing high school basketball, Lemel collapsed and went into Sudden Cardiac Arrest. His family learned that he could have been saved with the right preparation and equipment. An automated external defibrillator (AED) was not available. His parents helped start the Project ADAM program at the Children’s Hospital of Wisconsin in his memory. Cook Children’s was the first in Texas and is now one of 52 hospitals and program sites to provide free cardiac resources, including training and AED devices. 

Thieroff recalled the motivating force behind the program's founding: "What we learned now is that Adam could have had a chance. I was faced with a choice. I couldn't save my son, but maybe I can save yours," Adam's father said.

More than 780 schools and 28 school districts are recognized to be Heart Safe. A designated Heart Safe school and district have completed a quality AED training program that includes a CPR/AED trained emergency team, an emergency plan for their AED and required AED drills.

“Knowledge of what to do, and muscle memory from practicing the appropriate steps may correspond to earlier action and in turn lead to a more successful outcome,” said Danielle Moyé, M.D., at Cook Children’s Heart Center.

Beginning the 2026-2027 school year under Senate Bill 865, also known as the Landon Payton Act, public and private schools will be required to implement a cardiac emergency response plan, mandate CPR and AED certification for specific school employees and volunteers, and require drills to test their emergency response.

“With the SB 865 bill, we have legislative support to encourage schools to act now and prepare,” said Dr. Moyé. “And we are ready to help them. We are here and happy to walk through what this looks like and ease some of the burden from the school’s administration, nursing team, and district.”

An AED is supported by the FDA to detect ventricular fibrillation. It has been designed and tested in both children and adults. Cardiac arrest is reversible in most victims if it is treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A shock delivered by an AED within 3-5 minutes can save a life and for every minute that passes, survival rates drop by 10%.

Through the Cook Children’s Project ADAM program, anyone can be trained. The program provides schools across Texas with the necessary tools and education to plan and develop their public access defibrillation (PAD) program.

“The expectation is that schools will be prepared for if it happens, not just putting it off or waiting to establish an emergency team, plan and/or drill if/when it happens,” explained Thieroff.

Signs and Symptoms of Sudden Cardiac Arrest

• Not breathing or irregular breathing (i.e. agonal gasps)
• Unresponsive and/or sometimes there are “seizure-like” movements.
• If someone witnesses a collapse:
  • Check for responsiveness.
  • Tap/lightly shake the person and ask if they’re okay, then if they’re not responsive, call for help/have someone call 911 immediately
  • Send someone to get the AED. If they’re unsure where the AED is, when they call 911, the 911 dispatcher should tell them the location of the nearest registered AED in the area.

Cook Children’s provides free Hands Only CPR/AED training, cardiac emergency response planning, and AED drill assistance to any school in Texas. Call 682-885-6755 or email ProjectAdamTexas@cookchildrens.org. For more information on free resources on the local Project ADAM program, visit www.projectadamtexas.org or the national Project ADAM page at www.projectadam.com

Parents worry SO much when I hear one in their kiddo's chest and I tell them about it.

But I am here to help you not freak out!

I feel like I need to add "Parental Freak-Out Support and Management" to my resume. Maybe underneath "Office Donut Day Coordination Specialist"?

...

I hear heart murmurs in kids Every. Single. Day. Sometimes numerous times a day. We're deep into school physicals this time of year and that's when many doctors will find a heart murmur on exam.

They're really common.

I have read that anywhere from 30-70 percent of children and adults have a heart murmur at some point in their lives.

A heart murmur is a whooshy sound I hear in between the heart's little beats. So instead of "bum-bum, bum-bum," I hear something like "WHOOSH-bum, WHOOSH-bum".

Lots of things cause heart murmurs. A heart murmur can show up at any time in a child's life. And just because it wasn't heard before doesn't mean something bad has happened or is happening.

Anemia can cause murmurs. Dehydration can. Illness in general can.

Fevers are a common cause of murmurs. I can't tell you how many times one of my little patients goes to urgent care at night and a parent is told, "you should know your child has a heart murmur." And then of course they worry! When really, it was your poor kiddo's 102F temp that caused it.

Sometimes it's just the shape and size of your kiddo's heart at that time in their life. A "Still's Murmur" is something I often hear anywhere from age 2 to 6. It can come and go and causes no problems. It just has to do with the way the blood sounds whooshing through the valves and rooms in the heart.

Pediatricians have heard thousands of heart beats. We are pretty good at knowing which murmur sounds okay, and which murmur doesn't. And we will send you to a pediatric cardiologist if we are concerned or just wanna see why the sound is there.

So when do I worry a little more about a murmur?

• Any murmur heard in a newborn to 6 month old (these are more likely to be a structure problem in the heart that they were born with, and we need to investigate those further).
• Any murmur accompanied by other symptoms of heart problems, like: Skin that appears ashen or blue from poor circulation (cyanosis), pale skin, heavy or rapid breathing, a rapid heart rate, tiredness, difficulty feeding or poor growth.
• If your child has a murmur and you tell me that they can't keep up with their friends when playing sports, or have chest pain or tightness related to activity.
• If you have a family history of sudden and early cardiac death (think young people under 40 who suffer a heart attack during play).

If any of these are happening, more studies (like an EKG or heart echo) are usually needed.

I hope this helps you understand murmurs a little better!

As always, if you're concerned, just ask your pediatrician to explain things a little more if they mention your child has a murmur.

Have a great day!

Dr. Diane❤️

School physical season is one of my favorite times of the year for many reasons:

• It’s really fun to see kids grow up and get big over time.
• I love watching my patients’ personalities mature.
• I love that the visits become progressively more about my relationship with the child in addition to my relationship with their parents.
• For the most part everyone is healthy and happy.
• For most children, the promise of a new school year and new beginnings is exciting.

I have a few things on my agenda for each back-to-school checkup.

I want to talk about diet, exercise and sleep. I want to talk about how school went last year and what the plans are for the upcoming year.

But checkups are more than just about what I want. In order for the checkup to be a success, it must meet the goals of the child and parent. Parents are all over the place when it comes to their expectations for physicals.

Here are just a few examples:

1.“Let me get out my list.”

Whether your weapon of choice is a spiral-bound notebook or long thumb-scrolling iPhone lists, you know who you are. And frankly, I love you. Having a guide that directs the visit through any questions and concerns that you have is beyond helpful. It keeps me from having to talk about stuff that’s not important to you and wasting both of our time. So, bring it on, Listers, and I promise not to roll my eyes.

2.“I’m just here to get my form signed.”

No worries. That may be all you need and that’s great. In the meantime I can provide a quick screen for height, weight, body mass index, high blood pressure, heart murmurs, risk for sudden cardiac death, hearing and vision (and much more). I can also screen for drug/alcohol abuse, depression, attention problems and other school issues. “Here’s your form, thanks for coming in.”

But seriously, even in those children who come in with no apparent concerns or complaints, we do pick up health problems that need to be addressed to maximize your child’s ability to function well in school or compete at their best in their chosen activity.

3.“I’m not worried, but __________ wanted me to ask about __________.”

This is a tricky one. I’m totally cool with it, but it can be hard to get at exactly what the concerns is if that person isn’t there to ask questions. My advice … if that person is close enough to be providing this type of advice, they could probably come to the appointment. If the concern is coming from the child’s teacher, a quick note explaining what is going on can be really helpful.

Just don’t leave it up to chance that we can figure out what the problem is, especially if you don’t quite understand why they are concerned. Get specific information about the concern or have them come along.

I’m sure there are many more ways that parents think about their children’s checkup, but these are some common ones I notice.

No matter what, regular checkups are an important part of helping you maintain your child’s health. Good health increases their ability to be present for and to participate fully at school and extracurricular activities.

Which category do you fall in? Is there a different one you think I should include?

Sports EKGs are free through the month of August at specific locations in Arlington and Fort Worth. Cook Children's offers a $25 Sports EKG (electrocardiogram) screening test at our Cardiology offices in Mansfield, Southlake and Denton. Adding a sports EKG to your child’s physical can help detect most heart conditions that may lead to sudden cardiac arrest. Click to learn more. 

For school physicals, visit your local Cook Children's pediatrician. Click to find one near you. 

I can’t tell you how many times I’ve heard this from anxious parents as their child is having his echocardiogram done. In reality, a murmur is something that is heard, not seen.

In a normal heart, the valves make noises as they close, the classic “lub-dub” attributed to normal heart sounds. A murmur is an extra sound, “lub-shhh-dub.” Most of the time the murmur is innocent or functional, some may call it benign.

Innocent murmurs are simply sounds we hear as blood flows through a normal heart. More than two-thirds of children with normal hearts will have a murmur at some point in their life. There are classic innocent murmurs that occur at various times throughout a child’s life, and usually they go away on their own over time.

Aside from these are the pathologic murmurs, or sounds that occur because there is a problem with the heart, maybe a valve that isn’t working properly, a hole in the heart, or a vessel that is narrowed.

Typically there are characteristics that help distinguish innocent murmurs from pathologic murmurs. Louder, more harsh murmurs are more characteristic of pathologic murmurs. The timing that the murmur is heard is also important. Innocent murmurs are typically heard when the heart is squeezing (this is a systolic murmur). In the case of innocent murmurs, there is usually no need for further evaluation. Innocent murmurs don’t “progress” to pathologic murmurs. There is no need for activity restrictions and no need for antibiotics when the child goes to the dentist. In the case of pathologic murmurs, follow up, activity restrictions, and whether the patient needs antibiotics when he or she goes to the dentist all depend on what is causing the murmur.

Having said this, not all systolic murmurs are innocent. Murmurs heard when the heart is relaxing (diastolic murmur) are usually pathologic.

An echocardiogram is a test that helps us evaluate the heart in the event that the murmur sounds concerning. The probe, or camera, sends ultrasound waves toward the heart . This time it is about what we see. The waves bounce off solid structures and the machine organizes the returning signals into a 2D picture, which is displayed on the screen. The study also uses color signals to help determine the direction of flow, and Doppler signals to determine how fast the blood is traveling across different areas of the heart.

The cardiologist uses all of this information to determine if there is a problem and a treatment plan for the child begins. And to think it all begins with those first anxious moments of listening to a child’s heart.

About the author

Deborah Schutte, M.D., is the medical director of Cardiology at the Cook Children's Heart Center. The cardiology team at Cook Children's has extensive experience in the diagnosis and treatment of pediatric heart care. They know the unique requirements of treating the growing hearts of children, including those with extremely rare and difficult conditions. Our areas of expertise include cardiac surgery,interventional cardiology, adult congenital cardiology, electrophysiology, cardiac testing and imaging,echocardiography, fetal echocardiography and cardiac anesthesiology.