Elm Park air cadet who died at RAF camp had ‘silent killer’ heart defect
PUBLISHED: 15:43 04 September 2015 | UPDATED: 15:56 04 September 2015
A 14-year-old boy who died at an RAF cadet training camp had an undiagnosed heart defect known as a “silent killer”, an inquest heard yesterday.
The parents of David Efemena, of Elm Park, listened as expert pathologists described the hidden heart abnormality that caused their son’s sudden death.
David died during a weekend air cadet exercise at a defence training estate in Bramley, Hampshire, on March 23 last year after falling seriously ill in his tent.
It took adult supervisors 30 minutes to reach David as he lay dying because the cadets were camped 1.9km (1.2 miles) away from the adult base camp and radio messages took 10 to 20 minutes to reach leaders.
The 14-year-old, a pupil at Campion School in Hornchurch, was in cardiac arrest when paramedics arrived and later died in hospital.
Prof Mary Sheppard, a cardiac pathologist with 30 years experience examining the hearts of young people who die suddenly, told David’s parents he had a heart abnormality known as “the silent cause of sudden death” because most people never display symptoms.
“The majority of people are completely asymptomatic before they drop dead,” she said. “That’s the danger. They’re generally young people like this young boy.”
She explained David’s right coronary artery, one of two main blood vessels supplying the heart, was on the left side of his heart and was squashed between two vessels “capable of choking it”.
The court heard the defect would have been present from birth and was very difficult to diagnose.
Forensic pathologist Dr Russell Delaney, who carried out the first examination of David’s body, said the abnormality was “particularly dangerous” because it would not be picked up by routine health checks.
Prof Sheppard explained David’s heart muscle also had scar tissue that could lead to abnormal electrical impulses and cause the heart to stop.
She said the abnormal artery, the scar tissue, or both, could have caused his heart to fail and that it was “very difficult to resuscitate” someone with this type of heart defect once they go into cardiac arrest.
The inquest heard David had taken part in a cadet training exercise on Saturday, March 22 that involved carrying heavy packs, when he was seen to struggle.
He went to bed at 10pm and slept in a bivouac tent, unsupervised by adults, when other teenage cadets saw David shivering and shaking and making coughing or gurgling noises.
At 6.15am another cadet spotted David “shaking quite violently” and radioed for help from adults at the base camp 1.9km away.
Warrant Officer Michael White told the inquest he left the adult base at 6.25am to walk to the cadet camp and first heard crackles on the radio as the boys tried to message when he was about half way there.
He arrived at camp between 7.05 and 7.11am and found David was not breathing. Ambulance crews arrived at 7.30am and he was flown to hospital by helicopter but was pronounced dead at 9am.
Forensic pathologist Dr Delaney told the coroner he believed sleeping out over night may have contributed to David’s death.
“It would appear as though he had become unwell over a longer period of time than the majority of people would with a sudden death,” he said.
“It may well be that the conditions that he was sleeping out in, whilst not dangerous on their own, may have contributed to why he died from the coronary artery abnormality at that particular time rather than at any point previously.”
But Prof Sheppard said in her opinion this was not a factor as shaking and shivering were unlikely to have been caused by an irregular heart beat.
The court heard evidence that David, described as healthy and sporty, had complained of finding exercise more difficult in the year before his death and had reoccurring headaches and back pain.
He was referred to specialists, who diagnosed him with sickle cell traits, a less serious form of sickle cell anaemia that is usually benign, that had caused a slight curvature of his spine.
This was treated with physiotherapy.
The inquest continues.