Heart Disease Screening in School Children

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Abstract
Fifty-two children with known heart disease were chosen as index subjects among 1,382 school children. All 1,382 children were screened by two methods; namely, a clinical screening examination and a heart-sound tape recording with use of three independent cardiologists to read each tape. Both methods yielded nearly identical results, identifying 16 to 18 of 20 children with congenital heart disease and 10 to 11 of 29 children with rheumatic heart disease. Using published prevalence figures for congenital and rheumatic heart disease, the authors calculate that these methods will identify only 43 to 58 per cent of heart disease existing in school-age children. There is no appreciable difference in the sensitivity or specificity of the two methods. Tape recording of heart sounds with high-quality portable equipment is found to be more cumbersome, expensive, and time consuming, and of no greater sensitivity than clinical screening by available community physicians.