Heart Disease Screening of Schoolchildren in Taiwan

Abstract

Intervention: A 2-level heart disease screening program was undertaken. Level 1 screening included a history questionnaire and phonocardiography and electrocardiography. Level 2 screening consisted of examination by a pediatric cardiologist of all children who had abnormal findings on level 1 screening. A control group comprised children whose level 1 screening results were normal. Children with abnormalities on level 2 screening were referred for a detailed cardiac evaluation. Main Outcome Measures: Previously unsuspected heart diseases. Results: Of 25 816 children undergoing the level 1 screening program, 5330 had positive findings, of whom 5235 underwent level 2 screening, along with 1104 children in the control group. The pediatric cardiologist referred 780 children to the hospital for full evaluation, including 18 controls and 114 patients with a previous diagnosis of heart disease. A total of 292 children, including 2 controls, had evidence of heart disease, which was previously unsuspected in 178 (61.0%). Excluding children with a previous diagnosis of heart disease, the sensitivity of the screening program was 82.6%. The specificity and the positive predictive value were 98.3% and 28.6%, respectively. Conclusion: The 2-level heart disease screening program has good sensitivity and detects asymptomatic but potentially life-threatening heart disease in some children.

Cardiovascular Disease Screening in Primary School Children

“…Nearly half of them corresponded to minor CHD forms (such as bicuspid aortic valve (BAV) and small atrial septal defect (ASD2) not requiring any intervention. The detection rate of structural heart abnormalities in the present CVD screening program was comparable to the results of screening programs using digital PCG in China [ 29 ], with variable detection rates depending on screening program methodology [ 24 ] ( Table 1 ).…”

Spectrum of heart disease in children under 5 years of age at Liaquat University Hospital, Hyderabad, Pakistan

“…Regarding the type of CHD, around 74.6% were acyanotic which correlates well with study done in Kanpur, India 8 . Ventricular septal defect (VSD) is the most common CHD in infants and children, accounts for 25% of CHD, VSD was almost the same as found in studies done in India, Taiwan and Peshawar 9, 10, 11…”

“…Among cyanotic lesions tetralogy of Fallot (TOF) was the commonest lesion found in 11.2% of the patients, this number was higher as compared to international data 9, 10. However recent study of Agha Khan University, reported an even higher percentage of 25% 17 …”

Clinical Profile, Pattern of Presentation and Short Term Outcome of Cyanotic Congenital Heart Disease in Neonates

“…A study conducted by Tsao P-C et al where pulse oxymetric screening could detect 5 cyanotic congenital defects in neonates and among them 2 cases were TGA, 1 of HLHS,1 case of Ebstein anomaly and 1 case of DORV with single ventricle [34]. In another study by Nadia M et al, out of 150 study patient cyanotic lesions tetralogy of Fallot (TOF) was the commonest lesion found in 11.2% of the patients, this number was higher as compared to international data [35,36]. However recent study of Agha Khan University, reported an even higher percentage of 25% [37].…”