Long-term Cardiac Observation of Children

A Six-year Survey of the Cases Seen at a School Cardiac Clinic

“…Some of the discrepancies arise because children with certain anomalies may be referred more readily than others to clinics: a further discrepancy is evidently produced by variations in the criteria of diagnosis and in the use of ancillary methods of diagnosis. Thus, the high incidence of diagnosed pulmonary stenosis in the present series (19%), and in that of Price in 1949 (23 %/), should be contrasted with the very low incidence (1 %) reported by Keith (1951). The true incidence is clearly likely to be determined only in centres where there is access to unselected school and pre-school populations.…”

“…Both these computations are derived from 'heart registries' in which an attempt has been made to include all children in the district. In this country Price (1949) has published figures from a semi-urban cardiac clinic which, like the Bristol clinic, relies for its material on cases referred for an opinion. In his group the proportion of rheumatic to congenital cardiac disorders was 46% to 54%.…”

“…Finally, the analysis of the cases referred to the clinic gives information as to the incidence of the various types of heart disease occurring in the community served. Some reports giving information of this nature about such clinics have appeared in North America (e.g., Robinson, Aggeler and Daniloff, 1948;Keith, 1951), but we have traced only one from the British Isles, that of Price (1949), who described a clinic in a semi-urban area during its first 18 months. It was therefore considered that a report from a clinic in an urban area might provide material of interest, the value of which would be enhanced by a follow-up survey of several years' duration.…”