Screening for Heart Disease in Children

Heart disease is something we think of as being good screening tests for adults around the age of 40-50. But kids get heart disease, too, and can suffer from sudden cardiac arrest during activity primarily. One low cost test was able to detect heart conditions in 10 out of 400 kids using a low cost screening test. So what does this mean? It means we should consider screening all school aged

children and teens for heart disease, particularly those who are involved in physical activities and sports.

The test takes less than ten minutes to complete and includes a history, which detects family history for heart disease among other things, physical examination for heart murmurs and heart irregularities and an ECG or electrocardiogram, which checks for electrical activity of the heart.

Currently, in Italy and Japan, similar screening methods are compulsory for all children or for children participating in sports. The ECG was vastly able to determine those children at risk for heart disease. The idea is to look for signs of sudden cardiac arrest or for hereditary conditions such as idiopathic hypertrophic subaortic stenosis or IHSS. This is a common cause of sudden cardiac arrest in athletes.

Sudden cardiac arrest causes about 100 to 1000 more deaths among children in the US and the rate of heart disease in other countries is about the same. These deaths can be averted through careful screening tests and physical evaluation. Other things noted on exam are high blood pressure in children which can lead to sudden cardiac arrest and diabetes, depending on the family history and symptoms of type I or type II diabetes. Type II diabetes used to be a disease of older people but, with childhood obesity, it is being seen in children as well.

In another study, 2.5 percent of children were found to have potentially serious conditions of the heart and previously undisclosed high blood pressure was found in 5 percent. Undiagnosed heart conditions were diagnosed by ECG in slightly over 5 percent. The study recommended that the ECG be added to history and physical examination in order to complete the cardiac evaluation in children. It is a completely painless test that can be done at any age. Potentially serious heart conditions can be identified without difficulty. In the study, only 400 children were tested and the researchers recommended that a larger study be done on more children to see whether or not other countries should adopt compulsory screening.