Background
Unlike the newborn and adult population, there is little large-scale screening data and statistics in cardiovascular disease (CVD) in school-aged children, which may accurately define the impact of CVD on growth, development, school performance, sport participation, risks for sudden cardiac death (SCD), and to develop effective screening and preventive strategies to improve the cardiovascular health for this population.
Methods
From 2001 to 2006, we screened 276,332 school-aged children in primary and middle schools in central Taiwan by 2D echocardiography.
Results
The prevalence of CVD in this population is 17.82/1000. A total of 69.9% of CVD in this population are new diagnosis. Among these new cases, severe congenital CVD are rare and simple congenital CVD are more common. A total of 43.0% of these cases warranted surgical or transcatheter intervention. CVD that may lead to significantly high risk for sport participation and possible SCD, including hypertrophic cardiomyopathy, coronary anomalies, Marfan syndrome, etc. The largest under-diagnosed CVD that may cause morbidity is congenital vascular anomalies. In this group, only 48.0% of the patient has clinical signs and symptoms.
Conclusions
This study suggests that CVD in the school-aged children are more common than in the literature. Although severe congenital CVD and those with a high risk for SCD are rare, a significant number of children will need intervention for CVD. Congenital vascular anomalies are significantly under-diagnosed by clinical evaluation. Echocardiography is a useful tool for CVD screening for this population but the cost-effectiveness needs to be further evaluated.