Echocardiographic diagnosis of heart disease in apparently healthy adolescents

Objective. Comprehensive data are currently unavailable on the prevalence o f cardiac abnormalities in children after the newborn/infant period. The pr esent report describes the prevalence of echocardiographically detected car diac disease in a cohort of randomly selected healthy junior high school ch ildren. Methods. The cohort for this report consists of 357 children (mean age: 13 years) randomly selected after blood pressure screening of 12 043 fifth thr ough eighth grade students and having an echocardiographic examination as p art of a study of insulin resistance in childhood. Results. A physical examination performed by a board-certified pediatrician reported no cardiac abnormalities. However, echocardiography and Doppler s tudies identified 13 (3.6%) children (7 males and 6 females), with previous ly unknown cardiac abnormalities, as follows: abnormal mitral valve with mi tral regurgitation (4), bicuspid aortic valve (2), atrial septal defect (2) , coronary artery to pulmonary artery fistula (1), patent ductus arteriosus (1), pulmonary hypertension (1), cardiomyopathy (1), and pulmonary artery stenosis (1). Physical examination performed by a pediatric cardiologist de tected abnormal cardiac findings in 7 (54%) of the children. Cardiac cathet erization was required in 3 for additional diagnostic evaluation and in 2 f or therapeutic intervention; 1 patient underwent open-heart surgery. Bacter ial endocarditis prophylaxis was recommended in 8 (62%) of the 13 children. Conclusions. The results suggest that: 1) clinically significant cardiac di sease in childhood is more prevalent than previously reported; and 2) impro ved screening methods should be considered to detect asymptomatic but signi ficant cardiac abnormalities that may result in long-term complications.