PEDIATRICS Vol. 105 No. 4 April 2000, pp. 815-818

Echocardiographic Diagnosis of Heart Disease in Apparently Healthy Adolescents

Received Aug 20, 1999; accepted Dec 8, 1999.

From the Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.

Objective.  Comprehensive data are currently unavailable on the prevalence of cardiac abnormalities in children after the newborn/infant period. The present report describes the prevalence of echocardiographically detected cardiac disease in a cohort of randomly selected healthy junior high school children.

Methods.  The cohort for this report consists of 357 children (mean age: 13 years) randomly selected after blood pressure screening of 12 043 fifth through eighth grade students and having an echocardiographic examination as part 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 studies identified 13 (3.6%) children (7 males and 6 females), with previously unknown cardiac abnormalities, as follows: abnormal mitral valve with mitral 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 detected abnormal cardiac findings in 7 (54%) of the children. Cardiac catheterization was required in 3 for additional diagnostic evaluation and in 2 for therapeutic intervention; 1 patient underwent open-heart surgery. Bacterial endocarditis prophylaxis was recommended in 8 (62%) of the 13 children.

Conclusions.  The results suggest that: 1) clinically significant cardiac disease in childhood is more prevalent than previously reported; and 2) improved screening methods should be considered to detect asymptomatic but significant cardiac abnormalities that may result in long-term complications.echocardiography, prevalence, incidence, heart disease, children. .

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				K. L. McBride, M. F. Riley, G. A. Zender, S. M. Fitzgerald-Butt, J. A. Towbin, J. W. Belmont, and S. E. Cole NOTCH1 mutations in individuals with left ventricular outflow tract malformations reduce ligand-induced signaling Hum. Mol. Genet., September 15, 2008; 17(18): 2886 - 2893. [Abstract] [Full Text] [PDF]

				H. I. Michelena, V. A. Desjardins, J.-F. Avierinos, A. Russo, V. T. Nkomo, T. M. Sundt, P. A. Pellikka, A. J. Tajik, and M. Enriquez-Sarano Natural History of Asymptomatic Patients With Normally Functioning or Minimally Dysfunctional Bicuspid Aortic Valve in the Community Circulation, May 27, 2008; 117(21): 2776 - 2784. [Abstract] [Full Text] [PDF]

				V. L. Vetter, J. Elia, C. Erickson, S. Berger, N. Blum, K. Uzark, and C. L. Webb Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing Circulation, May 6, 2008; 117(18): 2407 - 2423. [Full Text] [PDF]

				K Pushparajah, D Garvie, A Hickey, and S A Qureshi Managed Care Network for the assessment of cardiac problems in children in a district general hospital: a working model Arch. Dis. Child., November 1, 2006; 91(11): 892 - 895. [Abstract] [Full Text] [PDF]

				A E Warren, M L Boyd, C O'Connell, and L Dodds Dilatation of the ascending aorta in paediatric patients with bicuspid aortic valve: frequency, rate of progression and risk factors Heart, October 1, 2006; 92(10): 1496 - 1500. [Abstract] [Full Text] [PDF]

				L. Cripe, G. Andelfinger, L. J. Martin, K. Shooner, and D. W. Benson Bicuspid aortic valve is heritable J. Am. Coll. Cardiol., July 7, 2004; 44(1): 138 - 143. [Abstract] [Full Text] [PDF]

				M. D. Cheitlin, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, J. L. Davis, P. S. Douglas, D. P. Faxon, L. D. Gillam, T. R. Kimball, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American college of cardiology/American heart association task force on practice guidelines (ACC/AHA/ASE committee to update the 1997 guidelines for the clinical application of echocardiography) J. Am. Coll. Cardiol., September 3, 2003; 42(5): 954 - 970. [Full Text] [PDF]

				M. D. Cheitlin, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, J. L. Davis, P. S. Douglas, D. P. Faxon, L. D. Gillam, T. R. Kimball, et al. ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography: Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography) Circulation, September 2, 2003; 108(9): 1146 - 1162. [Full Text] [PDF]

				E. G. Brookfield;, J. Steinberger, J. H. Moller, J. M. Berry, and A. R. Sinaiko Echocardiography in Healthy Children Pediatrics, May 1, 2001; 107(5): 1237 - 1237. [Full Text]

				Healthy Adolescents: Hidden Heart Problems? Journal Watch (General), April 7, 2000; 2000(407): 4 - 4. [Full Text]