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(Circulation. 1968;38:375.)
© 1968 American Heart Association, Inc.

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Detection of Heart Disease in Children 1919-1967

LEO M. HENIKOFF M.D.¹; WILLIAM A. STEVENS JR. B.S.¹; LOWELL W. PERRY M.D.¹

¹ From the Heart Disease Control Program, National Center for Chronic Disease Control, U. S. Public Health Service, Arlington, Virginia.

Since 1959, auscultation by physicians in screening 49,496 school children has yielded 4.5 cases of heart disease/1,000 students screened. Sensitivity by analysis of "inserted" cases averages 64%, but varies with capabilities of examining physicians.

X-ray and ECG evaluations on smaller populations have yielded, respectively, 2.7 and 2.8 cases/1,000 children screened, and sensitivity results average 30 to 40%.

The tape-recorded heart sounds technique has yielded 2.9 cases/1,000 in screening 188,925 children. Sensitivity by analysis of "inserted" cases averages 75% and, in the population of "naturally occurring" heart disease, 56%.

In 23,148 school children, an analog-digital device (PhonoCardioScan) has yielded 4.8 cases/1,000 children screened. Of "inserted" cases, 69% have been detected. Sixtyfour to 80% of "naturally occurring" cases have been detected.

With each technique, approximately 40% of the heart disease detected had been previously unknown. The specificity of these methods ranges from 95 to 99%.

For primary screening the analog-digital device is the most effective currently available alternative to examination by cardiologists.

Key Words: Screening techniques • Rheumatic heart disease • X-ray screening • Tape-recorded heart sounds • Congenital heart disease • ECG screening • PhonoCardioScan • Computer analysis of heart sounds • Heart sounds • Analog-digital device