ABSTRACT
Screening of schoolchildren for the presence of heart disease is an established epidemiological tool for early detection, further management and follow- up of uncovered congenital or acquired cardiac lesions. Many advances in cardiovascular imaging have occurred, of which two dimensional color flow Doppler echocardiography is the most non- invasive tool that received widespread use. This study aimed at assessing the prevalence of various heart lesions in school populations in different parts of rural Jordan, as well as the diagnostic value of additional echocardiography on subjects with cardiac auscultatory findings in further refining the screening process. Materials and methods: A survey was conducted during May and June of 1995 and 1996 as part of a joint Humanitarian Civic Action Project between the Royal Medical Services in Jordan and the Medical Corps of the United States Army. All screening examinations including the use of portable echocardiographic machine were done in the schools in the areas of AI-Mafraq, Zarqa and rural Aqaba. Four thousand one hundred and eighty school children were screened [1697 males, 2483females]. General practitioners and pediatricians performed the physical examinations. Heart murmurs were discovered in 80 subjects [Group I], 37 males and 43 females. A group of one hundred seventeen students [Group II], 86 males and 31 females, in whom physical cardiac examination was negative, were randomly selected and considered as a control group. Both groups I and II underwent further echocardiographic examinations, which were reviewed by the same interpreters. The prevalence of heart disease in our population was 3.8 in 1000. Heart murmurs were detected in 37 males [2.2%] and 43 females [1. 7%]. The murmurs were systolic [pan-, ejection, or long -] in 77 subjects [96.2%], and diastolic in 3 [3.8%]. Echocardiography showed that 76% of the group with murmurs [Group I] were normal, 7.5% had mistral regurgitation, 5% mitral valve prolapse, 5% pulmonary regurgitation, 3.8% tricuspid regurgitation, 2.5% had a small ventricular septal defect, one subject with aortic incompetence and one subject with turbulent pulmonary flow murmur. In the control group [Group II] 109 [93%] were normal, 2.6% had mitral valve prolapse, 2.6% tricuspid regurgitation, and 1.8% pulmonary regurgitation. The prevalence of cardiac lesions detected in our study is similar to other studies performed in healthy children in other parts of the world. Significant cardiac lesions were absent in the population studied. Based on our results; echocardiography is not recommended as part of the medical screening of school children in Jordan