Feasibility of Detailed Cardiovascular Screening—First Results of the “Orlando-Hand-aufs-Herz” School Project

Background: Cardiovascular diseases account for approximately 35% of all deaths in the Western world. About two to four young patients (i.e., less than 40 years of age) and approximately one to two children (i.e., below 18 years of age) die in Germany from acute cardiac death every day. To date, there are however no screening checkups for the young population despite the need for care. The planned screening with the new “Gesunde Herz Gesetz” is an important first political step. For children, these measures are however completely insufficient.

Methods: From April until July 2024, we established our “hand-on your heart” project. We combined all relevant diagnostic cardiovascular tools for assessment and prevention, created a comprehensive assessment protocol, and tested it at a middle-class school with 1,000 pupils for feasibility and practicability. This included a detailed questionnaire (i.e., sports, daily exercise, risk behavior, family history), complete medical examination, biometry, risk stratification, blood pressure, ECG, ECHO and standardized cardiorespiratory fitness tests, pulmonary function test (peak flow meters), and blood pathology (lipids and glucose).

Results: We could demonstrate that these very detailed and comprehensive examinations could be easily performed and the procedures were safe, feasible, and took approximately 90 minutes only on average. In 80/950 pupils, we detected significant cardiovascular abnormalities that required specialist controls for the future (i.e., 2 WPW syndromes, 4 dilatations of the aorta [>2 SD], 3 QTc prolongations, 1 coronary fistula, 4 hypertrophied interventricular septum, 12 bicuspid aortic valves, 2 children with pericardial effusions, and approximately 10 with ASDs). In addition, we detected many children with severe overweight and hypertension; the exact correlations between these findings and the results from the questionnaire are pending.

Conclusion: These preliminary results clearly indicate that a comprehensive cardiovascular screening is feasible and will show clinically relevant results that have an impact on cardiovascular health. Based on this, individualized prevention strategies can be offered to optimize cardiovascular health and reduce the risk of sudden cardiac death or cardiovascular disease in children and adolescents. We intend to continue our project to optimize the data quality, include more pediatric cardiac outpatient services, and finally provide data quality to implement a comprehensive cardiovascular screening in Germany for all children.

Publikationsverlauf

Artikel online veröffentlicht:
11. Februar 2025