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In recent years, the value of preventive heart screening for children has been increasingly recognized.

Why should I have my child’s heart screened?

Preventive screening is clearly performed on children from families with a history of hereditary heart disease, such as various cardiomyopathies, a history of arrhythmic syndromes that are responsible for sudden cardiac death at a young age, syndromes involving the aorta and/or other diseases with a hereditary background, but also on children who already have 1st degree relatives with congenital heart disease, diseases that have been created since fetal life, such as bicuspid aortic valve. Also, preventive screening is also performed on newborns when there is already a questionable finding from fetal life, even if during the newborn’s stay in the maternity hospital no symptoms indicative of heart disease appear.

Ultimately, however, preventive screening is also performed on the general population, in order to diagnose diseases in a timely manner that cannot be diagnosed during a regular pediatric examination, because they may not give clinical symptoms and signs, that is, the child does not have a murmur or a symptom, such as easy fatigue or fainting.

At what age should preventive screening be performed?

After the clinical examination of the child and if the pediatrician finds symptoms and/or signs that he/she deems to require specialized testing, he/she will recommend a check-up by a pediatric cardiologist at any age, starting from the neonatal period.

In children with a clear family history of heart disease, asymptomatic, without a finding from the clinical examination, the test is performed at school entrance. However, the tendency is for this test to be performed when the child begins to cooperate, that is, at the age of approximately 4 years.

It is then repeated at each change of educational level, that is, every 3-4 years.

Recent data have, however, highlighted the importance of a detailed annual evaluation of the child during his pediatric assessment with a focus on cardiovascular. Thus, the possibility of not diagnosing serious diseases in a timely manner, such as hypertrophic cardiomyopathy, is minimized.

Should children who participate in sports be screened and how often?

This population, which includes children who participate in sports regularly, especially those aged 12 and over, should be screened annually before participating in sports. Studies have shown that performing an electrocardiogram has significantly reduced the risk of sudden death in young athletes.

What does a complete preventive check-up of a child include?

First, taking a family history is the cornerstone of a complete and correct pediatric cardiological assessment. Specifically, the presence of hereditary heart disease, sudden death in young members, especially <35 years of age in the extended families of the child’s mother and father, sudden infant death, sudden drowning of young people or unexpected traffic accidents that indicate cardiac arrest while driving, are elements that should be asked about.

This is followed by a clinical examination of the child with palpation of the precordium and peripheral pulses, auscultation of the heart tones and the presence or absence of a murmur, innocent or pathological, in the supine and upright positions, and the measurement of blood pressure and/or peripheral arterial blood saturation if deemed appropriate.

The electrocardiogram provides important information, both for structural and electrical activity disorders of the heart.

And finally, the ultrasound of the heart completes the examination. With the colored Triplex of the heart, we examine the structure of the cavities, the valves, the vessels that flow into and out of the heart cavities, the integrity of the septa and the functionality of all these structures.

To summarize, preventive cardiac pediatric examination contributes to the early diagnosis of diseases of the cardiovascular system, therefore to timely intervention and treatment aimed at the safety of the child.