Abstract
Since the heart screening for school children has been established in Japan, majority of the heart diseases in school children is now well controlled and the total number of sudden cardiac death has been decreased. The first step of the screening consists of questionnaire of heart disease, physical examination by school doctors, and electrocardiography. Children with history of heart disease such as Kawasaki disease, rheumatic fever, hypertension, arrhythmia, syncope, or abnormal findings in the first step, are referred to the second step. The second step includes physical examination by pediatric cardiologists, and if necessary, electrocardiography, chest X-p, echocardiography, and exercise stress tests. Children who need further medical management or treatment are referred to the hospitals, i.e., the third step. Their exercise tolerance and school lifestyle are properly controlled with the table of management criteria for children with heart disease.
