School Heart Examination in Japan: A Nationwide Questionnaire Survey

Pediatric Cardiology and Cardiac Surgery
Vol.27 No.4 2011 (187-196)

Yoshiaki Takahashi¹⁾, Minoru Ogawa²⁾, Tohru Matsushita³⁾, Ken Ueda⁴⁾, Fumio Ohta⁵⁾, Yuichi Sato⁶⁾, Yoko Sawada⁷⁾,Sakae Narai⁸⁾, Shigehiro Yajima⁹⁾, Seiichi Watanabe¹⁰⁾

¹⁾Takahashi Pediatric Clinic, Shiga, Japan, ²⁾Ogawa Pediatric Clinic, Osaka, Japan, ³⁾Matsushita Kids’ Clinic, Osaka, Japan,
⁴⁾Ueda Pediatric Clinic, Shizuoka, Japan, ⁵⁾Ohta Pediatric Clinic, Chiba, Japan, ⁶⁾Sato Pediatric Clinic, Miyazaki, Japan,
⁷⁾Ikuai Pediatric Clinic, Hokkaido, Japan, ⁸⁾Department of Pediatrics, Tottori Prefectural Kousei Hospital, Tottori, Japan,
⁹⁾Yajima Children’s Clinic, Gifu, Japan, ¹⁰⁾Department of Pediatrics, Tsuchiura Kyodo General Hospital, Ibaraki, Japan

Abstract

Background and Methods: To clarify the actual status of the school heart examination in Japan, we sent questionnaires to 1,825 prefectural and municipal Boards of Education and 708 branches of the Japan Medical Association in Japan. We classified the answers into two groups from prefecture and municipality, and received answers from 23 prefectures and 810 municipalities.
Results: In 92% of municipalities, a school heart examination was performed in the first year of primary, junior high, and high school. The screening was also performed in the fourth grade of primary school in 33%. Most students, more than 98.5%, received the school heart examination. Incidents of students who were asked to receive further detailed examinations were 3% to 4% in the first year of primary school, 4% to 5% in the junior high school, and 6% in high school. After the second and third examinations, 1.3% of primary school students, 1.5% to 1.6% of junior high school students, and 1.5% of high school students were judged to be under control regarding exercise strength at school and sports clubs. As the first examination, an electrocardiogram (ECG) was solely used in 66% and a combination of ECG and phonocardiogram in 30%. The judgment was checked by responsible doctors or committees of school screenings in 17% to 39% of municipalities.
Conclusions: In advance of school heart examinations, the following should be necessary: first, improving the guidelines for examinations; second, improving the accuracy of automatic analysis system in ECG; and third, accumulating and reviewing all data including the proper management of daily activity in children under control.