It has been reported that heart disease is the most common cause of sudden death in children. There have been relatively few studies concerning heart disease screening of school children in Korea. This study was to evaluate the usefulness of 12-lead ECG for mass screening of heart disease in elementary school children.

Mass screening of heart disease with 12-lead ECG was done in 17,343 first grade elementary school children(male 8,948, female 8,395) in Kwangju area during 4 months period since September 1992. Among 200 children(male 135, female 65) who showed abnormal electrocardiographic findings, 128 were referred to pediatric cardiologist for detection of heart diseases by thorough examinations including 24-hour ECG, echordiography, cardiac catherization and angiocardiography.

1) The incidence of 12-lead ECG abnormalities was 1.2%. Male outnumbered female in the incidence of abnormalities(0.8% vs 0.4%).

2) Incomplete right bundle branch block was the most frequent ECG abnormality with the incidence of 5.3 among 1,000, followed by right ventricular hypertrophy and premature ventricular contraction, both of them stand the next common abnormalities with the same incidence of 1.6 among 1,000.

3) Out of 39 cases undergoing echocardiography, seven were found to have structual heart abnormalities : 6 atrial defects and one ventricular septal defect.

4) All patients having structual defects but one with atrial septal defect underwent open heart surgery without problems.

These results suggest that routine 12 lead ECG be one of the useful methods for mass screening of heart disease and imply that establishment of heart disease screening system is necessary for the health promotion of the school chidren with heart disease.