Heart disease in a total population of children: the Bogalusa Heart Study.

A cross-sectional survey of a total semirural biracial population of children was conducted to determine the prevalence and types of cardiac disease. Of 4,074 children examined, 146 were thought to have significant cardiac murmurs. One hundred thirteen of these participated in a follow-up study in which they received a physical examination by two adult cardiologists and one pediatric cardiologist, a chest roentgenogram, and an electrocardiogram. An attempt at a consensus concerning the diagnosis was made by subsequent discussions among the physicians. The discussions were repeated in 33 cases after a phonocardiogram and/or an echocardiogram were done. In 20 children, cardiac disease was diagnosed by at least two cardiologists. Supplementing this with information from hospital records on some of the children and data from a previous study, cardiac abnormalities were diagnosed in 25 children from the total population (0.6%). A disproportionately greater number of black children and boys were affected. Thirteen children had congenital heart disease, five had mitral valve prolapse, and only two had rheumatic heart disease. The prevalence of mitral valve prolapse was probably underestimated in this study.