Practices and pitfalls in the early detection and control of heart disease in children

Abstract

A T T H E present time we are able to do far more than ever before to prevent and to control heart disease in children. Twenty years ago, the average annual death rate for diseases of the heart in children 5 to 9 years of age, the age group most susceptible to rheumatic fever and rheumatic heart disease, was approximately 8 per 100,000 in the United States. In 1953, this rate had fallen to 1.5.1 Two factors have been especially important in bringing about the gains that have been made over heart disease in this age group. Surgical procedures first became an effective means of repairing congenital malformations of the heart 20 years ago. In 1938, the first successful ligation of the patent ductus arteriosus opened the door to the extraordinary advances in surgical techniques for the repair of cardiac defects? Second, at about the same time, chemotherapy with sulfonamide drugs provided a method of preventing the recurrences of rheumatic fever which so frequently caused death or disability for the child who had once had an attack of rheumatic fever or