Pre-participation cardiovascular screening: is community screening using hand-held cardiac ultrasound feasible?

We evaluated the feasibility and costs of utilising hand-held cardiac ultrasound (HHCU) as part of a community-based pre-participation cardiovascular screening programme. Ninety-seven school children were screened using a personal history, a physical examination, a resting 12-lead electrocardiogram (ECG) and a HHCU. A consultant cardiologist independently reviewed and reported the data. Previously undiagnosed cardiovascular abnormalities were identified in nine participants (9%). An additional three participants (3%) were diagnosed with hypertension. The nine abnormalities were identified at a cost of £460 per finding, with a cost of £43 per participant screened. The marginal cost of adding a HHCU to the personal history, physical examination and ECG was £16 per participant. Pre-participation screening in the community using hand-held echocardiography is practical and inexpensive. The additional sensitivity and specificity provided by the ultrasound may enhance screening programmes, thereby reducing false positives and the need for expensive follow-up testing.