ECG score for diagnosing right ventricular disease (RVD) in children aged 0 to 14 years. Check the findings present.
Score0
CHILDHEART 0
Low probability of RVD
Score 0: low probability of right ventricular disease.
Validated in children aged 0 to 14 years. A score ≥ 2 has high specificity (LR+ ~16 at < 3 years and ~36 at ≥ 3 years).
Decision rule
0 → low probability · 1 → intermediate · ≥ 2 → high probability of RVD.
A tool to support learning and decision-making. The result does not replace clinical evaluation of the patient.
About: CHILDHEART score
The CHILDHEART score helps recognize right ventricular disease on the ECG in children aged 0 to 14 years. It came out of the CHILDHEART project at the Dante Pazzanese Institute of Cardiology, which compared ECGs of children with confirmed structural heart disease and children without heart disease.
The score adds up five simple findings: right bundle branch block, pure R wave in V1, initial q wave in V1, S greater than R in V6, and RV1 + SV6 ≥ 18 mm.
How to use
Check the findings present on the child's ECG.
RV1 + SV6 ≥ 18 mm counts 2 points; each of the other findings counts 1 point.
How to interpret
0 points: low probability of right ventricular disease.
1 point: intermediate probability.
≥ 2 points: high probability, with high specificity.
Limitations
The CHILDHEART studies are retrospective with a case-control design, which may overestimate accuracy compared with the general population. Echocardiography confirms the diagnosis.
References
de Alencar JN, Monteiro JAM, Furtado JT, Sacre RC, Guerra CB, Knoblauch WS, et al. ECG criteria and diagnostic score for right ventricular disease in children: the CHILDHEART study. J Electrocardiol. 2025;92:154088.
de Alencar JN, Costa IR, Monteiro JAM, Furtado JT, Sacre RC, Guerra CB, et al. Age-related ECG milestones for rapid detection of congenital heart disease in children: a diagnostic test accuracy study. J Electrocardiol. 2025;92:154101.
