Outcomes are reported from a programme of echocardiographic scanning for undetected rheumatic heart disease (RHD) in 5 urban and rural schools in the Tairawhiti region (eastern part of the North Island) of New Zealand with high numbers of children already known to have had episodes of acute rheumatic fever. The age range of students in the urban schools was 10–13 years and in the rural schools 5–17 years. Of the total 685 echocardiograms performed, 629 (91.8%) were classified as normal and 56 (8.2%) as abnormal. After repeat hospital-based echocardiography of 11 students with abnormal echocardiograms, a total of 52 students were found to have a cardiac abnormality (30 due to RHD and 22 due to congenital heart defects). Of the 30 students with rheumatic valvular changes 11 (1.61%) had probable (n=7) or definite (n=4) RHD requiring prophylactic penicillin. Nineteen students (1.77%) had possible RHD. The programme identified 8 students with previously undetected RHD, with a prevalence of 1.17%.
