Approximately 60 to 80 cases of childhood sudden death occur under school supervision every year in Japan and about 71% of them are sudden cardiac death. The incidence of sudden death among school-age children increases with age. 0.3 per 100,000 for elementary schoolchildren, 0.8 per 100,000 for junior high school children and 0.9 per 100,000 for high school children, approximately. Boys are remarkably more prone to sudden death than girls. Cardiac sudden death is often related to physical exercise and 70% of cases occur during running exercise. Although it is usually difficult to prevent the actual occurrence of sudden cardiac death, efforts to decrease sudden cardiac death should be reinforced by the cardiac screening examination and by ensuring in cooperation with children themselves, their parents, school staffs, and medical professionals. In particular, it is recommended that all teachers at junior high schools and high schools should have more knowledge about diseases related to sudden death.

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