After two adolescents died of heart attacks last year in Houston, a doctor screened 94 6th graders at a local middle school. He found 7 with undiagnosed heart problems, including two that needed surgery to correct. They have ramped up to screen 1500 kids, and, as one might expect, they are pushing for universal screening of 6th graders for heart problems.
This is interesting from a health-care-cost perspective. We have to weigh the monetary and resource-use cost of giving all 6th graders a physical exam, electrocardiogram, and echocardiogram against the psychic and loss-of-production costs of the deaths of two kids a year in a city the size of Houston. The 2% who needed surgery would increase immediate health-care costs, but they might reduce chronic problems (and costs) later.
But one wonders why 6th grade is the magic place to start screening. If kid has a hole in her heart at age 12, she probably had it at age 3 and would have had a lot more energy in the ensuing 9 years if it had been taken care of earlier.