Questionnaire completed by parents of all children in Yamanashi prefecture as they entered school
| Have you ever been diagnosed with any heart disease? |
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| How old were you when it was first diagnosed? |
| What disease(s) have you been diagnosed with? |
| What management have you received? |
| Have you ever had diseases such as chorea, rheumatic fever, Kawasaki disease, hypertension, sepsis, thyroid disease, arthritis? |
| Have you had any of the following symptoms: fatigue, palpitations, shortness of breath, chest pressure, syncope or faintness? |
| Do you have any blood relatives who had sudden death younger than 40 years old? |