AIM To investigate the echocardiographic abnormalities in senior high school males in recruiting pilots from 2021 to 2023 and to provide the screening focuses of echocardiographic imaging for a large-scale screening.

METHODS The echocardiographic results of 18794 senior high school male students were collected and classified according to the source of the students (ordinary senior high school students or youth aviation cadets). The high prevalence of abnormal echocardiographic results was statistically analyzed.

RESULTS The detection rate of cardiac abnormalities within three years is relatively stable, with an overall elimination rate of 2.67%. The top four abnormalities detected are atrial septal aneurysm, patent foramen ovale, mild-moderate tricuspid regurgitation or above, and aortic valve malformation. Among them, the proportions of atrial septal aneurysm and mild-moderate tricuspid regurgitation or above in ordinary high school seniors are higher than that in high school seniors at youth aviation school (all P<0.01). Within three years, there was no difference in the detection rate of abnormalities among the recruitment centers.

CONCLUSION In the large-scale screening of young flying cadets, atrial septum should be the focus in echocardiography and attention should also be paid to aortic valve malformation and tricuspid valve regurgitation.