RT Journal Article
SR Electronic
T1 Detection of heart disease by open access echocardiography: a retrospective analysis of general practice referrals
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e105
OP e111
DO 10.3399/bjgp14X677167
VO 64
IS 619
A1 John Chambers
A1 Saleha Kabir
A1 Eric Cajeat
YR 2014
UL http://bjgp.org/content/64/619/e105.abstract
AB Background Heart disease is difficult to detect clinically and it has been suggested that echocardiography should be available to all patients with possible cardiac symptoms or signs.Aim To analyse the results of 2 years of open access echocardiography for the frequency of structural heart disease according to request.Design and setting Retrospective database analysis in a teaching hospital open access echocardiography service.Method Reports of all open access transthoracic echocardiograms between January 2011 and December 2012 were categorised as normal, having minor abnormalities, or significant abnormalities according to the indication.Results There were 2343 open access echocardiograms performed and there were significant abnormalities in 29%, predominantly valve disease (n = 304, 13%), LV systolic dysfunction (n = 179, 8%), aortic dilatation (n = 80, 3%), or pulmonary hypertension (n = 91, 4%). If echocardiography had been targeted at a high-risk group, 267 with valve disease would have been detected (compared to 127 with murmur alone) and 139 with LV systolic dysfunction (compared to 91 with suspected heart failure alone). Most GP practices requested fewer than 10 studies, but 6 practices requested over 70 studies.Conclusion Open access echocardiograms are often abnormal but structural disease may not be suspected from the clinical request. Uptake by individual practices is patchy. A targeted expansion of echocardiography in patients with a high likelihood of disease is therefore likely to increase the detection of clinically important pathology.