Patients with IHD warrant screening for heart failure

Many patients with a history of ischaemic heart disease (IHD) or diabetes have left ventricular systolic dysfunction and would be candidates for a targeted echocardiographic screening programme for heart failure. Davis and colleagues (p 1156) investigated the prevalence of systolic dysfunction and heart failure in patients in the community with general practice records of one or more risk factors. Systolic dysfunction was common in patients with a history of myocardial infarction, moderately so in those with angina or diabetes, but uncommon in those with uncomplicated hypertension. Formal trials of systematic echocardiographic screening of patients with ischaemic heart disease and diabetes should be considered.