Abstract
Echocardiography is now considered to be the key investigation when heart failure is suspected, and should improve clinical management. An open-access echocardiography service was piloted to 24 general practitioners and the service was audited after 250 cases. The impact on clinical management was assessed by reviewing general practice notes 2 months after the echocardiogram. Significant impairment of left ventricular function was found in 49 patients (20%). Out of these subjects, 38 had been started on an ACE inhibitor. Twenty patients were considered to have a significant valve lesion by echocritiera, of whom 14 had been referred for a cardiological opinion. The provision of an open-access echocardiography service was popular with general practitioners and the information resulted in appropriate management decisions being made.
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Selected References
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- Clarke K. W., Gray D., Hampton J. R. Evidence of inadequate investigation and treatment of patients with heart failure. Br Heart J. 1994 Jun;71(6):584–587. doi: 10.1136/hrt.71.6.584. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dargie H. J., McMurray J. J. Diagnosis and management of heart failure. BMJ. 1994 Jan 29;308(6924):321–328. doi: 10.1136/bmj.308.6924.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators. N Engl J Med. 1991 Aug 1;325(5):293–302. doi: 10.1056/NEJM199108013250501. [DOI] [PubMed] [Google Scholar]
- Francis C. M., Caruana L., Kearney P., Love M., Sutherland G. R., Starkey I. R., Shaw T. R., McMurray J. J. Open access echocardiography in management of heart failure in the community. BMJ. 1995 Mar 11;310(6980):634–636. doi: 10.1136/bmj.310.6980.634. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wheeldon N. M., MacDonald T. M., Flucker C. J., McKendrick A. D., McDevitt D. G., Struthers A. D. Echocardiography in chronic heart failure in the community. Q J Med. 1993 Jan;86(1):17–23. [PubMed] [Google Scholar]
