Focused cardiac ultrasound is feasible in the general practice setting and alters diagnosis and management of cardiac disease. Issue 3 (September 2016)

• Record Type: Journal Article
• Authors: Yates, James; Royse, Colin Forbes; Royse, Carolyn; Royse, Alistair George; Canty, David Jeffrey
• Is Part Of: Echo research and practice. Volume 3:Issue 3(2016)
• Page Start: 63
• Page End: 69
• Publication Date: 2016-09
• Subjects: echocardiography -- diagnosis -- echocardiography and management -- feasibility -- hand-carried ultrasound; Echocardiography -- Periodicals; Heart -- Imaging -- Periodicals; 616.1207543
• DOI: 10.1530/ERP-16-0026
• Languages: English
• ISSNs: 2055-0456

Abstract

Abstract : Background: Ultrasound-assisted examination of the cardiovascular system with focused cardiac ultrasound by the treating physician is non-invasive and changes diagnosis and management of patient's with suspected cardiac disease. This has not been reported in a general practice setting. Aim: To determine whether focused cardiac ultrasound performed on patients aged over 50 years changes the diagnosis and management of cardiac disease by a general practitioner. Design and setting: A prospective observational study of 80 patients aged over 50years and who had not received echocardiography or chest CT within 12months presenting to a general practice. Method: Clinical assessment and management of significant cardiac disorders in patients presenting to general practitioners were recorded before and after focused cardiac ultrasound. Echocardiography was performed by a medical student with sufficient training, which was verified by an expert. Differences in diagnosis and management between conventional and ultrasound-assisted assessment were recorded. Results and conclusion: Echocardiography and interpretation were acceptable in all patients. Significant cardiac disease was detected in 16 (20%) patients, including aortic stenosis in 9 (11%) and cardiac failure in 7 (9%), which were missed by clinical examination in 10 (62.5%) of these patients. Changes in management occurred in 12 patients (15% overall and 75% of those found to have significant cardiac disease) including referral for diagnostic echocardiography in 8 (10%), commencement of heart failure treatment in 3 (4%) and referral to a cardiologist in 1 patient (1%). Routine focused cardiac ultrasound is feasible and frequently alters the diagnosis and management of cardiac disease in patients aged over 50years presenting to a general practice.