OPEN ACCESS ECHOCARDIOGRAPHY IN MANAGEMENT OF HEART-FAILURE IN THE COMMUNITY

Objective-To assess the value of an open access echocardiography servi ce. Design-Study of new open access service for general practitioners, who were invited to refer who patients taking diuretics for suspected heart failure, untreated patients with symptoms of possible heart fai lure, and asymptomatic patients with risk factors for left ventricular systolic dysfunction. Setting-Regional cardiology centre. Subjects-25 9 consecutive patients. Main outcome measure-Presence or absence of le ft ventricular systolic dysfunction and consequent changes in clinical management. Results-119 treated patients, 99 untreated patients, and nine asymptomatic patients were referred over five months. 32 were con sidered to be inappropriately referred. Among the treated patients, 31 had impaired left ventricular systolic function and five had valvular disease; angiotensin converting enzyme inhibitors were recommended fo r 34 of these patients, In addition, 53 were thought not to need diure tics. Eight untreated patients had impaired systolic function and six valvular disease. Conclusions-The service was well used by general pra ctitioners and led to advice to change management in more than two thi rds of patients.