Evaluation of echocardiography in the management of elderly patients with heart failure

Objective: to determine the validity of a clinical diagnosis of systolic dy sfunction in elderly patients with heart failure and assess the contributio n of echocardiography to their management. Subjects: 61 elderly patients with a diagnosis of heart failure in a geriat ric assessment unit setting. Methods: prospective study determining sensitivity, specificity and predict ive values of a clinical and radiological diagnosis compared with echocardi ographic standard. Proposed management was compared before and after echoca rdiography. Results: clinical assessment was highly sensitive (93%) but lacked specific ity (32%). Combining radiological and clinical diagnoses increased specific ity to 58%. Echocardiography revised the lead cardiac diagnosis for 28% of patients and influenced patient management plans for 41%. Conclusion: for elderly patients with heart failure, echocardiography impro ves diagnostic accuracy and identifies those patients with potential to ben efit from angiotensin-converting enzyme inhibitors.