title: Open access echocardiography in management of heart failure in the community.
abstract: OBJECTIVE
  To assess the value of an open access echocardiography service.
  
  
  METHODS
  Study of new open access service for general practitioners, who were invited to refer patients taking diuretics for suspected heart failure, untreated patients with symptoms of possible heart failure, and asymptomatic patients with risk factors for left ventricular systolic dysfunction.
  
  
  METHODS
  Regional cardiology centre.
  
  
  METHODS
  259 consecutive patients.
  
  
  METHODS
  Presence or absence of left 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 considered 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 for 34 of these patients. In addition, 53 were thought not to need diuretics. Eight untreated patients had impaired systolic function and six valvular disease.
  
  
  CONCLUSIONS
  The service was well used by general practitioners and led to advice to change management in more than two thirds of patients.
authors.affiliation: Department of Cardiology, Western General Hospital, Edinburgh.
authors.forename: C M
authors.initials: CM
authors.lastname: Francis
authors.forename: L
authors.initials: L
authors.lastname: Caruana
authors.forename: P
authors.initials: P
authors.lastname: Kearney
authors.forename: M
authors.initials: M
authors.lastname: Love
authors.forename: G R
authors.initials: GR
authors.lastname: Sutherland
authors.forename: I R
authors.initials: IR
authors.lastname: Starkey
authors.forename: T R
authors.initials: TR
authors.lastname: Shaw
authors.forename: J J
authors.initials: JJ
authors.lastname: McMurray
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002303:Cardiac Output, Low / Q000000981:diagnostic imaging / Q000188:drug therapy; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography / Q000706:statistics & numerical data*; D005194:Family Practice; D005260:Female; D006297:Health Services Accessibility; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012307:Risk Factors; D012606:Scotland; D016526:Workload
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics