Evaluation of echocardiography in the management of elderly patients with heart failure.
OBJECTIVE
To determine the validity of a clinical diagnosis of systolic dysfunction in elderly patients with heart failure and assess the contribution of echocardiography to their management.


METHODS
61 elderly patients with a diagnosis of heart failure in a geriatric assessment unit setting.


METHODS
Prospective study determining sensitivity, specificity and predictive values of a clinical and radiological diagnosis compared with echocardiographic standard. Proposed management was compared before and after echocardiography.


RESULTS
Clinical assessment was highly sensitive (93%) but lacked specificity (32%). Combining radiological and clinical diagnoses increased specificity to 58%. Echocardiography revised the lead cardiac diagnosis for 28% of patients and influenced patient management plans for 41%.


CONCLUSIONS
For elderly patients with heart failure, echocardiography improves diagnostic accuracy and identifies those patients with potential to benefit from angiotensin-converting enzyme inhibitors.
Hendry
A
A
Department of Geriatric Medicine, Gartnavel General Hospital, Glasgow, UK.
Hacking
L
L
Langhorne
P
P
Vallance
R
R
MacDonald
J
J
D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D019468:Disease Management; D005069:Evaluation Studies as Topic; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006333:Heart Failure / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy
D000806:Angiotensin-Converting Enzyme Inhibitors