Diagnosis of heart failure in elderly patients in primary care.
BACKGROUND
Heart failure is difficult to diagnose in a primary care setting with a reported false positive diagnosis in up to 70% of cases.


OBJECTIVE
To use echocardiography in a large rural practice to evaluate the accuracy of diagnosis of heart failure in patients over 65 years of age.


METHODS
Sixty patients with a previous diagnosis of heart failure were selected at random from the practice records and were invited to attend for an echocardiogram at the practice premises.


RESULTS
Fifty-eight patients attended, the age was 81+/-7 years, 29% had impaired left ventricular (LV) systolic function of whom 65% were in atrial fibrillation. A further 7% had isolated diastolic LV dysfunction. The prevalence of heart failure by clinical assessment was 29 per 1000 in this patient group and 9 per 1000 when echocardiography was used to confirm the diagnosis.


CONCLUSIONS
True heart failure in this population is less prevalent than has been estimated from practice records.
Owen
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Department of Cardiology, Kent & Canterbury Hospital, Canterbury, CT1 3LP, Kent, UK.
Cox
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D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D004739:England / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D011320:Primary Health Care; D012424:Rural Population