title: Opportunistic screening for cardiovascular problems in rural and remote health settings.
abstract: BACKGROUND
  Cardiovascular disease is the leading cause of death in Australia and the United States. It is not known if routine electrocardiogram (ECG) assessment at the community level could identify a significant proportion of people with clinically relevant ECG anomalies who could benefit from intervention.
  
  
  OBJECTIVE
  This study aimed to elucidate the use of 3-lead ECG assessment by community nurses in rural and remote health settings. We report the findings obtained from 20-minute, lead II ECG recordings of 71 people who participated in a diabetes screening study.
  
  
  RESULTS
  Seven participants reported cardiac anomalies before screening. One or more ECG abnormalities were found in 45 participants. Of these, nine people who were otherwise asymptomatic showed abnormal ECG characteristics that warranted further investigation.
  
  
  CONCLUSIONS
  Although further research is needed, incorporating routine 3-lead ECG testing in rural and remote communities may improve general health in the community by providing early recognition of cardiac anomalies in otherwise asymptomatic individuals who may be amenable to treatment. This study has implications for community nurses on two levels: opportunistic screening, monitoring and evaluation.
authors.affiliation: School of Community Health, Charles Sturt University, Albury, NSW, Australia. hjelinek@csu.edu.au
authors.forename: Herbert
authors.initials: H
authors.lastname: Jelinek
authors.forename: Paul
authors.initials: P
authors.lastname: Warner
authors.forename: Stephen
authors.initials: S
authors.lastname: King
authors.forename: Bev
authors.initials: B
authors.lastname: De Jong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D003152:Community Health Nursing / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000451:nursing; D008875:Middle Aged; D017064:Process Assessment, Health Care; D019035:Rural Health Services; D012680:Sensitivity and Specificity