title: Detection of heart disease by open access echocardiography: a retrospective analysis of general practice referrals.
abstract: BACKGROUND
  Heart disease is difficult to detect clinically and it has been suggested that echocardiography should be available to all patients with possible cardiac symptoms or signs.
  
  
  OBJECTIVE
  To analyse the results of 2 years of open access echocardiography for the frequency of structural heart disease according to request.
  
  
  METHODS
  Retrospective database analysis in a teaching hospital open access echocardiography service.
  
  
  METHODS
  Reports of all open access transthoracic echocardiograms between January 2011 and December 2012 were categorised as normal, having minor abnormalities, or significant abnormalities according to the indication.
  
  
  RESULTS
  There were 2343 open access echocardiograms performed and there were significant abnormalities in 29%, predominantly valve disease (n = 304, 13%), LV systolic dysfunction (n = 179, 8%), aortic dilatation (n = 80, 3%), or pulmonary hypertension (n = 91, 4%). If echocardiography had been targeted at a high-risk group, 267 with valve disease would have been detected (compared to 127 with murmur alone) and 139 with LV systolic dysfunction (compared to 91 with suspected heart failure alone). Most GP practices requested fewer than 10 studies, but 6 practices requested over 70 studies.
  
  
  CONCLUSIONS
  Open access echocardiograms are often abnormal but structural disease may not be suspected from the clinical request. Uptake by individual practices is patchy. A targeted expansion of echocardiography in patients with a high likelihood of disease is therefore likely to increase the detection of clinically important pathology.
authors.affiliation: Adult Echocardiography, Cardiothoracic Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Chambers
authors.forename: Saleha
authors.initials: S
authors.lastname: Kabir
authors.forename: Eric
authors.initials: E
authors.lastname: Cajeat
mesh_terms: D004452:Echocardiography / Q000706:statistics & numerical data / Q000639:trends; D058006:General Practice; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology; D006784:Hospitals, Teaching; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012017:Referral and Consultation / Q000639:trends; D012189:Retrospective Studies; D006113:United Kingdom
keywords: echocardiography; general practice; heart valve disease