title: Focused cardiac ultrasound is feasible in the general practice setting and alters diagnosis and management of cardiac disease.
abstract: BACKGROUND
  Ultrasound-assisted examination of the cardiovascular system with focused cardiac ultrasound by the treating physician is non-invasive and changes diagnosis and management of patient's with suspected cardiac disease. This has not been reported in a general practice setting.
  
  
  OBJECTIVE
  To determine whether focused cardiac ultrasound performed on patients aged over 50 years changes the diagnosis and management of cardiac disease by a general practitioner.
  
  
  METHODS
  A prospective observational study of 80 patients aged over 50years and who had not received echocardiography or chest CT within 12months presenting to a general practice.
  
  
  METHODS
  Clinical assessment and management of significant cardiac disorders in patients presenting to general practitioners were recorded before and after focused cardiac ultrasound. Echocardiography was performed by a medical student with sufficient training, which was verified by an expert. Differences in diagnosis and management between conventional and ultrasound-assisted assessment were recorded.
  
  
  CONCLUSIONS
  Echocardiography and interpretation were acceptable in all patients. Significant cardiac disease was detected in 16 (20%) patients, including aortic stenosis in 9 (11%) and cardiac failure in 7 (9%), which were missed by clinical examination in 10 (62.5%) of these patients. Changes in management occurred in 12 patients (15% overall and 75% of those found to have significant cardiac disease) including referral for diagnostic echocardiography in 8 (10%), commencement of heart failure treatment in 3 (4%) and referral to a cardiologist in 1 patient (1%).Routine focused cardiac ultrasound is feasible and frequently alters the diagnosis and management of cardiac disease in patients aged over 50years presenting to a general practice.
authors.affiliation: The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Yates
authors.affiliation: Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors.forename: Colin Forbes
authors.initials: CF
authors.lastname: Royse
authors.affiliation: Nillumbik and Research Medical Centre, Eltham, Victoria, Australia.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Royse
authors.affiliation: Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors.forename: Alistair George
authors.initials: AG
authors.lastname: Royse
authors.affiliation: Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Victoria, Australia Department of Medicine, Monash University, Clayton, Victoria, Australia Department of Anaesthesia and Perioperative Medicine, Clayton, Victoria, Australia dj_canty@hotmail.com.
authors.forename: David Jeffrey
authors.initials: DJ
authors.lastname: Canty
keywords: diagnosis; echocardiography; echocardiography and management; feasibility; hand-carried ultrasound