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Focused cardiac ultrasound is feasible in the general practice setting and alters diagnosis and management of cardiac disease

Echo Research & Practice volume 3, pages 63–69 (2016)Cite this article

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.

Aim: 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.

Design and setting: 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.

Method: 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.

Results and conclusion: 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.

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Acknowledgements

The authors acknowledge the contributions from the GPs, staff and patients at the Nillumbik and Research Medical Centres.

Funding

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector. Sonosite (Fujifilm) provided a loan of echocardiography equipment. There were no external sources of funding and the authors had full access to all of the data (including statistical reports and tables) in the study.

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Authors and Affiliations

  1. The University of Melbourne, Parkville, Victoria, Australia

    James Yates MBBS

  2. Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia

    Colin Forbes Royse MBBS MD FANZCA, Alistair George Royse MBBS MD FRACS FCSANZ & David Jeffrey Canty MBBS (Hons) PhD FANZCA PGDipEcho

  3. Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Victoria, Australia

    Colin Forbes Royse MBBS MD FANZCA & David Jeffrey Canty MBBS (Hons) PhD FANZCA PGDipEcho

  4. Nillumbik and Research Medical Centre, Eltham, Victoria, Australia

    Carolyn Royse MBBS FRACP

  5. Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia

    Alistair George Royse MBBS MD FRACS FCSANZ

  6. Department of Medicine, Monash University, Clayton, Victoria, Australia

    David Jeffrey Canty MBBS (Hons) PhD FANZCA PGDipEcho

  7. Department of Anaesthesia and Perioperative Medicine, Clayton, Victoria, Australia

    David Jeffrey Canty MBBS (Hons) PhD FANZCA PGDipEcho

Authors
  1. James Yates MBBS
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  2. Colin Forbes Royse MBBS MD FANZCA
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  3. Carolyn Royse MBBS FRACP
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  4. Alistair George Royse MBBS MD FRACS FCSANZ
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Corresponding author

Correspondence to David Jeffrey Canty MBBS (Hons) PhD FANZCA PGDipEcho.

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Yates, J., Royse, C.F., Royse, C. et al. Focused cardiac ultrasound is feasible in the general practice setting and alters diagnosis and management of cardiac disease. Echo Res Pract 3, 63–69 (2016). https://doi.org/10.1530/ERP-16-0026

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  • DOI: https://doi.org/10.1530/ERP-16-0026

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Echo Research & Practice

ISSN: 2055-0464

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