Direct access exercise electrocardiography: a new service that improves the management of suspected ischaemic heart disease in the community.

Abstract

Direct access exercise electrocardiography for patients with suspected ischaemic heart disease is safe, feasible, and helpful to general practitioners. This service seems to reduce the number of patients referred to cardiology outpatient clinics and to facilitate the management of these patients in the community.

Open access echocardiography in management of heart failure in the community

“…This is in keeping with the findings of previous smaller studies which showed the difficulty of identifying left ventricular systolic dysfunction clinically 5 6. The rate of positive findings compares favourably with other reported direct access cardiac investigations such as exercise testing 13. A negative finding is also important, however, since it allows inappropriate treatment to be withdrawn.…”

“…In a comparable study of open access exercise testing only 140 patients were seen in two years 13. The demand for our service has been stable and the projected yearly total of patients is about 600.…”

Open access echocardiography has diagnostic yield similar to outpatient echocardiography and is highly rated by general practitioners and patients

“…However, some groups have been cautious about providing open access echocardiography to general practitioners without an accompanying clinical assessment [1]. We and others have previously shown that general practitioners generally use open access stress electrocardiography appropriately and that referring GPs find it a useful service [2]. A number of groups have reported their experience of open access echocardiography [3 -5].…”

Open access

“…Direct access to exercise testing was offered to 122 general practitioners in Belfast, and over two years 192 patients (a remarkably small number) were assessed 1. Only 18% of tests gave positive results.…”