Role of open access echocardiography in detection of cardiac structural and functional abnormalities

Abstract

PurposeTo evaluate the prevalence and incidence of significant structural heart disease in targeted patients with cardiac symptoms referred by general practitioners (GPs) using open access echocardiography, without prior clinical evaluation by a cardiologist.DesignData were derived from 488 subjects who underwent transthoracic echocardiography between January and April 2018. Patients were referred directly by GPs in East Berkshire, South England, through an online platform. Echocardiography was performed within 4–6 weeks of referral and all reports were assessed by a consultant cardiologist with expedited follow-up facilitated pro re nata. Results were analysed to determine the frequency of detection of structural abnormalities, particularly of the left ventricle and cardiac valves.ResultsEchocardiography was prospectively performed in consecutive subjects (50% male, mean (±SD) age 68.5±22 years; 50% female; mean (±SD) 64.6 (±19.1)). At least one abnormality likely to change management was found in 133 (27.3%) of all open access echocardiograms. Clinical heart failure with left ventricular systolic dysfunction (LVSD) and diastolic dysfunction was confirmed in 46 (9%) and 69 (14%), respectively. Of the 46 patients with LVSD, 33 were new diagnoses. Significant cardiac valve disease was found in 42 (8.6%) patients. 12 of these had known valvular disease or previous valvular surgery, and 30 were new diagnoses.ConclusionMajor structural and functional cardiac abnormalities are common in late middle-aged patients who present to GPs with cardiac symptoms and signs. Reported, unrestricted open access echocardiography enables early detection of significant cardiac pathology and timely intervention may improve cardiovascular outcomes.

Relationship between diagnosis of conus arteriosus malformation and genetic diagnosis results in fetal cardiac axis abnormalities by echocardiography during middle pregnancy

“…Echocardiography has good spatial and temporal resolution, and can clearly display the various structures of the fetal heart, providing a strong imaging basis for clinical diagnosis. Some studies have found that in some cases of abnormal cardiac axis detected by echocardiography, the genetic diagnosis result of some cases is negative, suggesting that there may be false positive phenomenon in the diagnosis of abnormal cardiac axis by echocardiography ( 15 , 16 ). In addition, some studies have found that the genetic diagnosis results of some cases of cardiac axis abnormalities are not consistent with the results of echocardiography, suggesting that the genetic diagnosis may not fully explain the cardiac axis abnormalities detected by echocardiography in some cases ( 17 , 18 ).…”