Key result
In a pilot of 75 patients, no patient with a normal point-of-care scan and normal auscultation subsequently had an abnormal transthoracic echocardiogram.
Highlights the under-recognition and suboptimal management of heart valve disease, advocating for the establishment of specialist valve clinics to improve care.
It is not widely known that valve disease is as common as heart failure, with a prevalence of 2.5% in the general population and over 10% in those aged >75.1 There are many well-established national programmes for heart failure yet none exist for valve disease, which can justifiably be regarded as the ‘next cardiac epidemic waiting to happen’.2 There are many limitations in our care for heart valve disease. Most patients are still cared for by general physicians or GPs without specialist expertise despite management decisions becoming increasingly complex.3 One-half of patients throughout Europe receive surgery too late.4 The situation is particularly poor for older people, at least 30% of whom are not referred even when clinically indicated.3 There is unacceptable variation in access to aortic valve surgery in the UK,5 particularly in London where Camden has observed activity 47% above age-predicted rates and Brent has activity 40% below age-predicted rates. These limitations have led to a call for specialist valve clinics.3,6 These are expected to improve the assessment of valve disease and the timing of surgery, and to ensure referral to an appropriately qualified and …
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Draper et al. (2016) conducted an editorial in Heart valve disease (n=75). Point-of-care echocardiography and auscultation was evaluated on Abnormal transthoracic echocardiogram following normal point-of-care scan and auscultation. In a pilot of 75 patients, no patient with a normal point-of-care scan and normal auscultation subsequently had an abnormal transthoracic echocardiogram.
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