Identifying Heart Valve Disease In Primary Care: Differences Between Practice In Germany, France And The United Kingdom

Objective: The objective of this study was to gain a deeper understanding of detection, diagnosis and referral of heart valve disease by general practitioners. Design: General Practitioners (GPs) participated in telephone interviews and were asked questions about the detection and referral of heart valve disease and their attitudes to management in patients aged over 65 years old. Participants: 153 general practice (GPs) physicians from France, Germany and the UK were interviewed. Setting: Urban and rural GPs were included. Results: French Physicians are more likely to auscultate routinely (62%) or prompted by symptoms (94%). However, in the UK auscultation was reported in only 38% of elderly patients with symptoms suggestive of valvular disease and in Germany in 40% of patients. This trend is then reflected on the number of patients with heart murmurs detected. GPs keep a significant proportion of valvular patients under their own surveillance without referring to specialist valve clinics. Conclusions: In the UK, GPs appear to auscultate less frequently than their colleagues in France. More targeted clinical processes may help but we also propose that clinically targeted echocardiography should be more widely available.