Elderly primary care hypertension patients–who to refer for echocardiography?

S C A M Bekkers,H P Brunner-La Rocca

doi:10.1007/s12471-014-0550-z

Abstract

Heart failure (HF) is a complex clinical syndrome resulting from impaired diastolic and/or systolic function and clinically manifested by numerous, rather unspecific symptoms such as dyspnoea (at rest or exertion), orthopnoea, wheezing, chronic fatigue and lower extremity oedema. The prevalence of HF increases steeply with age, causing high mortality and morbidity, substantial loss in quality of life, and high health care costs [1]. For the diagnosis of HF, guidelines require, in addition to symptoms, objective evidence of cardiac dysfunction that is most commonly assessed by echocardiography. While many conditions may cause HF, the most common aetiologies are coronary artery disease (CAD) and hypertension.

Highlights

Heart failure (HF) is a complex clinical syndrome resulting from impaired diastolic and/or systolic function and clinically manifested by numerous, rather unspecific symptoms such as dyspnoea, orthopnoea, wheezing, chronic fatigue and lower extremity oedema
General practitioners (GPs) and nurse practitioners (NPs) play a key role in identifying HF, but diagnosing HF in primary care remains challenging because symptoms are often unspecific, subtle or even absent [2]
There is an increase in the number of open access echocardiography services to primary care for early diagnosis and appropriate treatment of cardiac dysfunction and HF