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European Journal of Heart Failure 2001 3(1):79-81; doi:10.1016/S1388-9842(00)00086-6
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© 2001 European Society of Cardiology

Diagnosis of heart failure in elderly patients in primary care

Andrew Owena,* and Stephen Coxb

a Department of Cardiology, Kent & Canterbury Hospital Canterbury, Kent, CT1 3LP, UK
b The Surgery, Ivy Court, Tenterden, Kent, TN30 6RB, UK

* Corresponding author. Tel.: +44-1227-766877, ext. 3031; fax: +44-1227-781306.


  Abstract

Background: Heart failure is difficult to diagnose in a primary care setting with a reported false positive diagnosis in up to 70% of cases.

Aims: To use echocardiography in a large rural practice to evaluate the accuracy of diagnosis of heart failure in patients over 65 years of age.

Methods: Sixty patients with a previous diagnosis of heart failure were selected at random from the practice records and were invited to attend for an echocardiogram at the practice premises.

Results: Fifty-eight patients attended, the age was 81±7 years, 29% had impaired left ventricular (LV) systolic function of whom 65% were in atrial fibrillation. A further 7% had isolated diastolic LV dysfunction. The prevalence of heart failure by clinical assessment was 29 per 1000 in this patient group and 9 per 1000 when echocardiography was used to confirm the diagnosis.

Conclusion: True heart failure in this population is less prevalent than has been estimated from practice records.

Key Words: Heart failure • Primary care • Systolic function • Diastolic function • Prevalence • Atrioventricular plane

Received September 6, 1999; Revised March 20, 2000; Accepted April 25, 2000


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