Left ventricular dysfunction among elderly patients in general practice

BMJ 1999;318:1483 ( 29 May )

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Left ventricular dysfunction among elderly patients in general practice

Electrocardiograms are useful in these patients ...

... as are echocardiograms

Evidence based medicine is not yet possible in these patients

Electrocardiograms are useful in these patients ...

The first 150 words of the full text of this article appear below.

EDITOR $---$ Morgan et al have shown that left ventricular systolic dysfunction is common in elderly patients in a general practicesetting.¹ They mention that an optimal method of screeningfor the condition in general practice is not known and go on toconclude that "targeting individuals for more detailed assessment... would help detect a substantial proportion of the currentlyunrecognised left ventricular systolicdysfunction."

Davie et al have shown that left ventricular systolic dysfunction is unlikely to be present if an electrocardiogram is normalor shows only minor abnormalities.² The electrocardiogram hasa sensitivity of 94% and a negative predictive value of 98%, makingit invaluable in any general practice screening programme forleft ventricular systolic dysfunction.² Conversely, a majorelectrocardiographic abnormality usually exists in the presenceof left ventricular systolic dysfunction.²

In our opinion, electrocardiography, which is cheap and easily performed, should be incorporated into any general practice. . . [Full text of this article]

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Prevalence and clinical characteristics of left ventricular dysfunction among elderly patients in general practice setting: cross sectional survey: S Morgan, H Smith, I Simpson, G S Liddiard, H Raphael, R M Pickering, and D Mant
BMJ 1999 318: 368-372. [Abstract] [Full Text] [PDF]