Letters

Left ventricular dysfunction among elderly patients in general practice

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7196.1483 (Published 29 May 1999) Cite this as: BMJ 1999;318:1483

Electrocardiograms are useful in these patients

  1. S Talwar, Research fellow (st37@le.ac.uk),
  2. P F Downie, Medical student
  1. Department of Medicine and Therapeutics, Leicester Royal Infirmary, Leicester LE2 7LX
  2. Southampton General Hospital, Southampton SO16 6YD
  3. National Heart and Lung Institute, London SW3 6LY

    EDITOR--Morgan et al have shown that left ventricular systolic dysfunction is common in elderly patients in a general practice setting.1 They mention that an optimal method of screening for the condition in general practice is not known and go on to conclude that “targeting individuals for more detailed assessment … would help detect a substantial proportion of the currently unrecognised left ventricular systolic dysfunction.”

    Davie et al have shown that left ventricular systolic dysfunction is unlikely to be present if an electrocardiogram is normal or shows only minor abnormalities.2 The electrocardiogram has a sensitivity of 94% and a negative predictive value of 98%, making it invaluable in any general practice screening programme for left ventricular systolic dysfunction.2 Conversely, a major electrocardiographic abnormality usually exists in the presence of left ventricular systolic dysfunction.2

    In our opinion, electrocardiography, which is cheap and easily performed, should be incorporated into any general practice screening programme for left ventricular systolic dysfunction. Furthermore, electrocardiographic abnormalities such as left bundle branch block can …

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