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Value of the electrocardiogram in identifying heart failure due to left ventricular systolic dysfunction

BMJ 1996; 312 doi: (Published 27 January 1996) Cite this as: BMJ 1996;312:222
  1. A P Davie, cardiology registrara,
  2. C M Francis, cardiology registrara,
  3. M P Love, research fellowa,
  4. L Caruana, research techniciana,
  5. I R Starkey, consultant cardiologista,
  6. T R D Shaw, consultant cardiologista,
  7. G R Sutherland, consultant cardiologista,
  8. J J V McMurray, consultant cardiologista
  1. a Department of Cardiology, Western General Hospital, Edinburgh EH4 2XU
  1. Correspondence to: Dr McMurray.
  • Accepted 11 October 1995

Chronic heart failure due to left ventricular systolic dysfunction has a high morbidity and mortality. Angiotensin converting enzyme inhibitors reduce symptomatic deterioration, hospitalisation, and death. Most patients with suspected heart failure present first to general practitioners. Recent studies have emphasised the difficulty of diagnosing heart failure in the community. Fewer than half of patients treated for heart failure by general practitioners have objective evidence of cardiac disease.1 2

To improve diagnosis and treatment Dargie and McMurray suggested that echocardiography should be performed in all patients suspected of having chronic heart failure.3 Screening patients before referral for diagnostic investigation may lessen the considerable resource implications of this approach. We assessed the value of the electrocardiogram in identifying patients with possible chronic heart failure.

Subjects, methods, and results

An open access echocardiography …

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