Intended for healthcare professionals


Can heart failure be diagnosed in primary care?

BMJ 2000; 321 doi: (Published 02 December 2000) Cite this as: BMJ 2000;321:1414

Chest radiography is still useful

  1. Chris Davidson (, cardiologist
  1. Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton BN2 5BE
  2. University of Birmingham, Birmingham B15 2TT

    EDITOR—In his editorial on diagnosing heart failure in primary care Hobbs fails to mention the value of chest radiography.1 As every medical student knows, a chest x ray film provides information on cardiac size and the major cardiac structures, and more fundamentally on any respiratory cause of breathlessness. It is even more extraordinary that Caruana et al do not mention chest radiography in the diagnostic process in their paper, although their study focused particularly on excluding other causes of the patients' symptoms.2

    The current obsession with open access echocardiography is tending to unnerve general practitioners, who feel that they cannot now diagnose heart failure without showing abnormal left ventricular function. In fact, in most patients the disease can be diagnosed and treated with a knowledge …

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