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Diagnosis
A combination of tests done in general practice could assess the risk for left ventricular systolic dysfunction

https://doi.org/10.1136/ebm.5.6.185

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    (2000) BMJ 320, 220. Nielsen OW, Hansen JF, Hilden J. , et al.. Risk assessment of left ventricular systolic dysfunction in primary care: cross sectional study evaluating a range of diagnostic tests.. Jan 22;. :. –4.
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 QUESTION: In patients at increased risk for left ventricular systolic dysfunction (LVSD), are there clinical methods that general practitioners can use to determine which patients to refer for echocardiography?

    Design

    Blinded comparison of clinical data with echocardiographic results.

    Setting

    3 general practices in Copenhagen, Denmark.

    Patients

    126 patients who were 49 to 93 years of age (median age 71 y, 56% women) and had past or present signs or symptoms of heart disease, treatment for heart disease, referral to a coronary care unit, or previous cardiac abnormalities. Nursing home patients and all patients actively treated for advanced heart failure were excluded.

    Description of tests and diagnostic standard

    All patients received a physical examination, chest radiography, echocardiography, supine 12 lead electrocardiography, blood pressure measurements, and blood tests. LVSD was defined as an ejection fraction of <0.45 …

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    Footnotes

    • Source of funding: Danish Heart Foundation.

    • For correspondence: Dr O W Nielsen, Cardiovascular Department, Copenhagen University Hospital Bispebjerg, DK-2400 Copenhagen NV, Denmark. Fax +45 35 31 32 26. own{at}dadlnet.dk