[Suitability and performance of echocardiogram in primary care]

The echocardiogram (ECC) is not available to all Spanish General Practitioners (GP) despite its proven benefits in prevalent diseases, such as hypertension and heart failure.

To analyse the clinical adequacy of the application, performance, and diagnostic and therapeutic decisions of ECC indicated by the GP.

Descriptive, cross-sectional, retrospective, multicentre study.

Primary care. Four health centres (HC).

A total of 684 patients over 18 years who had an ECC performed in 2006-2007.

A review of medical records and the ECC report. The socio-demographic variables, clinical and diagnostic performance were also evaluated.

The majority of patients (62.3%) were ≥ 65 years, of which 61.8% were female The most frequent reasons for performing ECC were (but not limited to): heart failure: 30%, suspected valvular disease: 26%; suspected cardiomyopathy: 24.3%. Adequacy of the ECC: 84% (95% CI: 81.09-86.7%) with differences by age (p=.02), HC teaching (p<.001), comorbidity (p<.001) and abnormal ECC (p<.001). A disease was found in 80% of ECC, with differences according to age (p<.001), comorbidity (p=0.02), cardiovascular risk factors (p<.001) and degree of appropriateness of ECC (p=.001). The most common findings (but not limited to) included: valvular heart disease (61.6%) left ventricular hypertrophy (43%) diastolic dysfunction (28.2%). The results of the ECC helped make decisions in 35.2%, with 17.1% referred to cardiology, 10.5% treatment change and 9.6% other tests.

We found that the application of ECC was highly appropriate. The results of ECC drive clinical decisions in a high percentage of cases. The ECC should be accessible to all GP.