Open access echocardiography is feasible in the Netherlands

Area of Science:

• Cardiology
• Primary Care Medicine
• Diagnostic Imaging

Background:

• General practitioners (GPs) were offered an open-access echocardiography service in an urban Dutch region.
• This initiative aimed to improve access to cardiac diagnostics in primary care.

Purpose of the Study:

• To evaluate the outcomes and utilization of an open-access echocardiography service provided to GPs.
• To assess GP adherence to referral guidelines and the diagnostic yield of the service.

Main Methods:

• GPs received training on echocardiography indications (dyspnoea, cardiac murmur, peripheral oedema) and interpretation.
• A standardized request form and a one-week turnaround time for echocardiograms were implemented.
• Cardiologists interpreted results based on established international criteria.

Main Results:

• 198 patients were referred by 60 GPs over 24 months, representing 1.5% of the department's workload.
• GP adherence to indications was high (91%), suggesting conservative use.
• Abnormal echocardiographic findings were present in 53% of patients, including left ventricular dysfunction (25%) and significant valve disease (10%).

Conclusions:

• The open-access echocardiography service was not overused by GPs; usage appeared conservative.
• There is a need for integrated diagnostic strategies combining electrocardiogram, NT-pro-BNP, and echocardiography to prevent underdiagnosis of left ventricular dysfunction.