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Age and Ageing, Vol 28, 447-450, Copyright © 1999 by British Geriatrics Society

ARTICLES

Evaluation of echocardiography in the management of elderly patients with heart failure

A Hendry, L Hacking, P Langhorne, R Vallance and J MacDonald
Department of Geriatric Medicine, Gartnavel General Hospital, Glasgow, UK.

OBJECTIVE: To determine the validity of a clinical diagnosis of systolic dysfunction in elderly patients with heart failure and assess the contribution of echocardiography to their management. SUBJECTS: 61 elderly patients with a diagnosis of heart failure in a geriatric assessment unit setting. METHODS: Prospective study determining sensitivity, specificity and predictive values of a clinical and radiological diagnosis compared with echocardiographic standard. Proposed management was compared before and after echocardiography. RESULTS: Clinical assessment was highly sensitive (93%) but lacked specificity (32%). Combining radiological and clinical diagnoses increased specificity to 58%. Echocardiography revised the lead cardiac diagnosis for 28% of patients and influenced patient management plans for 41%. CONCLUSION: For elderly patients with heart failure, echocardiography improves diagnostic accuracy and identifies those patients with potential to benefit from angiotensin-converting enzyme inhibitors.
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