Tag Archives: referral

AS awareness and detection Low detection rates of valvular heart disease (VHD) and AS are widespread, as many patients are diagnosed only when symptoms occur.5,8 The OxVALVE study (https://academic.oup.com/eurheartj/article/37/47/3515/2844994) showed that 51% of the population aged 65 years and older have undiagnosed VHD, and 1.3% have undiagnosed AS.5 Among the general population, a lack of awareness exists of AS and its symptoms. In a European survey of over 12,000 people aged 60 years and over, only a fifth were aware of VHD, and less than 4% could provide an accurate description of AS.9 National campaigns are recommended to raise public

Echocardiography and enlarged cardiothoracic ratio Dear Sirs, The Guys’ and St Thomas’s echo team are to be congratulated on producing evidence-based advice that could result in a significant reduction in cardiac ultrasound referrals, which may be enhanced if our radiology colleagues are taken on board.1 Many years ago, our echo department was overloaded with requests for studies as a consequence of radiology reports that included the emotive term ‘cardiomegaly’. This expression is, of course, speculative, as enlargement of the ‘cardiac’ shadow may be due to an expiratory radiograph, prominent epicardial fat pads, pericardial effu

An extreme example is the terminally ill patient with severe central chest pain. Even if they are suffering a myocardial infarction, urgent admission may not be the best option in their care. Unnecessary referral wastes the time of both clinicians and patients. It adds to waiting times for more needy patients. Equally we could be guilty of under referral and could be providing less than perfect care for our patients. The clinician needs to ask four principle questions before referral. First: will the referral improve the accuracy of diagnosis and provide better management of the disorder? Second: have all the appropriate examinations and inve

Patient choice The other driver for PBC is that from the 1 April 2008, patients have a choice of any approved provider either from within the traditional National Health Service (NHS) or from the private sector. This bypasses any agreement the primary care trust (PCT) may have with a local provider and could potentially de-stabilise a secondary-care service if the GPs or their patients felt it was not giving them the level of care they might expect. We are witnessing the creation of a real market in the NHS! On the face of it, this might be seen as driving a wedge between primary and secondary care, but it does not need to be that way. Enterp

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