Value of the electrocardiogram in identifying heart failure due to left ventricular systolic dysfunction

Fewer than half of patients treated for heart failure by general practitioners have objective evidence of cardiac disease. 1 2 To improve diagnosis and treatment Dargie and McMurray suggested that echocardiography should be performed in all patients suspected of having chronic heart failure. 3 Scree...

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Bibliographic Details
Published in:BMJ 1996-01, Vol.312 (7025), p.222-222
Main Authors: Davie, A P, Francis, C M, Love, M P, Caruana, L, Starkey, I R, Shaw, T R D, Sutherland, G R, McMurray, J J V
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Beta blockers
Biological and medical sciences
Cardiac arrhythmia
Cardiac Output, Low - diagnosis
Cardiac Output, Low - etiology
Cardiograms
Cardiology
Cardiovascular disease
Echocardiography
Electrocardiography
Electrocardiography. Vectocardiography
Electrodiagnosis. Electric activity recording
Heart
Heart attacks
Humans
Investigative techniques, diagnostic techniques (general aspects)
Medical sciences
Medical specialists
Middle Aged
Morbidity
Mortality
Patients
Ventricular Dysfunction, Left - complications
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Summary:Fewer than half of patients treated for heart failure by general practitioners have objective evidence of cardiac disease. 1 2 To improve diagnosis and treatment Dargie and McMurray suggested that echocardiography should be performed in all patients suspected of having chronic heart failure. 3 Screening patients before referral for diagnostic investigation may lessen the considerable resource implications of this approach. Electrocardiographic findings Impaired left ventricular systolic function Preserved left ventricular systolic function Total Abnormal 90 169 259 Normal + 6 269 275 Total 96 438 534 Sensitivity 90/96=94%; specificity 269/438=61%; positive predictive value 90/259=35%; negative predictive value 269/275=98%. +Normal or minor abnormality (atrial enlargement, bradycardia, tachycardia, broadening of QRS complex, poor R wave progression, right axis deviation, myocardial ischaemia, first degree atrioventricular block, nonspecific ST-T wave changes).
ISSN:0959-8138
0959-8146
1468-5833
1756-1833
DOI:10.1136/bmj.312.7025.222