New guidance for GPs on diagnosing and referring patients with heart valve disease from the charity Heart Valve Voice, recommends that the stethoscope be used routinely on over 65s at the time of the flu jab, NHS Health Checks and new patient registrations.
On average GPs use their stethoscope on less than two-fifths of patients presenting with symptoms of heart valve disease, despite stethoscope use being one of the first key protocols in detecting the murmurs associated with heart valve disease.
Heart valve disease is a serious condition that affects more than one million over 65s in the UK. If left untreated, life expectancy for patients with severe symptoms can be less than two years. When identified, referred and treated early, patients can return to a good quality of life and a normal longevity.
On launching the Guidance, Heart Valve Voice recognised the immense pressures on GPs and made two key recommendations to ensure primary care physicians are better equipped to handle valve disease.
“It is important that NICE introduces Guidelines on heart valve disease, since this will ensure that greater priority is given at CCG level to this treatable disease,” commented Dr Matthew Fay, GPSI Cardiology and joint-author of the GP guidance document “If, in addition, appropriate funding is available to allow annual auscultation of all over 65s, we can ensure that more patients receive timely detection, referral and treatment.”
The GP guidance, the first of its kind to discuss heart valve disease, offers practical advice on the timely assessment and appropriate treatment of the disease by GPs, including step-by-step instructions on diagnosis, examination and referral.
Professor Ben Bridgewater, Cardiac Surgeon, University Hospital of South Manchester and the Chair of Heart Valve Voice, hopes that the heart valve disease GP guidance will “improve the under-diagnosis and under-treatment of heart valve disease in the UK. Referral and treatment barriers for heart valve disease exist throughout all levels of the NHS and this GP guidance is the first step in addressing this.”
About heart valve disease
Heart valve disease is primarily a condition caused by either wear or disease of the heart valve(s), affecting the flow of blood through the heart.i When diseased or defective, heart valves may not open or close properly and can interfere with the flow of blood. The most common valve problems involve the mitral and aortic valves, which are located on the left side of the heart.ii
Heart valve disease can be detected during a medical visit. A heart “murmur” or “click-murmur” heard through a physician‘s stethoscope is usually the first indication of a valve disorder.
Without treatment, patients with severe disease face shortened life, and impairments in physical and social functioning and emotional well-being that contribute to poor quality of life. ii, iii, iv, v