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Check for heart murmurs at health checks and vaccinations, GPs advised

GPs are being urged to routinely check for heart murmurs in over-65s, when carrying out new patients registrations, health checks or administering the flu jab.

New guidance, published by a UK charity for heart valve disease, warned that that many older people may attribute their symptoms to ageing so might not report their condition and might never be diagnosed.

Heart Valve Voice urges GPs to take a more proactive approach with older patients and to think about opportunities when they have more time to use chest auscultation.

‘The annual flu jab, NHS health checks and new patient registrations are therefore excellent opportunities to screen them for underlying valvular disease using the stethoscope,’ the guidance says.

‘As GPs, we currently use auscultation routinely in less than two fifths of patients whose symptoms suggest heart valve disease.

‘We need to use our stethoscopes more often to check for heart valve disease when an older patient reports symptoms, and potentially consider using this basic investigation during routine consultations with our elderly patients,' the guidance adds.

Commonly reported symptoms that could indicate heart valve disease include shortness of breath on exertion, chest tightness and/or pain, palpitations, fatigue, dizziness, pre-syncope and syncope, Heart Valve Voice said.

Dr Jarir Amarin, a GP in Enfield and trustee of the charity, said: ‘GPs are put under immense pressure and have very limited consultation times, so this guidance offers brief, practical advice, such as the routine use of the stethoscope in over 65s at flu clinics or NHS checks, to ensure that patients are diagnosed and referred early, and reach the appropriate cardiology team for treatment. Ultimately, leading to a future with better quality and longevity of life.’

Heart Valve Voice points out that heart valve diseases currently affects over 1.5 million people over the age of 65 in the UK. The UK’s ageing population means that the number of people with heart valve disease is expected to rise to 3.3 million by 2056 – a 122% increase.

Readers' comments (12)

  • The charity could of course raise sufficient money to send someone round to listen to everyone's heart.
    Rather than trying to make it my job

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  • GPs are ideally placed...

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  • Oh, push off. I'm too busy doing their boiler check.

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  • Listen mate! - being forced to work to 68 or more for my pension my presbycusis should be sufficiently well established that I won't hear half of anything by then.

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  • So are they going to come and train the HCAs to listen to hearts?

    Because they are the ones giving flu jabs and doing health checks.

    Utter rubbish.

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  • ^^^ says a CVD Clinical Lead

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  • Absolutely agree Shaba! How often does a gp do flu clinics or NHS health checks? It is mainly PN's and HCA's who do them!
    I remember a few years ago when we as PN's were expected to check for irregular pulse rates in flu clinics, with average two minute appt lengths how impractical was that!
    Of course, Heart Valve Voice like every body else in the country who is not working in a GP setting, still think we are all just sitting twiddling our thumbs waiting for pt's to pop in "on the off chance"!
    Perhaps the cardiology consultants in their hospital clinics could just pop into the waiting room with their stethoscope between appts and check everyone who is waiting with patients???

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  • Dear Charities, self interest groups, pressure groups, tabloid article writers,

    If you don't already know, most of the heavily depleted and demoralised GP workforce are already dangerously overloaded with tasks and are now struggling just to provide safe care and attention to those who are already sick and dying.

    Your well-intentioned request that GPs incorporate your additional work at this time is unhelpful.

    Please just pop-in your suggestions later when workload and funding are restored to safe levels and we will see what we can do to help.

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  • What a load of tosh. How long does it take to properly auscilate the 4 areas getting them appropriately undressed with correct positioning and manoeuvres this in on top of jabbing them with a needle a all that goes with the health check? It's pretty resource intensive. I'm sure there are plenty of undiagnosed murmurs out there in this age group but waving a stethoscope at them for 5 seconds is not going to pick them up. If you want to set up a screening programme for valvular defects fund it properly and do it properly with a bloody echo!

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  • this is in effect a screening procedure-therefore it should meet most or all criteria for valid screening, plus there should be minimal chance of diagnosing pre-symptomatic heart murmurs actually causing harm to patients .while not having looked at their references ,unless this is being presented as a screening test fulfilling the usual criteria ,stick to usual clinical practice I would say

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