Department of Cardiology, Atrium Medical Centre Parkstad, Heerlen, the Netherlands.
Neth Heart J. 2007;15(10):342-7. doi: 10.1007/BF03086012.
Cardiac disease is not easy to recognise in general practice. An echocardiogram is an excellent way to provide information about left ventricular mass and diastolic (dys)function and the presence of valvular heart disease. To improve diagnostic care of cardiac patients, an open access echocardiography service was established in the referral area of our hospital, where general practitioners were able to ask for an echocardiogram without referring the patient to the cardiologist. Between December 2002 and October 2006 echocardiograms were requested for 471 patients. Thirteen percent of the patients referred for dyspnoea and 3% of patients with a cardiac murmur had a left ventricular ejection fraction <40%. In 28% of patients no cardiac abnormality could be found. If we looked at the prevalence of hypertension in the referred patients, this was very high with a prevalence of up to 60% in the older age groups. If we included hypertension in the analysis, only 16% of patients had no structural cardiac or vascular abnormality. The study shows that the advantage of open access echocardiography in the Netherlands is that the general practitioner is able to make a better diagnosis and unnecessary referrals of patients with suspected cardiac disease can be avoided. (Neth Heart J 2007;15:342-7.).
在一般实践中，心脏病不易识别。超声心动图是提供有关左心室质量和舒张（dys）功能以及瓣膜性心脏病存在的信息的极好方法。为了改善心脏患者的诊断护理，在我们医院的转诊区域建立了开放获取的超声心动图服务，在这里，全科医生可以在不将患者转介给心脏病专家的情况下要求进行超声心动图检查。在 2002 年 12 月至 2006 年 10 月期间，为 471 名患者请求了超声心动图。在因呼吸困难转诊的患者中，有 13%和有心脏杂音的患者中有 3%的左心室射血分数<40%。在 28%的患者中未发现心脏异常。如果我们观察转诊患者中高血压的患病率，在年龄较大的患者中患病率高达 60%，这是非常高的。如果我们将高血压纳入分析，只有 16%的患者没有结构性心脏或血管异常。该研究表明，荷兰开放获取超声心动图的优势在于全科医生能够做出更好的诊断，并且可以避免对疑似心脏病患者进行不必要的转诊。（Neth Heart J 2007;15:342-7.）。
