The charity Heart Valve Voice has released new guidance for primary care. The guidance – the first of its kind – offers practical advice on the assessment and treatment of the disease by GPs and other primary care givers.
Specifically, the guidance recommends that the stethoscope be used routinely on over 65s at the time of the flu jab, NHS Health Checks and new patient registrations, and aims to ensure that GPs are better equipped to handle valve disease without overwhelming them at a time when they already face significant pressure.
Heart valve disease is a common, but treatable, heart condition where the heart valves no longer work properly. However, many patients do not suffer severe or visible symptoms, or put their symptoms down to the natural ageing process, making diagnosis difficult. In the UK, the prevalence of heart valve disease rises with age, and currently affects more than 1.5 million people over the age of 65 years. Estimates suggest that by the age of 75, the prevalence of heart valve disease is over 13%. 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, representing a 122% increase.
Early identification, referral and subsequent treatment are essential for patients with heart valve disease, because if left untreated, half of those patients will die within two years of developing symptoms. Early detection is particularly important in primary care, because most patients are likely to first seek help for their symptoms from their GP. Despite this, there remains significant under-diagnosis of heart valve disease patients in the UK compared to the rest of Europe, and inequity in terms of geographical location, age and gender. This is partly due to the reported rare use of a stethoscope examination in over 60s during routine consultations, one of the first key protocols in detecting the murmurs associated with heart valve disease. In a recent survey of this same age group, almost three-quarters (72%) claimed that their doctor rarely or never checks their heart with a stethoscope. In addition, the survey found a disparity amongst the sexes, with 81% of women versus 66% of men saying they are rarely or never checked with a stethoscope.
Dr Jarir Amarin, Trustee of Heart Valve Voice and General Practitioner Carlton House Surgery, Enfield, said: “I am very pleased to be sharing the first ever Heart Valve Disease Primary Care Guidance with my colleagues, with the aim of improving the under-diagnosis and under-treatment of the disease in the UK.
“One of our sayings is ‘the more we listen, the more lives we save’. 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.”
The launch of the guidelines follows the publication of the charity’s 2020 Vision Report, entitled ‘Towards a Heart Healthy Future: a 2020 Vision for Heart Valve Disease’ at a parliamentary event that was attended by MPs from across the country. The report sets out recommendations to improve the diagnosis, treatment and care of heart valve disease in the face of significant challenges for the NHS and with an aging population, including: the development of NICE guidelines to make heart valve disease a priority for CCGs, the introduction of effective and targeted education and awareness-raising campaigns for primary healthcare professionals and the public, routine use of the stethoscope in over 65s, improved access to echocardiography (ultrasound of the heart) for GPs and equal access to treatment for patients across the UK and compared to the rest of Europe.