How is echocardiography used? An audit of 11,701 studies

Abstract

Objective: to review the utilisation of 2-D and Doppler echocardiography between 1984 and 1990.

Methods: analysis of request forms and echocardiogram reports for patient demographics, major clinical indications and principal echocardiogram findings.

Results: between May 1984 and December 1990 11,701 studies were done in 8101 patients. Requests for scans increased by an average of 225 per year. Most frequently scanned were male (55%), inpatients (52%) and patients aged 60-69 yr (19%). In 1984 cardiologists made 100% of the requests and did 78% of the studies. In 1990 noncardiologists requested 48% of scans and 91% of studies were done by technicians. Echocardiograms were requested most often for assessment of valve disease (39%), left ventricular function (18%) and congenital heart disease (15%). Thirty-five percent of studies showed valve disease, 17% myocardial disorders and 10% congenital heart disease. Normal findings were shown in 25%.

Conclusion: in this 6.5 year period there was a rapid increase in the utilisation of echocardiography and the practice changed from one requested by and done by cardiologists to a generally available service provided by technicians. The greatest application for scanning was in the assessment of acquired valvar disease and myocardial disorders. One-quarter of echocardiograms showed normal cardiac structure and function.