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Medical > Cardiology > Direct Access Echocardiography


Direct Access Echocardiography

  

Direct access echocardiography service based at North Warwickshire Community Diagnostic Centre GEH. Offering county wide direct access echo

Reviewed on : 6 Jun 2025

Reviewed by : Jo Purvis

Expires : 6 Jun 2027

Direct access echocardiography service based at North Warwickshire Community Diagnostic Centre GEH

Updated Direct Access Echocardiography Service. These updates are designed to streamline referrals and improve access to diagnostic investigations for your patient .Offering county wide direct access echo

Key updates:
  • Revised referral criteria: We have updated our clinical criteria to ensure appropriate and timely use of Echocardiography
  • New LMC approved referral from: A new standardised referral from must now be used and should be completed in full to avoid delays
  • Booking Process: All referrals will be vetted by a Senior Echocardiopgrapher using the most up to date triaging guidelines as per the British Society of Echocardiography
  • Reporting: Reports will be sent directly to the referring practice via Docman. Any urgent finding will be flagged for immediate action
Intended use of the service:

This service is for patients with new suspected structural heart disease where Echocardiography will aid in diagnosis or management. It is not intended for routine screening or assessment of known stable cardiac conditions

For any queries or to discuss a referral please contact the Physiological Sciences Services on 02476865128 or email CRUReception@geh.nhs.uk

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North Warwickshire Guidance  
About the Direct Access Echocardiography Service

Senior physiologists triage echo requests. If a request does not meet the criteria outlined by the British Society of Echocardiography (2024), it may be rejected.
If this request is not completed in full, it may be returned, resulting in possible delays in patient investigations.
Where appropriate, if a referral is rejected, we will advise to redirect the referral to other services if appropriate.
All referrals must be made via the E-referral system; alternatively, this form may be emailed to crureception@geh.nhs.uk.
By completing the patient referral, both the referrer and the patient agree to appropriate diagnostics being undertaken and further referral to other available services where clinically indicated.

Inclusion Criteria

Heart murmur:

Cardiac symptoms – dyspnoea, palpitations, severe fatigue, light-headedness/ dizziness
Asymptomatic heart murmur with abnormal ECG or abnormal chest X-ray

Exclusion:

Innocent murmur (systolic, grade 1/2 with no other abnormalities and no increase in intensity with Valsalva)
Unchanged murmur in asymptomatic patient with previously normal echo

Hypertension + suspected LVH based on:

Clinical findings – cardiac symptoms – dyspnoea, palpitations, light-headedness/ dizziness
Abnormal ECG or chest X-ray

Exclusion: Routine assessment of essential hypertension with normal ECG and examination in a patient >40 years old

New AF

Exclusion: Previous echo performed since AF diagnosis

Pulmonary disease with clinical suspicion of cardiac involvement (Cor Pulmonale), pulmonary hypertension

Exclusion: Lung disease with no evidence of cardiac involvement or pulmonary hypertension

Palpitations/Syncope

Exclusion:

Palpitations with no ECG confirmed arrhythmia or clinical suspicion of structural heart disease. (Ectopic burden should be >10% on Holter)
Classic neuro-cardiogenic (vasovagal) syncope

Other – Please document any relevant information that outlines indication for an ECHO referral

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