Identifying Gaps in Detection of Heart Valve Disease in Australia: A Population Survey.

Abstract

Background: Untreated severe heart valve disease (HVD) is associated with premature mortality. Research shows low population awareness of when to seek assessment and low focus on cardiac auscultation by physicians in primary care settings. We studied contemporary public knowledge of HVD and assessment by their general practitioner (GP) in Australia.

Method: A total of 1,041 Australians >60 years of age participated in an online survey via the YouGov platform. The results were compared with data collected in 2020 using a similar approach. In addition, in-depth online interviews with 10 GPs were conducted.

Results: The top health concerns were cancer (29.7%), heart attack (14.6%), and Alzheimer's disease (14.3%), and only 2.4% rated HVD as a major health concern (in 2020: 1.4%; p<0.001). HVD could be explained by 17.1% of respondents, with 29.3% being aware of aortic stenosis (in 2020: 17.3%; p<0.001). The majority of Australians >60 years of age reported being socially and physically active on a regular basis. A total of 41.6% of respondents had a cardiac auscultation rarely or never performed by their GP (in 2020: 37.1%; p<0.001). Although GPs were confident with detecting the presence of a murmur, they were not confident to diagnose HVD without further investigation by a cardiologist.

Conclusions: The knowledge and concern about HVD are low among Australians >60 years of age. Large gaps remain including the need for simple, cost-effective strategies to improve patient education to seek routine medical care, promote regular auscultation within primary care, and request echocardiography if clinical suspicion of HVD is present.