Opportunistic screening for cardiovascular problems in rural and remote health settings

BACKGROUND: Cardiovascular disease is the leading cause of death in Australia and the United States. It is not known if routine electrocardiogram (ECG) assessment at the community level could identify a significant proportion of people with clinically relevant ECG anomalies who could benefit from intervention. PURPOSE: This study aimed to elucidate the use of 3-lead ECG assessment by community nurses in rural and remote health settings. We report the findings obtained from 20-minute, lead II ECG recordings of 71 people who participated in a diabetes screening study. RESULTS: Seven participants reported cardiac anomalies before screening. One or more ECG abnormalities were found in 45 participants. Of these, nine people who were otherwise asymptomatic showed abnormal ECG characteristics that warranted further investigation. CONCLUSION: Although further research is needed, incorporating routine 3-lead ECG testing in rural and remote communities may improve general health in the community by providing early recognition of cardiac anomalies in otherwise asymptomatic individuals who may be amenable to treatment. This study has implications for community nurses on two levels: opportunistic screening, monitoring and evaluation.