THE CASE FOR EARLY DETECTION OF STRUCTURAL HEART DISEASE: WHAT NEEDS TO HAPPEN TO IMPLEMENT SHD SCREENING PROGRAMS IN EUROPE

Structural heart diseases (SHD) are set of cardiovascular diseases affecting the structure of the valves, atria, ventricles, and blood vessels in the heart. The majority of these conditions are degenerative, which means that they primarily affect the elderly. It is estimated that 14 million people in Europe were living with SHD in 2020, and that by 2050, this cipher will increase to 23 million. 

As SHD generally cannot be prevented, it needs to be detected early on so that patients may be treated to improve their health, quality of life, and reduce healthcare costs they might incur, otherwise. 

There are no screening programs for SHD in Europe to this day. As a result, older people may suffer from the condition without actually knowing it, especially as SHD symptoms are not specific, and awareness of the disease is poor both in patients and health care professionals. 

However, early detection of such diseases can very easily be put in place via heart checks using a stethoscope. If an abnormal heart murmur is detected by the general practitioner, the patient is referred to a cardiologist for further examination using echocardiography. 

The development of SHD screening programs could be inspired by the experience garnered by already implemented screening programs, such as cancer, which have demonstrated positive outcome. In addition, SHD screening could be integrated into broader cardiovascular disease (CVD) screening in primary care. These screening programs could be envisioned from a certain age onwards. 

The EU SHD Coalition has identified that the implementation of effective screening program for SHD will require the definition and development of specific features to facilitate its implementation by the Health Authorities of the EU Member States: 

  • Definition of the target population and SHD detection guidelines,
  • Program of awareness, training and incentivization of General Practitioners to perform heart checks,
  • Development of awareness campaigns to maximize adherence of the target population, with the involvement of healthcare professionals to improve awareness and adhesion to the program,
  • Evaluation of the use of new techniques for SHD detection.

The EU SHD coalition is calling the EU to take steps to encourage the development of screening programs for CVD and SHD, by including it in its Healthier Together - EU Non-Communicable Disease Initiative. In addition, minimum screening targets should be set, and sufficient funding should be allocated to the improvement of early detection, notably through the impending EU4Health Joint Action on CVD. 

This will in turn stimulate the exchange of best practices, data and knowledge sharing across and between Member States, enhancing the development of guidelines and policies, ultimately improving the health and quality of life of elderly citizens in the EU. No EU citizen should ever be left behind because of a lack of awareness of medical experts and access to heart checks.

The full policy narrative is accessible here.