Abstract 4367372: Hidden Heart Disease Uncovered: The power of community-based echo screening program - A Case Report from the Every Heart Matters Program

Abstract

Introduction: Access to cardiovascular diagnostics remains a major barrier to equitable care, particularly among underserved populations. In alignment with ASE, ACC, and AHA recommendations for targeted screening, the Every Heart Matters Program (EHMP) was launched in 2023 to provide free transthoracic echocardiograms (TTEs) across Western Pennsylvania. To date, EHMP has performed over 350 echocardiograms, identifying structural heart disease (SHD) in more than 25% of participants. African American women were identified as a particularly high-risk group, with 1 in 5 showing abnormal findings. We present a case that illustrates the clinical impact of this initiative. Description of Case: A 50-year-old uninsured African American woman with a history of poorly controlled hypertension, preeclampsia, tobacco and alcohol use, and a sedentary lifestyle presented with exertional dyspnea and a new murmur. Blood pressure was 202/102 mmHg. Due to longstanding gaps in healthcare access, she had never undergone cardiac evaluation. EHMP provided a screening TTE, which revealed moderate concentric LV hypertrophy, global hypokinesis, reduced ejection fraction (EF) of 40%, mild left atrial enlargement, moderate-to- severe aortic regurgitation, moderate mitral regurgitation, and mild pulmonary hypertension. She received urgent cardiology follow-up and was provided a free heart health kit (digital BP monitor, scale, fitness tracker). Guideline-directed medical therapy was initiated. Within 12 weeks, she demonstrated substantial lifestyle changes, including smoking cessation and reduced alcohol intake. Blood pressure normalized to 112/70 mmHg. Repeat TTE showed EF improvement to 55%, resolution of mitral regurgitation and pulmonary hypertension, and improvement in aortic regurgitation to mild. Discussion: This case highlights the transformative role of community-based echocardiographic screening in identifying and reversing subclinical cardiovascular disease in high-risk, uninsured individuals. EHMP’s outreach to federally qualified health centers, residential complexes, community centers, and churches—serving predominantly minority populations—demonstrates a scalable and impactful approach to reducing disparities. Early detection enabled timely medical intervention, lifestyle modification, and significant cardiac recovery. Expansion of similar programs is critical to advancing equity in cardiovascular care.