Six-month wait for critical heart diagnosis highlights regional disparities in aortic valve stenosis

Patients with life-threatening faulty heart valves are facing a regional delay in diagnosis, with some waiting more than six months from their first appointment to receive a diagnosis of aortic valve stenosis, according to new data. The condition narrows the aortic valve, reducing blood flow to the body and, if untreated, can progress to heart failure and death.

London patients were the worst affected, with about half waiting more than six months from first appointment to diagnosis. In the West Midlands, 46% waited longer than six months to be told they had the condition. By contrast, the South West experienced the shortest delays, with just 16% waiting longer than six months.

Experts say the regional differences largely reflect how often general practitioners in different parts of the country can perform thorough physical examinations that might reveal signs of aortic valve stenosis. In more populated areas, clinicians reportedly have less time to conduct detailed checks that could prompt earlier investigation, according to researchers and advocacy groups.

Aortic valve stenosis affects more than 300,000 Britons. It is usually caused by a buildup of calcium on the valve, a process that accelerates with age. Smoking, high blood pressure and obesity can hasten valve calcification. Replacing the faulty valve can stop heart failure from developing, and on the NHS this is typically done by surgery. The pathway to diagnosis commonly begins with a GP exam using a stethoscope to listen for an abnormal heartbeat, followed by a referral for a hospital echocardiogram.

But Wil Woan, chief executive of Heart Valve Voice, which commissioned the research, said many patients who present with symptoms are not immediately examined by a GP. He and others argue that the data point to a postcode lottery, where regional practice patterns and primary-care pressures influence how quickly a life-threatening diagnosis is reached. The study underscores the need for faster access to echocardiography and for more routine evaluation of cardiac symptoms in primary care.

Health experts emphasize that earlier detection improves outcomes. When diagnosed promptly, patients can be referred for valve replacement before the condition progresses to heart failure. The NHS faces ongoing debates about how to streamline referrals and expand access to diagnostic imaging, particularly in busy urban areas where the study notes the longest delays.

The data were provided to The Mail on Sunday and illustrate how regional variations in primary care practices can affect the diagnostic timeline for a condition that already threatens many Britons. Public-health advocates say policymakers should consider strengthening GP training, increasing diagnostic capacity in primary care, and implementing clearer pathways for rapid referral when patients report hallmark symptoms such as breathlessness, chest pain or dizziness.

For patients and families affected by aortic valve stenosis, awareness of symptoms remains crucial. Breathlessness during rest or activity, unexplained chest pain, dizziness or fainting spells warrant prompt medical evaluation, and patients should seek care if symptoms worsen. As the population ages, experts stress the importance of proactive screening and timely investigations to prevent progression to heart failure and reduce regional disparities in diagnosis and treatment access.