in our department, all hip fracture patients with newly diagnosed cardiac murmur on auscultation on admission had a pre-operative echocardiogram based on NCEPOD [3] report 2001. It recommended that 'whenever possible the anaesthetist of a patient with aortic stenosis should obtain a preoperative echocardiogram of the aortic valve'. Moreover, the NCEPOD also recommended invasive monitoring and ICU/HDU, and excellent postoperative pain control for patients with aortic stenosis. The aim of our audit was to assess the impact of obtaining a pre-operative echocardiogram on the management of hip fracture patients in our unit.