This website is intended for UK healthcare professionals only Log in | Register

Latest articles

May 2025 Br J Cardiol 2025;32(2) doi: 10.5837/bjc.2025.019 Online First

Epidemiology and aetiology of sudden cardiac death in athletes

Joseph Westaby, Mary N Sheppard

Abstract

Sudden cardiac death (SCD) is a devastating and tragic occurrence that may affect individuals of all ages. It is defined as an unexpected death occurring within one hour of the onset of symptoms, if witnessed, or within 24 hours of last being seen alive and well, if unwitnessed. Athletes are considered to be the healthiest of all the population, and exercise is known to reduce the risk of atherosclerotic coronary artery disease. However, both amateur and highly trained athletes do die suddenly and unexpectedly, and this gets widespread media attention as it is so shocking and unexpected. This brings SCD, its frequency and causes into the spotlight. This review focuses on the epidemiology and aetiology of SCD in athletes from a pathological perspective.

| Full text

May 2025 Br J Cardiol 2025;32(2) doi: 10.5837/bjc.2025.020 Online First

Advances in aortic surgery

Ishtiaq Ali Rahman, Shakil Farid, Ravi De Silva

Abstract

The sixteenth-century French surgeon Ambroise Paré remarked, “aneurysms which happen in the internal parts are incurable”,1,2 underscoring the historical challenges of managing aortic disease. Frank Nicholls’ autopsy report of King George II of England (1760) was the first to describe aortic arch dissection.3 It was not until 1944 that Crafoord and Nylin reported the first end-to-end aortic anastomosis for coarctation resection,4 and shortly after, Gross set the stage for rapid aortic repair advancements by replacing a coarctation segment with an arterial homograft.5

In 1952, Cooley and DeBakey utilised homografts for thoraco-abdominal aortic aneurysm repair,6 and by 1954 they introduced aortic dissection surgery. In 1957, homografts had been used to replace ascending aorta7 and arch.8

During the 1970s, Crawford pioneered thoraco-abdominal aneurysm repair, employing an anatomic endovascular graft-inclusion technique. His innovations improved early survival rates, achieving a remarkable 92%.9 Rather than fully resecting the aneurysm, the retained aneurysmal wall was wrapped around the replacement graft. In contemporary practice, open aortic repair remains the standard of care for the majority of patients.

| Full text

May 2025 Br J Cardiol 2025;32(2) doi: 10.5837/bjc.2025.021 Online First

Proton-pump inhibitors: use and effectiveness in ACS patients receiving dual antiplatelet therapy

Faisal Shehzad, Sundip Patel, Khurram Shahzad, Obi Ikechukwu

Abstract

We performed a cross-sectional study to determine the frequency of use of proton-pump inhibitors (PPIs) in acute coronary syndrome (ACS) patients on dual antiplatelet therapy (DAPT) within 24 hours of hospital admission, and their effectiveness in reducing bleeding complications.

This cross-sectional study included a total of 83 patients admitted via the medical take to Queen Elizabeth Hospital, Lewisham and Greenwich Trust (LGT), London, with ACS from May 2022 to June 2022. The data of these patients were analysed to see whether ACS patients on DAPT were given PPIs within 24 hours of their hospital admission. These patients were further assessed for any bleeding event during their hospital admission and its association with the prescription of PPIs.

A significant number of ACS patients (26, 32.1%) were not prescribed PPIs within 24 hours of hospital admission. However, 55 (67.9%) patients were prescribed PPIs within 24 hours of their hospital admission. Of the 26 ACS patients not given PPIs within 24 hours of their hospital admission, three patients developed bleeding complications during their admission. Two out of the three patients developed gastrointestinal (GI) bleeding (melena) with a significant drop in their haemoglobin levels, while one patient developed haematuria.

In conclusion, a large number of patients admitted with ACS and started on DAPT did not receive a concomitant PPI within 24 hours of admission to the hospital in accordance with European Society of Cardiology (ESC) and American Heart Association (AHA) guidelines, and, as such, were at significant risk of bleeding events.

| Full text

May 2025 Br J Cardiol 2025;32(2) doi: 10.5837/bjc.2025.022 Online First

Delay to ICA for patients with NSTEMI admitted to hospitals without cardiac catheterisation facilities in SE Scotland

Man Hei Marcus Kam, Reagan Lee, Brayden Zheng Lin Ng, David Gringras, Joseph Coong, Brian Moosa, Lynn Wood, Sara Bamford, Nicholas L M Cruden, Rong Bing, Peter A Henriksen

Abstract

National Institute for Health and Care Excellence (NICE) guidance recommends routine early inpatient invasive coronary angiography (ICA) for patients presenting with non-ST-elevation acute myocardial infarction acute coronary syndrome (NSTEMI-ACS) within 72 hours of hospital admission. For patients admitted to hospitals without invasive cardiac facilities, completing interhospital transfer and investigation within this timeframe is challenging. This retrospective cohort study evaluated factors influencing time to ICA, diagnosis and treatment allocation decisions in 4,087 NSTEMI-ACS patients referred from five district general hospitals to the Royal Infirmary of Edinburgh over four years. The mean time from admission to coronary angiography was 5.0 ± 3.0 days, with the majority waiting longer than the 72-hour NICE target. Admission towards the end of the week, defined as Wednesday to Saturday, was associated with longer delay. Coronary revascularisation was not required in 34% of patients. The presence of obstructive coronary disease and use of coronary revascularisation varied with age and sex, with younger female patients more likely to have normal coronary arteries or mild non-obstructive plaque disease. Use of percutaneous coronary intervention (PCI) varied with supervising consultant operator. These findings highlight disparity between clinical practice and NICE guideline recommendations for NSTEMI-ACS patients admitted to hospitals without invasive cardiac facilities, and highlight the need for the development of treatment pathways that reduce delay and better identify patients who will benefit from coronary revascularisation.

| Full text

May 2025 Br J Cardiol 2025;32(2) doi: 10.5837/bjc.2025.023 Online First

Devastating impact of performance-enhancing drugs: a case of severe heart failure in a young bodybuilder with body dysmorphic disorder

Ismail Sooltan, Sudantha Bulugahapitiya

Abstract

A 24-year-old male bodybuilder presented with cardiac symptoms following long-term performance-enhancing drug (PED) use. He was diagnosed with heart failure with reduced ejection fraction and body dysmorphic disorder. Treatment included cardiac medical therapy and psychiatric support. After PED discontinuation and ongoing psychological care, symptoms improved and relapse was prevented. This case highlights the potential severe cardiovascular consequences of PED abuse in young, healthy individuals. It emphasises the importance of early recognition, multidisciplinary intervention addressing both physical and psychological aspects, and increased awareness about PED risks, particularly among those with body image disorders.

| Full text

April 2025 Br J Cardiol 2025;32(2) doi: 10.5837/bjc.2025.016 Online First

Cardiac Risk in the Young: 30 years of supporting families and preventing young sudden cardiac deaths

Steven Cox

Abstract

For more than 30 years, Cardiac Risk in the Young (CRY) has been at the forefront of efforts to prevent sudden cardiac deaths in young people. Established in 1995, CRY has transformed the landscape of cardiac screening, research, and bereavement support in the UK and beyond. Through pioneering research, large-scale screening initiatives, and raising awareness, CRY has saved lives, supported affected families, and driven critical policy changes. This article explores CRY’s impact over the past three decades and its continuing efforts to prevent young sudden cardiac death (YSCD).

| Full text

April 2025 Br J Cardiol 2025;32(2) doi: 10.5837/bjc.2025.017 Online First

Effect of hyperbaric oxygen therapy on LV function in CAD patients after reperfusion based on echo: a meta-analysis

Ketut Angga Aditya Putra Pramana, Ni Gusti Ayu Made Sintya Dwi Cahyani, Yusra Pintaningrum

Abstract

Hyperbaric oxygen therapy (HBOT) is successfully implemented for the treatment of several disorders. HBOT is a promising treatment modality for coronary artery disease (CAD), where outcomes are frequently poor despite early revascularisation. The aim of this study is to investigate the effect of HBOT on the left ventricular function of patients with CAD after reperfusion.

Electronic journal searching was performed in PubMed, ScienceDirect, and Cochrane to find studies that investigate the effect of HBOT on the myocardial function of patients with CAD. The primary outcomes were left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular ejection fraction (LVEF). Meta-analyses were performed on included studies and mean differences (MD) and 95% confidence intervals (CI) were estimated using Review Manager v5.4.

A total of three observational studies enrolling 195 participants were included in our analysis. HBOT significantly increased LVEF by 4.16% in patients with CAD after revascularisation compared with non-HBOT (MD=4.16, 95%CI 0.97 to 7.34, p=0.01). There was no statistical significance observed in the HBOT versus non-HBOT comparison on LVEDV (MD=–1.63, 95%CI –6.52 to 3.26, p=0.51) and LVESV (MD=–1.58, 95%CI –4.06 to 0.90, p=0.21).

In general, this meta-analysis shows HBOT significantly increased LVEF in patients with CAD after revascularisation compared with non-HBOT. There were no significant changes in LVEDV and LVESV in the HBOT group and non-HBOT group.

| Full text

April 2025 Br J Cardiol 2025;32(2) doi: 10.5837/bjc.2025.018 Online First

Heart failure services from the community perspective in the UK: a cross-sectional survey

Jayne Masters, Chun Shing Kwok, Simon Duckett, Susan E Piper, Christi Deaton

Abstract

Heart failure (HF) is a highly prevalent long-term condition, with variation in services and resources across the UK. This report provides findings from a cross-sectional survey of community HF services in the UK between September 2021 and February 2022.

Eighty-five responses describing community HF services were received. Community services were primarily led by a HF specialist nurse (HFSN), with a median of 1.25 cardiology consultants with HF training, and a variety of other nurses and support workers. All services reviewed patients with HF with reduced ejection fraction (HFrEF), only 58% reviewed patients with HF with preserved ejection fraction (HFpEF). Median wait time was 20 days, with substantially longer waits in many areas. All services accepted referrals from multiple sources. Most services provided admission avoidance (96.5%), post-discharge checks (87%), pharmacological optimisation (99%), ongoing monitoring (82%) and palliative care (87%).

In conclusion, UK community-based HF teams provide many services, however, there is significant geographical variation. Studies are needed to determine if they are adequately resourced to meet population needs and improve patient outcomes.

| Full text

March 2025 Br J Cardiol 2025;32:7–11 doi: 10.5837/bjc.2025.011

Diagnosis and management of ACS in patients with ESRD on haemodialysis: a comprehensive review

Muhammad Anis Haider, Muhammad Usman Shah, Xenophon Kassianides, Adil Hazara, Noman Ali, Dmitriy N Feldman

Abstract

Acute coronary syndromes (ACS) are common in patients with end-stage renal disease (ESRD). Diagnosis may be challenging given diverse symptomatology, absence of classical symptoms on presentation, and difficulties in the interpretation of biomarkers. Morbidity and mortality in this patient population remain high compared with patients with normal renal function, partly due to a lack of evidence for optimal management. This review presents a summary of the diagnostic features and early management of ACS in patients with ESRD on haemodialysis.

| Full text
READ MORE

Latest news

MEETING REPORT Online First

BSH 2024: societies together – fostering synergy

April 2, 2025

IN BRIEF

In brief

March 4, 2025

MEETING REPORT Online First

Heartfelt innovations: advances in cardiorenal care

January 14, 2025

READ MORE

Close

You are not logged in

You need to be a member to print this page.
Find out more about our membership benefits

Register Now Already a member? Login now
Close

You are not logged in

You need to be a member to download PDF's.
Find out more about our membership benefits

Register Now Already a member? Login now