This issue – from the GP perspective

When I first arrived at Whitby Group Practice (WGP) in the middle 80s, my surgery was next to Whitby Hospital Outpatients, where Anthony Bacon conducted his cardiology clinic. Dr Bacon’s article on aortic stenosis was in our previous issue.¹ In this issue, Tariq Enezate and colleagues add to our knowledge of managing this condition.²

In those early days at WGP, all my colleagues were men. General practice has reversed that bias but the editorial by Alexandra Abel, Rosita Zakeri, Cara Hendry and Sarah Clarke, highlight the challenges in cardiology, which still has some catching up to do with women being underrepresented in this specialty.³

My colleagues at Hull York Medical School, Harshal Deshmukh et al, contribute an article on PCSK9 inhibitors.⁴ At WGP we are starting our seventh PCSK9 study in seven years, which has involved more than 50 patients over that time… but as a GP I am still not permitted to prescribe this drug to my NHS patients.

We are gaining more insights into the emerging world of cardio-oncology. Next issue, we will be carrying a review on cancer immunotherapy and its potential cardiac complications. One of its authors, Chris Plummer and I recently co-authored a paper in the other BJC, the British Journal of Cancer.⁵ The cancer theme continues with an interesting case report in this issue by Matthew Johnson and Rohan Penmetcha from the US that highlights a rare, atypical presentation of a cardiac disorder related to a malignancy.⁶

Conflicts of interest

None declared.

Terry McCormack
Vice-President British and Irish Hypertension Society
Honorary Professor of Primary Care Cardiovascular Medicine, Hull York Medical School
General Practitioner
Whitby Group Practice, Spring Vale Medical Centre, Whitby, North Yorkshire, YO21 1SD ([email protected])

References

1. Bacon APC, Rosen H, Ruperelia N. My 60-year relationship with aortic stenosis. Br J Cardiol 2019;26:99–100. https://dx.doi.org/10.5837/bjc.2019.028
2. Enezate T, Omran J, Abdullah O, Mahmud E. Transcatheter aortic valve replacement in patients with systolic heart failure. Br J Cardiol 2019;26:149–52. https://dx.doi.org/10.5837/bjc.2019.033
3. Abel A, Zakeri R, Hendry C, Clarke S. Women in cardiology: glass ceilings and lead-lined walls. Br J Cardiol 2019;26:125–7. https://dx.doi.org/10.5837/bjc.2019.032
4. Deshmukh H, Narayanan D, Papageorgiou M, Holloway Y, Ali S, Sathypalan T. PCSK9 inhibitors in familial hypercholesterolaemia: a real-world experience and a meta-analysis. Br J Cardiol 2019;26:137–40. https://dx.doi.org/10.5837/bjc.2019.036
5. Plummer C, Michael A, Shaikh G et al. Expert recommendations on the management of hypertension in patients with ovarian and cervical cancer receiving bevacizumab in the UK. Br J Cancer 2019;121:109–16. https://dx.doi.org/10.1038/s41416-019-0481-y
6. Johnson MJ, Penmetch R. Atypical presentation of STEMI with pericardial effusion causing cardiac tamponade related to malignancy. Br J Cardiol 2019;26:159–60. https://dx.doi.org/10.5837/bjc.2019.037