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March 2005 Br J Cardiol 2005;12:139-41

A brief report on the data available on rapid access cardiology clinics

Rapid Access Cardiology Clinics were introduced many years ago for the assessment of chest pain. Following the publication of the National Service Framework (NSF) for Coronary Heart Disease (CHD)1 the number of rapid access chest pain clinics (RACPCs) has expanded dramatically. Standard 8 of the NSF for CHD describes the use of chest pain clinics to provide specialist advice to people with symptoms of angina or suspected angina. One of the goals of the NSF was that there should be at least 100 RACPCs in the UK by April 2002. This goal has been superseded. More recently, rapid access clinics have also been introduced for the assessment of suspected cases of heart failure and cardiac arrhythmias. While the concept is that a prompt ‘one-stop’ assessment provides care that is clinically superior to traditional services in a cost-effective manner, there are few data describing outcomes of the patients seen in these services. In this report, we review the available evidence on rapid cardiology services....

September 2004 Br J Cardiol 2004;11:399-02

Community echocardiography for heart failure

A consensus statement from representatives of the British Society of Echocardiography, the British Heart Failure Society, the Coronary Heart Disease Collaborative and the Primary Care Cardiovascular Society....

September 2004 Br J Cardiol 2004;11:369-75

The prevalence and natural history of anaemia in an optimally treated heart failure population

The prevalence of anaemia in heart failure (HF) is becoming better recognised, yet little is known about its natural history in a HF population. We examined the records of 200 consecutive patients who were admitted to our service with New York Heart Association (NYHA) class IV HF, survived and were followed for six months following discharge. Complete records were available on 120 patients. Anaemia was defined as a haemoglobin concentration of < 13 g/dL in males and < 12 g/dL in females. Forty-one patients (34%) were found to have anaemia of unknown cause on admission. At follow-up (mean time 6.1+0.3 months), 28 patients were persistently anaemic. The haemoglobin concentration in the remaining 13 had returned to normal. A further group of 11 patients had become anaemic during the six-month follow-up period. All patients had been treated with maximally tolerated medical therapy. Anaemia was found to be equally prevalent in patients with preserved systolic function HF. Factors found to be independently associated with lower haemoglobin at follow-up were female sex, a history of gastrointestinal disease, inflammatory disease and a low glomerular filtration rate (GFR). Haemoglobin concentration at follow-up was found, on univariate analysis, to be associated with an increased risk of a HF-related admission during the follow-up period and increased severity of HF symptoms. On multivariate analysis, haemoglobin concentration at follow-up was found to be an independent predictor of NYHA class III–IV symptoms. In conclusion, anaemia is prevalent in a population admitted with class IV failure. While the haemoglobin concentration had normalised in a significant number of patients during follow-up, the presence of anaemia six months after discharge was associated with having a HF-related readmission and independently associated with moderate-to-severe HF symptoms....

March 2004 Br J Cardiol 2004;11:106-11

Improving secondary prevention of coronary heart disease: using the new GP contract to drive change

This is the final article in a series examining how the Coronary Heart Disease Collaborative (CHDC) supports clinical teams to improve services for coronary heart disease. The focus in this issue is on secondary prevention services....

January 2004 Br J Cardiol 2004;11:24-6

Cardiac surgery – improvement along the patient pathway

We continue our series on the work of the Coronary Heart Disease Collaborative (CHDC), which is part of the NHS Modernisation Agency. In this issue the CHDC looks at how its teams are helping improve services for patients undergoing cardiac surgery....

November 2003 Br J Cardiol 2003;10:450-2

Non-surgical aortic valve replacement

Percutaneous aortic valve replacement, a new technique developed to overcome the problem of restenosis of the native valve in patients treated with balloon aortic valvuloplasty. It describes the first four cases which have been undertaken using this new technique that show the potential for its development for more widespread use in the future. ...

November 2003 Br J Cardiol 2003;10:446-9

The angina journey: a major challenge in cardiology

Patients with suspected angina pectoris pose a major challenge to all levels of cardiology services. Their pathway through their NHS care can involve many stages over many years – figure 1 shows this hypothetical journey. ...

July 2003 Br J Cardiol 2003;10:269-71

Better care without delay: cardiac rehabilitation

Cardiac rehabilitation received full support in the National Service Framework (NSF) for Coronary Heart Disease (CHD). ...

May 2003 Br J Cardiol 2003;10:189-92

Better care without delay: heart failure

Better care without delay: heart failure Coronary Heart Disease Collaborative Heart failure is a subject that is equally challenging to primary and secondary care physicians but in different ways. These challenges, however, are different faces of the same problem but their presentation can lead to confusion and anxiety among some doctors treating heart failure patients. We continue our series on the Coronary Heart Disease Collaborative (CHDC) and turn our focus in this issue to its work in helping clinical teams improve heart failure services across the country....

March 2003 Br J Cardiol 2003;10:101-4

Better care without delay: acute myocardial infarction

Exploring how the CHD Collaborative is helping clinical teams across the country achieve clear improvements in services for patients with coronary heart disease. Each article will focus on one of the Collaborative’s six project areas (seen in the heart right). Here, national clinical leads and other Collaborative staff, who have a particular interest in the acute myocardial infarction pathway, report on some of the work that has been done so far....


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