Tag Archives: angina

Introduction Undifferentiated chest pain places a significant burden on the UK National Health Service (NHS). Up to 50% of the general population experiences chest pain in their lifetime contributing to at least 1% of GP consultations and 5% of accident and emergency (A&E) attendances.1 Chest pain patients have a twofold higher mortality versus age-matched asymptomatic controls.1 One reason is undiagnosed obstructive coronary artery disease (CAD), which has effective treatments to prolong life and improve symptoms.1 The challenge is identifying the patients at greatest risk, providing a timely diagnosis and starting effective treatment. T

Dear Sirs, Statistical probabilistic reasoning is important in understanding the likelihood of ‘false-positive’ (FP) and ‘false negative’ (FN) results when requesting any diagnostic test. In cohorts with a low prevalence of disease, a significant number of positive results are likely to be FP. Conversely, when the disease has high prevalence, FN results increase. Identification of patients with suspected coronary artery disease (CAD) relies on clinical history, examination and electrocardiogram (ECG)/laboratory results. The National Institute for Health and Care Excellence (NICE) define angina as “typical” or “atypical” depend

Introduction Approximately 4.2 million people (7.5% of population), whose racial origins are from South Asia, live in the UK. High rates of coronary disease in Asians,1-4 seem likely to be influenced by genetic factors.5 We have previously reported differences in the presentation of coronary syndromes between British South Asians, as a whole, and white Europeans.6 The term ‘South Asian’ describes around 1.5 billion people (22.5% of the world’s population), occupying regions as diverse as Sri Lanka to Nepal. A wide variety of genotypes, cultures, diets, belief systems, educational attainment, socioeconomic status and risk factors are enc

Coronary heart disease is responsible for one sixth of UK deaths. Improvements in making an earlier diagnosis and more effective management have aided a reduction in mortality over the last two decades. Such improvements would not have been possible without well thought-out and carefully constructed guidance and teaching programmes. With the spread of internet technology, online medical education has seen an exponential growth in popularity. The British Journal of Cardiology (BJC) has recently launched its e-learning site BJC Learning and its first e-learning programme on angina (www.bjcardio.co.uk/learning). The angina e-learning programme

Introduction Angina is the most common presentation of coronary heart disease (CHD).1 Effective treatment requires appropriate medical care, but also patient participation in lifestyle changes and medication concordance. Patient understanding of their disease and its treatment is desirable to enhance patient participation. Angina may be treated with medication only, through percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). Although there are some circumstances where there is a preferred treatment option, research increasingly shows that in many situations the different treatment options for angina have similar

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The Euro Heart Survey documented considerable variation in the management of patients with new-onset stable angina, due in part to uncertainties about the prognostic impact of both drug treatment and revascularisation. These uncertainties were inevitable given that much of the evidence used to guide management was incomplete and out of date. There have been further developments since the European Society of Cardiology guidelines on angina were published in 2006: these include better understanding of the efficacy and role of newer agents such as ivabradine and ranolazine, better understanding of secondary prevention measures, and refinements i

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The new guideline from the National Institute for Health and Clinical Excellence (NICE)1 covers adults who have been diagnosed with stable angina due to atherosclerotic disease, following on from clinical guideline 95,2 which advises on diagnosis of chest pain of recent onset. A key priority for implementation in the latest guidance is to ensure that people with stable angina receive balanced information and have the opportunity to discuss the benefits, limitations and risks of their treatment. Initial management of stable angina should be to offer optimal drug treatment, addressing both the angina itself and secondary prevention of cardiovas

The objective of this study was to look at how well patients with coronary artery disease are managed, and whether community-based angina clinics might be an alternative, or even more beneficial, to these patients compared with hospital-based clinics. Patients with coronary artery disease need regular follow-ups to review their lifestyle and medications, and to ensure angina symptoms are well controlled. Heart rates should be checked regularly as high heart rate is associated with increased risk of myocardial ischaemia. In this study, 41 patients with coronary artery disease were assessed at a community-based angina clinic. Our results showe