Tag Archives: angina

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New editorial board member We are delighted to welcome Steve Parry to our editorial board. Steve is a Senior Lecturer at Newcastle University’s Institute for Ageing and Health and Consultant Physician in Acute Medicine and Geriatrics at Newcastle’s Royal Victoria Infirmary. His clinical and research interests lie in syncope and falls, with particular expertise in the cardiovascular causes of the latter. He has published widely on these problems, is Chair of the British Geriatrics Society Cardiovascular Section, co-author of the European Society of Cardiology 2009 Syncope Guidelines and a member of the national Chapter 8 (CHD National Serv

Lessons Both patients and doctors can learn from this study. Patients need to be better informed about the natural history of coronary heart disease and what can be done to try to alter it – that is control not cure. Patients also need to understand the limitations of pharmaceutical agents and what revascularisation strategies can realistically achieve in the short and long term. In particular, over-optimistic pre-operative expectations1 need to be tempered with a dose of reality – the TV soaps and tabloid newspapers and magazines may be partly responsible – but more detailed explanation prior to intervention would not go amiss. Doctors

Prevention In the opening session on prevention strategies, Dr Brendan Lloyd, Medical Director, Cardiff Local Health Board commented that these must be carefully chosen based on the evidence and focused towards those most likely to show the most benefit, ie. higher risk patients. However, as Dr Phil Webb, All Wales Specialist Commissioner of Cardiothoracic Services pointed out, without an appreciation of the spectrum of decisions that influence healthcare managers, clinicians cannot begin to understand their reasoning. Dr Terry McCormack, a Whitby GP and PCCS Chairman, showed that, according to national statistics, coronary heart disease (CHD

Introduction It has been estimated that about two million people in the UK experience the painful and debilitating symptoms of angina – one million men and more than 920,000 women.1 About 17% of men and 8% of women aged 65–74 have been diagnosed with angina at some point in their lives2 and there are about 338,000 new cases of angina each year.1 Not only does angina pose a considerable burden on patients and their carers, it also represents a significant financial burden, costing the National Health Service (NHS) about £700 million each year.3 Alongside the physical trauma of symptoms experienced by patients, angina also detrimentally af

Introduction An elevated heart rate may be a primary determinant of myocardial ischaemia by altering the balance of oxygen demand and coronary perfusion. Given that there is considerable evidence showing survival is inversely related to heart rate, lowering heart rate would be expected to be an important tool in the management of angina.1-3 Theoretically it may also be beneficial in the prevention of myocardial infarction as the haemodynamic stresses placed upon the myocardium by a high heart rate are associated with coronary plaque rupture.4 Approaches to lowering heart rate include the use of beta blockers and certain calcium channel blocke

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