Tag Archives: decision making

Dr Joanne Taylor, Manchester University Hospitals NHS Foundation Trust; University of Manchester, Manchester Academic Health Science Centre What does this study add to the debate? Warraich et al. reviewed data from 700 consecutive adults who underwent de novo bradycardia implantation (2016–2021), with a primary outcome of 12-month all-cause mortality. First, it is notable that the mean age of implantation was 78 years old. Baseline characteristics showed 45% of patients had at least mild frailty (318/700, Rockwood clinical frailty score [CFS] 5–8), and on average three to four significant comorbidities. Of those implanted, 12.4% were dead

Introduction Acute heart failure (AHF) syndromes are the leading cause of hospitalisation in patients over 65 years of age in the UK, accounting for 67,000 admissions per year.1 The immediate management of AHF focuses on symptom relief and stabilisation of the patient’s haemodynamic profile – traditionally achieved with a combination of oxygen, diuretics and nitrate therapy.1-5 Recent guidelines from the National Institute for Health and Care Excellence (NICE),1 and the European Society of Cardiology (ESC),5 have highlighted the poor-quality evidence base for many of these interventions.3,4,6 The ESC guidelines (updated in 2016) state th

Figure 1. A short-axis slice of the mid left ventricle illustrating contrast enhancement in the anterior segment (25% transmurality – viable), anterolateral segment (50–75% transmurality – non-viable), inferolateral segment (50% transmurality – potentially viable) Case 1 Mr K P is a 45-year-old man who presented to our hospital with symptoms of exertional breathlessness. His LV function was found to be severely impaired on echocardiography and it was initially thought that he had ‘dilated cardiomyopathy’. As he had a strong family history of coronary artery disease and was an ex-smoker, he underwent X-ray coronary angiography. He