March 2024 Br J Cardiol 2024;31:31 doi:10.5837/bjc.2024.012
Ishtiaq Rahman, Cristina Ruiz Segria, Jason Trevis, Sharareh Vahabi, Richard Graham, Jeet Thambyrajah, Ralph White, Andrew Goodwin, Simon Kendall, Enoch Akowuah
Introduction Timely corrective surgery for severe mitral regurgitation (MR) reduces the risk of limiting symptoms and irreversible left ventricular dysfunction.1,2 Left untreated, severe MR carries a poor prognosis. In asymptomatic patients, the estimated five-year rates of death from any cause, death from cardiac causes and adverse cardiac events (death, heart failure or new atrial fibrillation), are 22%, 14% and 33%, respectively.2 The prognosis for symptomatic patients is significantly worse, and further adversely affected by older age and comorbidities, including atrial fibrillation, pulmonary hypertension, left atrial dilatation, and re
January 2024 Br J Cardiol 2024;31:17–22 doi:10.5837/bjc.2024.002
Hayley Birrell, Omar Fersia, Mohamed Anwar, Catherine Mondoa, Angus McFadyen, Christopher Isles
Introduction In recent years heart failure with preserved ejection fraction (HFpEF) has become a research priority, since despite having a preserved ejection fraction (EF), it is still associated with mortality and survival rates similar to heart failure with a reduced ejection fraction (HFrEF).1 Historically, the interest in HFpEF stems from the collaboration of two areas of research. Studies found that diastolic left ventricular (LV) dysfunction contributed to myocardial hypertrophy.2,3 Shortly after, HFpEF was found to be an adjunct in heart failure (HF) trials, examining the usefulness of angiotensin-converting enzyme (ACE) inhibitors in
November 2023 Br J Cardiol 2023;30:123–4 doi:10.5837/bjc.2023.036
Claire L Colebourn
The problems First: we are leaking highly skilled workforce Dr Claire Colebourn, President of the British Society of Echocardiography The experienced Band 7 echocardiographer is the lynch-pin of every UK NHS echo service, acting as trainers, on-the-ground supervisors and quality assurers. Our data show that, far from recruitment being our major issue, there is a steady drip of senior workforce leaking from the profession. Departments with a high proportion of newly qualified echocardiographers risk a gradual decline in quality without adequate senior presence, the ‘rookie factor’ is simply too high. Second: echocardiography is an advanced
June 2023 Br J Cardiol 2023;30:77–8 doi:10.5837/bjc.2023.019
Oscar M P Jolobe
Table 1. Clinical features and complications First author Symptoms / complications Pur Jn Spl SCH Os Valve Culprit pathogen Cecarelli1 Meningitis, SMA, SE Y N N N N Mitral Staph. aureus Deonarine2 Cirrhosis, CHF, spondylitis Y N N N N Quadrivalve Strep. mutans El Chami3 CHF, respiratory failure Y N N N N Aortic Enterococcus faecalis Yokota4 Mesenteric abscess Y N N N N Mitral MSSA Miridjanian5 Fever, myalgia, headache Y N Y Y N Aortic Moraxella kingae Mahmoud6 Cirrhosis, CHF, ICE Y N N N N Mitral Pasteurella multocida Tiliakes7 Polyarthralgia, ANCA+ve, splenomegaly Y N N N N Aortic Strep. viridans Messiaen8 CHF, Gln, ANC
April 2023 Br J Cardiol 2023;30:43–4 doi:10.5837/bjc.2023.010
Madalina Garbi
Dr Garbi (President, British Heart Valve Society, and Consultant Cardiologist) Capacity increase is imminently needed to meet the current demand. An immediate increase in workforce to increase capacity is not realistic, because of the national shortage of cardiac physiologists and the time needed to appropriately train them in echocardiography. Thus, the BHVS proposed an increase in capacity by reducing the time used for echocardiography when a comprehensive study is not needed. The complete description of the proposal is available on the BHVS website (https://bhvs.org/bhvs-management-of-echocardiography-requests/). The BHVS proposes the use
January 2023 Br J Cardiol 2023;30:10–1 doi:10.5837/bjc.2023.001
Ishtiaq Ali Rahman, Gopal Bhatnagar
Discussion Biomarkers have not been used routinely in clinical AS management, but recent advances look set to change this. The PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) study identified that a higher ratio of apolipoprotein B/apolipoprotein A‐I was associated with a 3.4-fold increase in haemodynamic progression in the younger (<70 years) AS cohort. The balance of atherogenic and anti-atherogenic lipid factors appears to play a crucial role in pathogenesis in younger patients,4 presenting a screening target. Regardless of symptom status, biomarkers have application in risk stratification. Systematic review
October 2022 Br J Cardiol 2022;29:158–60 doi:10.5837/bjc.2022.033
Milaras Nikias, Boli Aikaterini, Beneki Eirini, Nevras Vasilios, Zachos Panagiotis, Tsatiris Konstantinos
Introduction Takotsubo cardiomyopathy (TTCM) is an often reversible injury of the myocardium caused by catecholamine excess, usually after a stressor.1 The first case series were described by Tsuchihashi et al. three decades ago, and it was named due to the resemblance of the left ventricle (LV) in ventriculography to a Japanese pot used to catch octopuses. It usually affects post-menopausal women and has a typical form involving the mid and apical segments of the LV (apical ballooning), and atypical forms (mid, basal and focal TTCM).2 Mid-ventricular TTCM is a rare variant that affects the mid-segments of the LV, and accounts for 14.6% of pa
July 2021 Br J Cardiol 2021;28:115–6 doi:10.5837/bjc.2021.033
Fraser J Graham, Shona M M Jenkins
Presentation A 52-year-old woman with a background of alpha-1-antitrypsin deficiency and severe emphysema underwent transthoracic echocardiography (TTE) that demonstrated an apparent right atrial mass adhering to the inter-atrial septum. She was referred for transoesophageal echo (TOE) to investigate further. Additionally, she had been noted to desaturate on exercise, raising the possibility of intra-cardiac shunting. She was thus also referred for saline-bubble contrast TTE. Figure 1. Transthoracic echocardiography immediately following transoesophogeal echocardiogram. Apical four-chamber view at end-diastole demonstrating normal left ventri
January 2019 Br J Cardiol 2019;26:27–30 doi:10.5837/bjc.2019.004
Alexander J Gibbs, Andrew Potter
Introduction Palpitations are a common reason for presentation to the emergency department (ED),1,2 and can be extremely concerning to the patient and doctor. In the ED, clinical history, examination and basic investigations (including an electrocardiogram [ECG]) at the time of presentation often cannot elicit the cause for the symptoms. After ensuring that there is no acute rhythm disturbance necessitating a hospital admission, patients are routinely discharged back to their primary care doctor with advice for referral to a cardiology outpatient service for prolonged ECG recording and echocardiogram, as per National Institute for Health and
March 2017 Br J Cardiol 2017;24:8
Priya Margaret Joseph
Publisher: CRC Press, Taylor and Francis Group 2015 ISBN: 978-1-4822-3192-2 Price: £27.99 Echocardiography is considered to be the only one diagnostic tool that allows live assessment of a beating heart, either cardiac function or valvular function as well as morphologic evaluation. It is therefore one of the most widely used first-line cardiac diagnostic tools for both cardiac and non-cardiac clinicians. This book, by authors among the most experienced echocardiographers provides an up-to-date and clear overview for how to report and interpret echocardiograms. With the straightforward approach, this book sets out to make an echo report in
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