Tag Archives: exercise tolerance test

Introduction Multi-detector computed tomography coronary angiography (CTCA) is becoming increasingly available in UK Hospitals. The National Institute for Health and Clinical Excellence (NICE) clinical guideline 95, released in 2010, recommended the use of calcium score ± CTCA in patients with low likelihood chest pain of recent onset.1 American College of Cardiology (ACC)/American Heart Association (AHA) appropriateness criteria for CTCA recommend its use in patients with low or intermediate likelihood chest pain.2 The rationale for the recommendations of CTCA is its excellent negative-predictive value.3 A further important point is that fu

When the dentist said: “Be still your beating heart!” Dear Sirs, We all often encounter a patient history and apparent presenting complaint that we can not precisely and cleverly explain. Our patient, Mr BW, a fit and active 53-year-old man, attended a routine appointment as an outpatient. He had done this many times previously as he was experiencing difficuties with heart rate control and troubling symptoms secondary to atrial fibrillation (AF). Coincidentally, he had also had amalgam dental fillings drilled some 18 months previously. Since then, his cardiac problems had escalated. There appeared no clear causality between the fillings a