Tag Archives: heart failure

Professor Stephen Westaby NICE’s medical therapy is excellent, until the end game, but drugs alone have limitations.5 Inotropes worsen ischaemia, while vasopressors elevate afterload. Injured myocardium needs rest to promote recovery, not a flogging.6 Consider two real patients. A 21-year-old female with ion-channelopathy is admitted to a tertiary care centre. After 75 DC shocks and cardiac massage she is in shock. She needs extracorporeal membrane oxygenation (ECMO) circulatory support but cannot be transferred.6 She dies. A 56-year-old male with ischaemic cardiomyopathy suffers acute on chronic heart failure. Renal impairment and pulmonar

Introduction  Heart failure is a complex clinical syndrome and is the only cardiovascular disease that is increasing in prevalence.1 It has a profound impact on both the patient’s quality of life and functional capacity, as well as causing premature death.2 Traditionally, cancer patients have been the main focus for specialist palliative care services, though it is increasingly well-recognised that chronic heart failure is equivalent to malignant disease,3 with patients experiencing debilitating physical symptoms, as well as psychosocial and spiritual problems. Despite the growing recognition of the palliative care needs of this complex gr

Professor Miriam J Johnson Overcoming barriers The misunderstanding that palliative care is only for those in the last few days or weeks of life, only to be implemented once all other options are gone and irreversible deterioration is certain, forms a major barrier to access to palliative care. Attempts to identify a prognostic tool to identify when palliative care should be employed have failed, and the consensus is that a problem-based approach is more fit for purpose.11–12 Such a model would enable the “concerns of today” facing the patient to be addressed in the context of the management options appropriate at their stage of disease

Publisher: British Journal of Cardiology, 2014 Available from: https://bjcardio.co.uk/learning In September 2014 the online learning section of the British Journal of Cardiology website released a six-part series of learning modules covering heart failure. As a core medical trainee, I found that theoretical knowledge did not always translate into clinical practice and, prompted by my educational supervisor (the trust heart failure lead), I undertook the online modules to gain further insight when managing complex patients on the wards. The content of each module and continuing professional development (CPD) points allocated is outlined in ta

Introduction For patients with acute coronary syndrome (ACS) who survive to reach hospital, the majority of mortality and morbidity over the following five years occurs after discharge.1 Of all complications, development of acute heart failure (AHF) and left ventricular systolic dysfunction (LVSD) are key determinants of adverse outcome. Approximately half of patients with ACS are readmitted to hospital, constituting a profound burden on healthcare resources.1 In several healthcare systems there are financial penalties when ACS patients are readmitted within 30 days.2 Prediction of the development of AHF and hospital readmission following ACS

Introduction Occupational radiation doses in fluoroscopy-guided interventional procedures are highest among medical staff using X-rays, particularly cardiologists involved in interventional procedures.1 The danger of radiation, such as radiation-induced cataracts in operators,2 has led to a significant focus on radiation safety in the cardiac catheterisation laboratory. Garments, lead goggles, skull caps, ceiling suspended shields, curtains under the table, and other protective equipment, provide a significant reduction in occupational doses.3 It is necessary for cardiologists to wear personal dosimeters during procedures for personal safety

Introduction Heart failure (HF) costs the National Health Service (NHS) £625 million per year and accounts for 5% of all emergency medical hospital admissions in the UK.1,2 Interventions with the potential to reduce admissions and lessen this economic burden are always of clinical interest; however, any such potential for cost-avoidance must always be balanced against the financial cost of the intervention. While there is evidence to suggest that exercise training may reduce emergency admissions in HF,3,4 this research invariably focuses on training that includes a hospital-based component. Though exercising at home may offer a more practic

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National survey of patients with AF in the acute medical unit: a day in the life survey Dear Sirs, The first national survey examining the management of atrial fibrillation (AF) within acute medical units up and down the country has just been published in the British Journal of Cardiology.1 Essentially it seems to show that secondary care is just as bad as primary care in initiating warfarin for AF patients. This group of patients is five times more likely to have a thromboembolic cerebrovascular accident than matched populations in sinus rhythm and yet doctors are ineffective at influencing change. This study took place over a 24-hour period

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