Tag Archives: history

Professor John B Chambers Introduction Aortic stenosis (AS) is the most common type of primary heart valve disease in industrialised countries. Although echocardiography is key for its assessment, the need for surgery is most frequently dictated by symptoms.1 However, the history can be surprisingly elusive, and physicians without specialist competencies in valve disease may miss their onset.2 This is important because the risk of death is approximately 1% per annum without symptoms but 4% in the first three months after the onset of symptoms,3 usually before the patient has time to contact their physician (figure 1). It then rises up to 14%

Two recent, but completely separate instances, prompted me to produce the paragraphs below. The first was National Institute for Health and Clinical Excellence (NICE) guidance covering the management of patients with recent onset chest pain. As a cardiologist with more years of experience than I would wish to count, this will, of course, prove to be most helpful in the interpretation of the symptom complex with which our patients present. The second, and probably more pertinent, was a tutorial I was delivering (sic) to a small group of medical students about the clerking of cardiac patients. It dawned on me that the ease with which we chat to

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