Tag Archives: myocardial infarction

Introduction This retrospective audit was performed to assess whether patients discharged from the cardiology ward at the Queen Elizabeth Hospital, Birmingham, following ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI) were prescribed the recommended medication at appropriate doses. The evidence for the prognostic benefit of drugs such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers and statins after a myocardial infarction (MI) is derived from studies in which these drugs were used at high doses, such as Acute Infarction Ramipril Efficacy (AIRE),1 Carvedilol Post-I

A computed tomography (CT) coronary angiogram (CTA) was performed, as the patient was not keen on an invasive angiogram, and demonstrated sub-endocardial hypoattenuation at rest in the anterior wall, apex and apical inferior walls (figure 1B). It was not clear if there was any reversible ischaemia so a myocardial perfusion scintigraphy (SPECT) was performed, and demonstrated a partial thickness infarction involving the anterior wall, apex and apical inferior wall (figure 1A). A research cardiac magnetic resonance (CMR) scan demonstrated late Gadolinium enhancement in the same territories as the other two studies (figure 1C). Figure 1. A. Myoc

An extreme example is the terminally ill patient with severe central chest pain. Even if they are suffering a myocardial infarction, urgent admission may not be the best option in their care. Unnecessary referral wastes the time of both clinicians and patients. It adds to waiting times for more needy patients. Equally we could be guilty of under referral and could be providing less than perfect care for our patients. The clinician needs to ask four principle questions before referral. First: will the referral improve the accuracy of diagnosis and provide better management of the disorder? Second: have all the appropriate examinations and inve

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The authors, from the Institute for Clinical Evaluative Sciences, Toronto, Canada, note that most studies of CV outcomes associated with rosigllitzaone and rosiglitazone have been conducted in patients younger than 65 years. Diabetes is most common in older patients. They analysed information on 159,026 diabetes patients (mean age 74.7 years) being treated with an oral hypoglycaemic agent from Ontario healthcare databases. The risks of congestive heart failure, MI, and death were compared between persons treated with rosiglitazone or pioglitazone and those given other oral hypoglycaemic agent combinations, after matching and adjustment for pr

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