Our study investigated the primary risk factors present in patients admitted for acute coronary syndromes. There were significant numbers of current smokers, and patients with hypertension, hyperlipidaemia and diabetes. Aggressive secondary prevention measures are recommended, and education on hospital discharge is essential.
Profiles of primary cardiovascular risk in STEMI: how do these differ between men and women?
Editorial
It is commonly accepted that nurses are better than doctors at following guideline-based protocols. Protocols have a number of benefits. They provide us with a structured approach to the consultation and added confidence in clinical management. Following a protocol also means that patients are more likely to be offered evidenced-based therapies. But familiarity with practice protocols does have its drawbacks when they have to be revised when new guidelines are published.
Taking the mystery out of peripheral arterial disease
Peripheral arterial disease (PAD) forms part of the same generalised vascular disease as coronary heart disease and cerebrovascular disease. Recent National Institute for Health and Clinical Excellence (NICE) guidelines emphasise the importance of a standardised approach in primary care. The aims of this article are to provide an update for practice nurses, and to highlight the importance of asymptomatic PAD as an independent risk factor for cardiovascular morbidity and mortality.
Get to grips with the ankle brachial pressure index
Peripheral arterial disease (PAD) has had a lower profile than other vascular diseases, but it is moving up the agenda following recent publication of guidelines from the National Institute for Health and Clinical Excellence (NICE). Take a look at NICE’s priorities for implementation, and you will see that using the ankle brachial pressure index (ABPI) to check for PAD is set to become part of routine cardiovascular risk assessment in primary care.
Fatal epistaxis: case report and review of the trigemino-cardiac reflex
The trigemino-cardiac reflex can result in potentially fatal apnoea, hypotension or dysrhythmia when thesensory branches of the trigeminal nerve located in the nasopharynx are stimulated. We report the occurrenceof this reflex, following nasal packing for epistaxis, that led to respiratory and circulatory arrest.
A patient with Lyme disease: complete heart block treated with antibiotics
British Heart Foundation – new support for practice nurses
The British Heart Foundation (BHF) is often seen as an organisation focused on patients. This is true, but along with major research, supporting healthcare professionals is also a vital part of our role. In the past we have worked mainly with specialists in secondary care, but now we are re-focusing our attention. For the first time, we are supporting primary healthcare professionals with education and training.
British Heart Foundation – New support for GPs
The British Heart Foundation (BHF) is often seen as an organisation focused on patients. This is true, but along with major research, supporting healthcare professionals is also a vital part of our role. In the past we have worked mainly with specialists in secondary care, but now we are re-focusing our attention. For the first time, we are supporting GPs and other primary healthcare professionals with education and training, and becoming involved in projects where GPs play a central role in improving patient outcomes.
Be aware: signposting acute chest pain
The Mid and South West Wales Cardiac Network (now the South Wales Cardiac Network) identified the need to devise resources to encourage patients to dial 999, safely signposting those calling into a GP practice complaining of acute chest pain to the 999 system. The resources and educational sessions were well received, with outcomes demonstrating improvements in staff confidence, backed up with the rationale and guidance, and an improvement in those directly accessing the 999 system, with the potential to receive reperfusion more quickly, preserving myocardium.
The GRANITE project: evaluating a novel cardiovascular prevention model in Scotland
Targeted case-finding for cardiovascular disease (CVD) prevention may be preferable to universal screening. Quality Improvement Scotland (QIS) has recommended that identification of high-risk individuals is needed. In this study, probable CVD risk in patients within the 40-70 years age range who were not on the CHD, Diabetes and Stroke registers and who were not already receiving statins was analysed using a predictive software toolkit which utilised the ASSIGN risk calculator. This programme effectively identified a patient population with a probable high 10-year CVD risk requiring intervention for CVD prevention after clinical assessment.
Attitudes to taking medications for cardiovascular disease prevention
Cardiovascular disease prevention is one of the main challenges facing primary care today. In order to reduce the burden of disease, national guidelines recommend that asymptomatic patients who are at high risk of cardiovascular disease should be offered preventive medications. This article discusses cardiovascular disease risk assessment, communication of this risk to patients and attitudes of both general practitioners and patients to preventive medications.
Integration of cardiac services
Prominent consequences of the Health and Social Care Act which has now passed into law will be the increased commissioning of cardiac services and changes in how they are delivered. This Act, although establishing an NHS Commissioning Board to provide commissioning guidance, intends to increase markedly GPs’ power to commission services. Monitor, the non-departmental public body, will be developed into an economic regulator to oversee access and competition within the NHS