This month’s double Back to Basics feature focuses on coronary artery disease and understanding the differences between stable angina, unstable angina, STEMI and NSTEMI, and their secondary prevention and management in primary care.
Back to Basics: Recognising different types of coronary artery disease 2
Back to Basics: Recognising different types of coronary artery disease 1
This month’s double Back to Basics feature focuses on coronary artery disease and understanding the differences between stable angina, unstable angina, STEMI and NSTEMI, and their secondary prevention and management in primary care.
Evaluating low-risk patients with chest pain
A local GP practice in Milton Keynes has designed a valuable tool to triage patients presenting with chest pain and to help them avoid unnecessary emergency hospital admissions. The locality has no dedicated unit, so patients require either emergency hospital admission, a referral to Rapid Access Chest Pain Clinic (RACP), cardiology outpatient clinic (OPD), or management in primary care.
Caring for patients following PCI and stents
Most people with coronary heart disease (CHD) can be managed with lifestyle change and optimal medical therapy, but some patients need revascularisation procedures such as angioplasty with stenting (percutaneous coronary intervention [PCI]). These patients spend minimal time in hospital, and GPs have an increasingly important role in follow-up to minimise the risk of adverse events, promote lifestyle change and ensure continuing adherence to medication.
Stable angina: the no tears review
Approximately 5% of adults aged over 40 years have stable angina, appear on our coronary heart disease (CHD) registers and are recalled at least annually for reviews. People with angina are often prescribed four or more regular items, and it is widely believed that patients are more likely to take their medicines effectively when they agree to their prescription and feel involved in decision-making. The medication review involves patients in prescribing decisions, and supports them in taking their medicines most effectively, so improving health outcomes and satisfaction with their care.
Back to Basics 9 – Secondary prevention for the four types of coronary artery disease
Back to Basics 8 – Recognising the four types of coronary artery disease
Back to Basics: Recognising the four types of coronary artery disease
Back to Basics: Secondary prevention for the four types of coronary artery disease
Back to Basics: Recognising the four types of coronary artery disease
Long live the difference? Why women lose out in heart health
In the UK, the last 30 years have seen a significant decline in deaths from coronary heart disease (CHD) in men, but the fall has been less significant in women. This may be because women need a different, more gender-specific approach if they are to benefit fully from recent advances in treatment.
Managing patients with recent onset chest pain: key steps
Chest pain and discomfort are common symptoms that account for 1% of visits to primary care, 5% of visits to accident and emergency departments and 25% of emergency hospital admissions. Coronary artery disease (CAD) is one of many causes of chest pain and is the commonest cause of death in the UK. However, there are treatments available that can improve symptoms and prolong life, making prompt assessment and diagnosis essential. The National Institute for Health and Clinical Excellence (NICE) has recently published a new guideline on the assessment and investigation of patients presenting with acute chest pain suggestive of acute coronary syndrome (ACS) and stable chest pain suggestive of angina. It includes recommendations that will mean some changes to the way these patients are managed in practice. This article looks at how we can put these changes into action.
