Coronary heart disease

Previous coronary artery bypass graft (CABG) surgery

Keeping it in the Family: Reducing Risk in Relatives of Patients with Premature Heart Disease

In this article, we look at how a primary prevention team introduced a systematic approach to target people who had premature coronary heart disease in their family and offer them a comprehensive cardiovascular disease risk assessment.Based on the findings from the EUROACTION study, the next step was to involve their partners based on the recognition that they often share risk factors due to lifestyle.

Why is cardiac mortality higher around Christmas and New Year?

Higher cardiac mortality in the winter has long been recognised. It may be due to colder temperatures, which have been associated with depression of heart rate variability and increases in vascular resistance, coronary vasospasm, blood pressure and haemostasis. The peak in cardiac mortality around Christmas and New Year is likely to be compounded by factors that accompany the holiday season: overindulgence in food, salt and alcohol, emotional stress or depression, exposure to particulates from fireplaces, holiday-induced delays in seeking medical attention and reduced staffing of healthcare facilities. How can we help our patients to reduce their risk?

Making sense of myocardial perfusion scans (MPS)

More and more of our cardiac patients are having scans to check what is going on in their hearts. There were about 1,200 single photon emission computed tomography (SPECT) scans per million population in the UK in 2000, according to the British Nuclear Cardiology Society (BNCS) survey. The National Institute for Health and Clinical Excellence (NICE) has recommended this should increase to about 4,000 scans per million population per year, based on current revascularisation and coronary angiogram rates. This article explains what is involved in a myocardial perfusion scan (MPS), giving you the information to answer your patients’ questions.

Validating and maintaining your CHD register

Disease registers are essential for practices to optimise the diagnosis, management and follow-up of patients with a particular condition, in addition to being an important feature of the Quality and Outcomes Framework. Practices are responsible for demonstrating that they have systems in place to maintain a high-quality register. In this article, we look at a ‘recipe’ for validating a coronary heart disease (CHD) register – but the same method used for validating and maintaining the register can apply to any disease, using appropriate diagnostic and treatment information.

How to score top marks for secondary prevention of coronary heart disease

In this second article in our series on the Quality and Outcome Framework (QOF), we will discuss how to maximise points in the secondary prevention of coronary heart disease (CHD) and heart failure. This will include lipid management and smoking cessation.

How to: create and maintain a Coronary Heart Disease

The aim of the National Primary Care Development Team (NPDT) is to develop healthcare professionals who have the knowledge and skills to apply quality improvement methods to local priorities. CHD is one such priority and has been within the focus of our work for almost four years. Working in partnership with other agencies who share our priorities is essential. Janet Potts, who leads on the work of the NPDT in West Yorkshire, joined forces with Adele Graham from the CHD Collaborative in West Yorkshire, to give the strongest possible support to local primary healthcare professionals. The CHD register ‘recipe’ was devised by this partnership.

Bringing CHD management back to primary care

Managing heart failure effectively in the community Community-based nurses are at the forefront of vigorous efforts to improve the management of coronary heart disease. The Coronary Heart Disease Collaborative is spearheading 30 projects around the country to find practical ways forward. This issue reviews how Durham Dales PCT has brought the management of heart failure firmly back into primary care, with up-to-date registers of heart failure patients and regular clinics in the community.

Chest pain in Primary Care – would you and your team know what to do?

This article considers a possible scenario in primary care in which a patient presents with chest pain. Test yourself to see what you would do. Then check this against our recommendations, reflecting on your current procedures and policies within your practice.

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