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Found 127 results
  1. Content Article
    More women than men die annually from ischaemic heart disease (IHD) in the developed world. This represents a reversal of fortune from previous decades and places women firmly as the new majority now impacted. Notably, the adverse IHD gender gap is the widest in relatively young women, where myocardial infarction (MI) mortality is 2-fold higher in women under 50 years compared with age-matched men. While it is now clear that there are many gender differences in IHD outcomes, including more frequent angina diagnosis, more office visits, more avoidable hospitalisations, higher MI mortality, and higher rates of heart failure in women compared with men, the aetiologies contributing to these differences are less clear.
  2. News Article
    Around 5000 fewer people were admitted to hospitals in England for acute coronary syndrome than expected from January to the end of May this year, an analysis has shown. The results, published in the Lancet, indicate that many patients have missed out on lifesaving treatments during the COVID-19 outbreak. This decline started before the UK lockdown began on 23 March and “was qualitatively similar throughout the country, with only minor variations … in different demographic groups,” the authors wrote. Among patients admitted to hospital with acute myocardial infarction there was a “sustained increase in the proportion ... receiving [a percutaneous coronary intervention (PCI) for acute myocardial infarction] on the day of admission and a continued reduction in the median length of stay,” they added. “The reduced number of admissions … is likely to have resulted in increases in out-of-hospital deaths and long-term complications of myocardial infarction and missed opportunities to offer secondary prevention treatment for patients with coronary heart disease,” they concluded. Read full story Source: BMJ, 15 July 2020
  3. Content Article
    The perspective of Megha Prasad, a New York cardiologist leading a COVID-19 infections disease service, discusses leadership qualities of being available, communication, adaptability, humility and gratitude as key to effective leadership during challenging times.
  4. Content Article
    COVID-19 rehabilitation will improve exercise tolerance, muscle strength, and help patients manage breathlessness, and potentially allow someone to be discharged earlier. The treatments in this guide, produced by Liverpool Heart and Chest Hospital, focus on breathing, functional and physical exercises. Only complete exercises at home and in hospital that have been discussed with a clinician.
  5. News Article
    The postponement of tens of thousands of hospital procedures is putting the lives of people with long-term heart conditions at risk, according to the British Heart Foundation. The coronavirus pandemic has created a backlog which would only get larger as patients waited for care, it said. People with heart disease are at increased risk of serious illness with COVID-19, and some are shielding. The BHF estimates that 28,000 procedures have been delayed in England since the outbreak of coronavirus in the UK. These are planned hospital procedures, including the implanting of pacemakers or stents, widening blocked arteries to the heart, and tests to diagnose heart problems. People now waiting for new appointments would already have been waiting for treatment when the lockdown started, the charity said, as it urged the NHS to support people with heart conditions "in a safe way". Read full story Source: 5 June 2020
  6. Content Article
    COVID-19 is an illness that can affect your lungs and other parts of the respiratory system. The main symptoms of the disease are fever, cough, and shortness of breath. Most people will have mild symptoms and recover without having to go to the hospital, but the virus can cause severe illness with complications such as pneumonia and even death. People who are at higher risk of these complications include those with heart disease, lung disease, and those who are older than 65. People with high blood pressure also appear to be at higher risk, according to early research from China. More research is needed to understand whether high blood pressure alone increases risk. CardioSmart (Amercian College of Cardiology) have put together resources and updates about how COVID-19 affects patients with heart conditions. 
  7. News Article
    The coronavirus crisis has led to a sharp rise in the number of seriously ill people dying at home because they are reluctant to call for an ambulance, doctors and paramedics have warned. Minutes of a remote meeting held by London A&E chiefs last week obtained by the Guardian reveal that dozens more people than usual are dying at home of a cardiac arrest – potentially related to coronavirus – each day before ambulance crews can reach them. And as the chair of the Royal College of GPs said that doctors were noticing a spike in the number of people dying at home, paramedics across the country said in interviews that they were attending more calls where patients were dead when they arrived. The minutes also reveal acute concern among senior medics that seriously ill patients are not going to A&E or dialling 999 because they are afraid or do not wish to be a burden. “People don’t want to go near hospital,” the document said. “As a result salvageable conditions are not being treated.” Read full story Source: The Guardian, 16 April 2020
  8. News Article
    Healthcare staff in the West Midlands have been told not to start chest compressions or ventilation in patients who are in cardiac arrest if they have suspected or diagnosed covid-19 unless they are in the emergency department and staff are wearing full personal protective equipment (PPE). The guidance from the University Hospitals Birmingham NHS Foundation Trust says that patients in cardiac arrest outside the emergency department can be given defibrillator treatment if they have a “shockable” rhythm. But if this fails to restart the heart “further resuscitation is futile,” it says. If a patient with suspected covid-19 is in cardiac arrest they should be given cardiac compressions and be ventilated only if they are in the emergency department and the person attending them is wearing aerosol generating procedures (AGP) PPE. That means wearing an FFP3 mask, full gown with long sleeves, gloves, and eye protection. The advice rests on the premise that performing cardiac compressions risks virus particles being released into the air that could infect staff. Read full story Source: BMJ, 29 March 2020
  9. Content Article
    Blog from Ken Spearpoint on the aerosol generating procedures in cardiopulmonary resuscitation in Covid-19 patients. Ken is a Lecturer in Post Graduate Medicine at the University of Hertfordshire and critical care nurse for the match day medical team at Millwall FC,
  10. Content Article
    The president of the Vascular Society of Great Britain and Ireland, Chris Imray, has issued a letter to Vascular Society members on the COVID-19 virus and vascular surgery, offering “general principles” on vascular patients and COVID-19, elective surgery and outpatients, urgent vascular surgery, trainees, other specialities, the appropriate use of scarce resources, documentation, personal safety, mental health and burnout, research, clinical training/education, and audit. Imray stresses that “local decision making is key.
  11. News Article
    The number of heart and lung transplants could quadruple thanks to a "reanimation" machine used in a pioneering operation, a hospital says. The device, developed at Royal Papworth Hospital in Cambridge, managed to pump oxygenated blood into both organs in a world-first procedure. The machine can revitalise deteriorating organs allowing "donation after circulatory death" (DCD). Hospital surgeon Pedro Catarino said it was like "recharging the batteries". "It is reanimation and then it replenishes the energy stores of the heart, what we call reconditioning, which allows it be transplanted," he said. "We think it could at least double and perhaps quadruple the number of [heart and lungs] available for transplant." He said it was desperately needed, adding: "Patients die on the waiting list every day." Read full story Source: BBC News, 23 March 2020
  12. News Article
    MedStar Health launched a new tool that automatically calculates a patient's risk of having a heart attack or stroke within 10 years. The tool enables doctors to more easily show patients their personal risk for heart disease, stroke and other cardiovascular diseases over time using easy-to-read graphics. "Seeing their risk on a visual display is more powerful than me telling them their risk,” said Ankit Shah, Director, Sports and Performance Cardiology for the MedStar Heart & Vascular Institute at Union Memorial Hospital in Baltimore. The tool is embedded in MedStar's Cerner electronic health record (EHR), making it easier for physicians to use it during patient visits, health system officials said. The project highlights how MedStar Health National Center for Human Factors focuses on human factor design to improve technology for patients as well as providers. Final rules from the US Department of Health and Human Services (HHS) will make it easier in the future for patients to share their health data with third-party apps. Read full story Source: FierceHealthcare, 9 March 2020
  13. News Article
    There is significant variation in ambulance response times to patients with serious conditions such as suspected strokes or heart attacks, which is not fully explained by how rural an area is, an HSJ analysis has revealed. The exclusive analysis represents the first time ambulance performance for category two calls, which have an 18-minute response time target, have been broken down to clinical commissioning group level. Category two, known as emergency calls, covers a wide range of conditions, including suspected stroke and heart attacks (except cardiac arrests), major burns and epileptic seizures. They account for well over half of ambulance responses. The findings — described as “alarming” by the Stroke Association — lay bare the incredibly long waits which are usually hidden, because average waiting time data is usually published for ambulance trusts, which cover far larger areas than CCGs. Mark MacDonald, Deputy Director of Policy at the Stroke Association, said: “It is alarming to hear that in some cases ambulance staff are taking over an hour to reach patients because when it comes to stroke, being assessed quickly and then, if necessary, transferred to hospital, is really important.” Read full story (paywalled) Source: HSJ, 5 March 2020
  14. Content Article
    The Royal College of Anaesthetists (RCoA) and the Difficult Airway Society (DAS) have collaborated to create the video resource Capnography: No Trace = Wrong Place.  Presented by Professor Tim Cook, the video shares the important message that during cardiac arrest, if a capnography trace is completely flat, oesophogeal intubation should be assumed until proven otherwise. 
  15. News Article
    Up to half of all patients who suffer an acute aortic dissection may die before reaching crucial specialist care, according to a new Healthcare Safety Investigation Branch (HSIB) report. The report highlights the difficulty which can face hospital staff in recognising acute aortic dissection. The investigation was triggered by the case of Richard, a fit and healthy 54-year old man, who arrived at his local emergency department by ambulance after experiencing chest pain and nausea during exercise. It took four hours before the diagnosis of an acute aortic dissection was made, and he spent a further hour waiting for the results of a CT scan. Although Richard was then transferred urgently by ambulance to the nearest specialist care centre, he sadly died during the journey. The report has identified a number of risks in the diagnostic process which might result in the condition being missed. These include aortic dissection not being suspected because patients can initially appear quite well or because symptoms might be attributed to a heart or lung condition. It also highlighted that, once the diagnosis is suspected, an urgent CT scan is required to confirm that an acute aortic dissection is present. Gareth Owens, Chair of the national patient association Aortic Dissection Awareness UK & Ireland, welcomed the publication of HSIB’s report, saying: “HSIB’s investigation and report have highlighted that timely, accurate recognition of acute Aortic Dissection is a national patient safety issue. This is exactly what patients and bereaved relatives having been telling the NHS, Government and the Royal College of Emergency Medicine for several years." Read full story Source: HSIB, 23 January 2020
  16. Content Article
    The aorta is the largest artery in the body. Acute dissection occurs when a spontaneous tear allows blood to flow between the layers of the wall of the aorta, which may then rupture with catastrophic consequences. There are about 2,500 cases per year in England, with around 50% of patients dying before they reach a specialist centre for care and 20-30% of patients dying before they reach any hospital. This Healthcare Safety Investigation Branch (HSIB) report highlights the difficulty which can face hospital staff in recognising acute aortic dissection. Although sudden severe chest or back pain is the most common symptom, the picture can vary or mimic other conditions, which may lead to an incorrect diagnosis or delays in recognising a life-threatening condition which needs urgent treatment.
  17. Content Article
    In this blog, published by Physician-Patient Alliance for Health & Safety, Drs. Nidhi Madan and Annabelle Volgman discuss why early detection of atrial fibrillation can lead to a significant reduction of morbidity and mortality.
  18. News Article
    European clinical guidelines on how to treat a major form of heart disease are under review following a BBC Newsnight investigation. Europe's professional body for heart surgeons has withdrawn support for the guidelines, saying it was "a matter of serious concern" that some patients may have had the wrong advice. Guidelines recommended both stents and heart surgery for low-risk patients, but trial data leaked to Newsnight raises doubts about this conclusion. Thousands of people in the UK and hundreds of thousands worldwide will be treated for left main coronary artery disease each year. This is a narrowing of one of the main arteries in the heart. The guidelines on how to treat it were largely based on a three-year trial to compare whether heart surgery or stents – a tiny tube inserted into a blocked blood vessel to keep it open – was more effective. The trial called Excel started in 2010 and was sponsored by big US stent maker, Abbott. Led by US doctor Gregg Stone, the study and aimed to recruit 2,000 patients. Half were given stents and the other half open heart surgery. Success of the treatments was measured by adding together the number of patients that had heart attacks, strokes, or had died. The research team used an unusual definition of a heart attack, but had said that they would also publish data for the more common "Universal" definition of a heart attack alongside it. There is debate around which is a better measure and the investigators stand by their choice. In 2016, the results of the trial for patients three years after their treatments were published in the New England Journal of Medicine. The article concluded stents and heart surgery were equally effective for people with left main coronary artery disease. But researchers had failed to publish data for the common, "Universal" definition of a heart attack. Newsnight has seen that unpublished data and it shows that under the universal definition, patients in the trial that had received stents had 80% more heart attacks than those who had open heart surgery. The lead researchers on the trial have told Newsnight that this is "fake information". But Newsnight has spoken to experts who say they believe the data is credible. Read full story Source: BBC News, 9 December 2019
  19. Content Article
    Effective teamwork is critical to successful outcomes in pediatric cardiac surgery. Unfortunately, lapses in professional performance and conduct by those who treat paediatric cardiac patients pose threats to quality and safety. One hallmark of a profession is self regulation. Therefore, healthcare leaders need specific means for identifying and addressing those lapses and indicators of unsafe systems or individuals. This article from Pichert et al. describes an initial “near miss” event involving a paediatric cardiac surgeon. While fictional, the case represents a composite of events involving several paediatric cardiac surgeons who practice at different medical centers throughout the US.
  20. Content Article
    Following the inquest into the death of former patient Amy Allan and the subsequent Preventing Future Deaths report given to Great Ormond Street Hospital for Children, Chief Executive Matthew Shaw would like to outline how the hospital is learning from this and what action has been taken to address the concerns that have been raised.
  21. Content Article
    This investigation was prompted by evidence given to the Bristol Royal Infirmary Inquiry which spoke of the benefits of retaining hearts for the purpose of study and teaching and identified Alder Hey as holding the largest collection. Previously, the Director of the Association of Community Health Councils had expressed concerns about contraventions of the Human Tissue Act 1961 to the then Secretary of State for Health.
  22. Content Article
    The PatientSafe Network is a registered non for profit charity in Australia. It has been developed by front line healthcare staff and is for anyone who wants to improve patient safety. Their combined commitment is to improve patient safety through the transparent review of medical mistakes and the generation of transparent networked projects. Hundreds of patients die every year from avoidable central line related air emboli. This animation explains what air emboli are and how they may be avoided.
  23. Content Article
    This case story highlights the missed opportunities that could have prevented a cardiac arrest and subsequent severe hypoxic brain injury in an intensive care patient. 
  24. Content Article
    Nationally, it is estimated that nearly 1.4 million people in the UK are affected by atrial fibrillation (AF), and a quarter of these people are unaware that they have AF. AF causes an irregular or abnormally fast heart rate. It increases the risk of stroke by up to five times, with about 12,500 strokes per year directly attributed to AF. Recognising and receiving proper treatment for AF is important because the strokes due to AF are often more severe, with a survival rate of only 50 per cent and a risk of increased disability among those who do survive, compared to those who have a non-AF related stroke. At the age of 40, we all have a one in four lifetime risk of developing AF. Eleven AHSNs have contributed to the detection of 365 patients with undiagnosed atrial fibrillation, in one year. This means that the equivalent of one stroke per day has been prevented by this work, saving lives, reducing disability, and saving almost £8.5 million to the NHS and social care.
  25. Content Article
    Getting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings.
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