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Showing results for tags 'Medicine - Cardiology'.
Found 127 results
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Content ArticleThis study in Nature Medicine aimed to characterise post-acute cardiovascular manifestations of Covid-19 that had not yet been comprehensively researched. The authors used national healthcare databases from the US Department of Veterans Affairs to build a cohort of 153,760 individuals with Covid-19, as well as two sets of control cohorts with 5,637,647 (contemporary controls) and 5,859,411 (historical controls) individuals, to estimate risks and one-year burdens of a set of pre-specified cardiovascular outcomes. The study demonstrated that, following the initial 30 days after infection, individuals with Covid-19 are at increased risk of incident cardiovascular disease, including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease. These risks were evident even among individuals who were not hospitalised during the acute phase of the infection and increased in a graded fashion according to the care setting during the acute phase (non-hospitalised, hospitalised and admitted to intensive care). The authors conclude the risk and one-year burden of cardiovascular disease in survivors of acute Covid-19 are substantial, and that pathways should include attention to cardiovascular health and disease.
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Content ArticlePulmonary arterial hypertension (PAH) is a rare disease characterised by pulmonary vascular remodelling and elevated pulmonary pressure, which eventually leads to right heart failure and death. Registries worldwide have noted a female predominance of the disease, spurring particular interest in hormonal involvement in the disease pathobiology. Several experimental models have shown both protective and deleterious effects of oestrogens, suggesting that complex mechanisms participate in PAH pathogenesis. In fact, oestrogen metabolites as well as receptors and enzymes implicated in oestrogen signalling pathways and associated conditions such as BMPR2 mutation contribute to PAH penetrance more specifically in women. Conversely, females have better right ventricular function, translating to a better prognosis. Along with right ventricular adaptation, women tend to respond to PAH treatment differently from men. As some young women suffer from PAH, contraception is of particular importance, considering that pregnancy in patients with PAH is strongly discouraged due to high risk of death. When contraception measures fail, pregnant women need a multidisciplinary team-based approach. This article from Cheron et al. aims to review epidemiology, mechanisms underlying the higher female predominance, but better prognosis and the intricacies in management of women affected by PAH.
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Content ArticleThe aim of this study from Mahadevan et al. was to understand human factors (HF) contributing to disturbances during invasive cardiac procedures, including frequency and nature of distractions, and assessment of operator workload. They observed 194 cardiac procedures in three adult cardiac catheterisation laboratories over 6 weeks. The study found that fewer than half of all procedures were completed without interruption/distraction. The majority were unnecessary and without relation to the case or list. The authors propose the introduction of a ‘sterile cockpit’ environment within catheter laboratories, as adapted from aviation and used in surgical operating theatres, to minimise non-emergent interruptions and disturbances, to improve operator conditions and overall patient safety.
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Content ArticleGetting 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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Content Article
Think Aorta
PatientSafetyLearning Team posted an article in Improving patient safety
Think Aorta is a global campaign focused on the problem of misdiagnosis and delay in acute aortic dissection. It was created and is led by Aortic Dissection Awareness UK & Ireland. Think Aorta provides free, accredited learning resources for emergency medicine and radiology teams and for first responders, improving their ability to spot a time-critical, life-threatening aortic dissection and take appropriate action. -
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The Aortic Dissection Charitable Trust
PatientSafetyLearning Team posted an article in Improving patient safety
The Aortic Dissection Charitable Trust aims to improve the diagnosis of aortic dissection and bring consistency of treatment across the whole patient pathway. They accomplish this through: Increased access to education for medical professionals and patients in the UK & Ireland Working with those responsible for Healthcare policy in the UK & Ireland to ensure that there is consistency in the provision of diagnosis for acute aortic dissection, specialised follow-up for survivors and access to clinical genetics for relatives Promoting funding for medical research into the detection, prevention, treatment and cure of aortic dissection. Follow the link below to access their resources. -
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Prevention of future deaths report – Paul Sartori
PatientSafetyLearning Team posted an article in Coroner reports
Paul Satori died as a result of a dissecting aortic aneurysm following a misdiagnosis, and being discharged from hospital. -
Content ArticleS. Dorothy Smith instinctively knew that something was wrong with her daughter Katiana, but was dismissed as a hysterical first-time mum who just couldn't cope with normal newborn crying. She wrote a guest post for the Hysterical Women website, which can be accessed via the link below.
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Content ArticleTelemetry monitoring of heart rates and rhythms was introduced in intensive care units in the 1960s, and since then it has expanded into patient rooms and units in noncritical care settings. It allows healthcare workers to watch the condition of many patients all at once and intervene quickly when their condition changes; however, if the technology is not used appropriately or the equipment malfunctions, relying on telemetry monitoring also risks patient harm. This study from Kukielka et al. looked at real-life cases of breakdowns in the processes and procedures regarding telemetry monitoring, such as user errors and miscommunication, and equipment failures, including broken transmitters and dead batteries. The lessons learned can help improve training and best practices to improve the safety of patients being monitored.
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Prevention of Future Deaths report – Ann Geraghty
Patient Safety Learning posted an article in Coroner reports
Ann Geraghty was being treated for heart failure at Good Hope Hospital and subsequently died following a cardiac arrest. In their report, the Coroner raised patient safety concerns relating to two periods of ventricular standstill (this is a rare issue when the heart stops beating and stands perfectly still), which were missed due to a combination of policy, staffing, workplace and equipment issues. -
Content ArticleThis report summarises some of the key findings from the full 2020 National Cardiac Audit Programme (NCAP). It provides useful background information and highlights what you can do to help improve cardiac health for you and your friends and family. It includes answers to some frequently asked questions and links to where to go for more information or support.
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Content ArticleThis research was conducted with the aim to reduce the number of poor outcomes for surgical patients with a National Early Warning Score (NEWS) score ≥7 in the author's institution by 50%. Results found that the introduction of the surgical safety huddle supported by the deteriorating patient response team reduced the number of cardiac arrests and poor outcomes in a surgical inpatient cohort.
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Content ArticlePast research, some dating as far back as 1990 has highlighted a number of inaccuracies in readings when measuring oxygen levels in ethnic minorities. Especially now with the outbreak of coronavirus, further assessment is needed to ensure accurate measurements are being taken. The NHS Race and Health Observatory is now calling for further action and research alongside a rapid review includes a series of recommendations for national healthcare, regulatory and research bodies.
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Content ArticleHealthcare Safety Investigation Branch (HSIB) looked into the suitability of equipment and technology used within maternity departments to conduct continuous fetal heart rate monitoring during labour and birth. Although there are multiple methods used to monitor fetal heart rate, the main equipment used is a continuous fetal heart rate monitoring is the cardiotocograph (CTG) machine. There has been some common safety issues identified with availability of equipment and functionality, staff understanding of the equipment and its purpose and an inability to understand and interpret the fetal heart rate. HSIB conducted an investigation into how cardiograph machines are used, any problems staff experienced while using them and problems that staff using them and how the equipment was purchased experienced, and how staff are trained and assessed as being competent to use them.
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Content Article
Prehabilitation (November 2019)
Patient-Safety-Learning posted an article in Surgery
Durrand et al. look at ways patients may be able to better prepare for major surgery, including targeting behaviours and lifestyle choices such as smoking and excessive drinking. The authors review evidence that physical inactivity and poor fitness, among other behaviours, has an impact on a patient's outcome. They also explore evidence for possible interventions at the perioperative stage. -
Content Article
Prevention of future deaths reports - Mary Mellor
Patient-Safety-Learning posted an article in Coroner reports
Mary Anne Mellor died from a ruptured thoracic aortic aneurysm caused by a leak from an aortic stent inserted four years previously. -
Content ArticleThis study in JAMA Network Open sought to determine whether limited English proficiency (LEP) is associated with not reporting a history of cardiovascular disease among patients with angina symptoms. The study found that patients reporting symptoms of angina were more likely to not report having cardiovascular disease if they had limited English proficiency. This discrepancy may be because of higher rates of undiagnosed cardiovascular disease or lower awareness of such diagnoses among individuals with LEP. The authors highlight the importance of finding effective communication strategies for people with LEP in order to make prevention and treatment for cardiovascular disease more effective.
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Content ArticleIn this blog Dr Peter Green, CVDPREVENT Workstream Clinical Lead for the NHS Benchmarking Network, looks at the importance of understanding how demographic factors impact the risk of cardiovascular disease, which is a leading risk factor for premature death. He discusses how the CVDPREVENT audit will help primary care healthcare professionals work with their patients to achieve better outcomes for all.
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Content ArticleThe Cardiovascular Disease Prevention Audit (CVDPREVENT) is a national primary care audit that automatically extracts routinely held GP data. This tool provides open access to the data, with clear, actionable insights for those tasked with improving cardiovascular health in England.
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Content ArticleThis is the first annual report for CVDPREVENT, an audit commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). It presents analysis of data recorded by GPs up to March 2020, providing a pre-pandemic baseline for indicators of cardiovascular disease (CVD) prevention. The analysis focuses on understanding variation in identification, diagnosis and management of people at risk of CVD against metrics of deprivation, age, sex, and ethnicity. There has also been further analysis undertaken on comorbidities amongst those with conditions that put them at a higher risk of cardiovascular disease.
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Content ArticleThis article looks at the issue of oxygen hoses becoming disconnected from transport ventilators when patients are moved between hospitals, which led to a patient death. Following the incident, the National Patient Safety team worked with national partners involved in transfer of patients to ensure a ‘tug test’ is incorporated into local practice.
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Content Article
NHS England: Variation in use of cardiac telemetry
Becky T posted an article in Medical devices (existing)
This article discusses the use of wireless heart monitoring in hospitals - telemetry - and the safety standards that need to be met. -
EventuntilCardiovascular disease (CVD) is one of the leading causes of morbidity, disability and mortality in England and a significant driver of health inequalities. It disproportionately affects people in deprived and ethnic minority communities and accounts for one-fifth of the gap in life expectancy between most and least deprived areas. The King’s Fund report, Cardiovascular disease in England, highlights the need to prevent and manage CVD. CVD accounts for one in four of all deaths in England. The yearly health care costs related to CVD are estimated at £7.4 billion with an annual cost to the wider economy of £15.8 billion. At a time when the NHS and social care workforce and finances are facing unprecedented and rising pressures, urgent comprehensive action across the public health, health and care sectors is needed to significantly reduce the adverse health impacts of CVD and associated workloads and costs. Leaders and experts from across the NHS and its partners will gather to discuss how best to prioritise and deliver services to reduce the prevalence of CVD and its risk factors across the population, and to improve early detection, management and treatment of CVD and its risk factors. Register
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EventuntilCardiovascular disease (CVD) is one of the leading causes of morbidity, disability and mortality in England and a significant driver of health inequalities. It disproportionately affects people in deprived and ethnic minority communities and accounts for one-fifth of the gap in life expectancy between most and least deprived areas. The NHS Long Term Plan (2019) highlights the need to prevent and manage CVD. CVD accounts for one in four of all deaths in England. The yearly health care costs related to CVD are estimated at £7.4 billion with an annual cost to the wider economy of £15.8 billion. At a time when NHS and social care workforce and finances are overstretched, urgent comprehensive action across the public health, health and care sectors is needed to significantly reduce the adverse health impacts of CVD and associated workloads and costs. Leaders and experts from across the NHS and its partners will gather to discuss how best to prioritise and deliver services to reduce the prevalence of CVD and its risk factors across the population, and to improve early detection, management and treatment of CVD and its risk factors. Register
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Content ArticleThis study in the Journal of Medical Virology aimed to assess the extent and the disparity in excess acute myocardial infarction (AMI)-associated mortality during the pandemic, focusing on the outbreak of the Omicron strain. Using data from the US Centers for Disease Control and Prevention's (CDC's) National Vital Statistics System, the authors found that excess death, defined as the difference between the observed and the predicted mortality rates, was most pronounced for the 25–44 years age group. Excess deaths ranged from 23%–34% for the youngest compared to 13%–18% for the oldest age groups. The trend of mortality suggests that age and sex disparities have persisted even through the Omicron surge, with excess AMI-associated mortality being most pronounced in younger-aged adults.
