Implantable Cardioverter Defibrillators (ICDs) have – quite literally – fired a major revolution in the management of patients at high risk for potentially life-threatening arrhythmias. More sophisticated than pacemakers, ICDs monitor the heart constantly, but only initiate an electrical signal when they detect an incorrect heart rhythm. ICDs can function as pacemakers for slow heart rates, but may also deliver high-energy electrical therapy for fast heart rates. In this article, we review how ICDs work, how they are used and what care we need to provide for patients who have had these devices implanted.
Aspirin is the most widely used long-term antiplatelet therapy, achieving benefits in patients with a range of cardiovascular conditions by blocking one of the blood clotting pathways. It is cheap and relatively safe, despite the possible risks of gastric irritation or bleeding. In this article, we explore what we know about aspirin, together with its pros and cons in patients with cardiovascular disease.
Diabetes is the leading cause of blindness in the UK in people of working age. Diabetic retinopathy occurs when blood vessels in the retina become blocked, leaky, or grow haphazardly. There are usually no obvious symptoms, making the condition difficult to detect until it is well advanced. However, irreparable damage has been done by this time. This article outlines the importance of screening for early detection of retinopathy, and reviews the targets set in the National Service Framework (NSF) for Diabetes Priorities document (2003) regarding annual retinal screening tests.
There are several blood tests that can be used to measure blood sugar levels, including random blood sugar, fasting blood sugar, glycosylated haemoglobin (HbA1C) and the glucose tolerance test (GTT). This article provides a 'whistle-stop' tour updating you on what information each of these tests provides, what test to use when and how to explain the procedures and results to your patients.
In a recent report on childhood obesity, the British Medical Association described the significant increase in levels of childhood obesity as a 'cause for great concern' and stated that healthcare professionals have a pivotal role to play in tackling this epidemic. It is estimated that there are now approximately 1 million obese children under the age of 16 in the UK and numbers are increasing annually. In this article, we review the impact of this growing epidemic, the underlying causes and how healthcare professionals can help.
Physical activity reduces the risk of developing heart disease and lowers the risk of death and further events in patients with cardiovascular conditions. This article reviews the benefits of exercise and shares some of the strategies our team uses to help patients with heart disease increase their levels of physical activity and keep active after they have completed phase 3 cardiac rehabilitation.
Chronic leg ulcers are a major health problem in the UK, affecting many older people and costing the NHS up to £600 million per year. Chronic leg ulcers are generally managed in primary care: more than 80% of chronic leg ulcers are cared for in the community. Healing rates are currently low and recurrence rates are higher than 67%. However, appropriate use of available treatments can reduce recurrence rates to between 20% and 30%. In this article, we review the causes of venous ulceration, how to spot the problem early and how to optimise leg ulcer healing.
An estimated two-thirds of the population are thinking about, or trying to lose weight at any time. To meet this demand, there is a growing range of commercial and 'fad' diets available but, unfortunately, very little research to indicate what works and what doesn't. This article looks at some of the more popular fad and commercial diets you may be asked about in clinic, giving you the information you need to have a discussion about the pros and cons of different weight loss methods with your patients, to help them lose weight and keep it off. The key finding seems to be – if it sounds too good to be true, it probably is!