Cardiology

Diuretic Resistance, a Factor in Chronic Kidney Disease

Diuretic Resistance, a Factor in Chronic Kidney Disease – MM1605

Diuretics exert their effects via the kidney, relying on secretion, and to a minor degree on glomerular filtration, to achieve therapeutic concentrations in the tubule. Diabetes and atherosclerosis can both cause glomerular damage and glomerulosclerosis, affecting glomerular filtration rate (GFR), while the Renin-Angiotensin system activation and inflammation common to both conditions also contributes to a reduced response.

Modern Medicine – May 2016

May 31, 2016 by Cardiology

Managing Heart Failure – The key role of the GP

Managing Heart Failure – The key role of the GP – MM1603

HF is a complex syndrome whereby systemic perfusion is insufficient to
meet the body’s metabolic demands. Although its clinical features are quite
varied, it is frequently characterised by elevated left ventricular filling pressures, inadequate peripheral oxygen delivery and neurohormonal activation. In particular, activation of both the renin–angiotensin–aldosterone and sympathetic nervous systems leads to fluid retention and adverse pathological axis remodelling of the heart.

Management of most patients with heart failure occurs at an outpatient
level, with the GP playing a central role in initial diagnosis, counselling, regular
assessment of fluid status, titration and monitoring of medications and end-of life care.

Modern Medicine – March 2016

March 18, 2016 by Cardiology Heart Disease Heart Failure

Acute Coronary Syndromes | The Importance of Secondary Prevention

Acute Coronary Syndromes The Importance of Secondary Prevention – MM1510

Managing patients with acute coronary syndromes extends well beyond hospitalisation with the index event. It is essential to recognise the importance of secondary prevention as patients with acute coronary syndromes experience higher mortality and morbidity and are at high risk of future cardiovascular events. GPs play a crucial role in optimising secondary prevention to ensure these patients receive the best possible cardiac care.

Modern Medicine – October 2015

October 27, 2015 by Acute Coronary Syndrome Cardiology

How to Diagnose and Manage Resistant Hypertension

How to Diagnose and Manage Resistant Hypertension – MM1510

The number of truly drug-resistant hypertensive patients is small if careful attention is paid to blood pressure measurement , lifestyle measures are instituted and treatment is adjusted as required. An effective drug combination for the treatment of resistant hypertension is an ACE inhibitor (or angiotensin II receptor blocker), a calcium channel blocker and a thiazide-like diuretic, with possibly the addition of a fourth drug.

Modern Medicine – October 2015

October 27, 2015 by Cardiology Hypertension

Advances in Management of Abdominal Aortic Aneurysms

Advances in Management of Abdominal Aortic Aneurysms – MM1509

Management of abdominal aortic aneurysms is guided by aneurysm diameter and symptoms. Patients with small asymptomatic aneurysms require regular surveillance for aneurysm enlargement and risk factor control. Endovascular repair has become the treatment modality of choice for most patients with aneurysms above a threshold diameter.

Modern Medicine – September 2015

September 28, 2015 by Aneurysm Cardiology

Anaemia in Heart Failure: The Clinical Perspective

Anaemia in Heart Failure: The Clinical Perspective – MM1508

Anaemia is common in heart failure and is a risk factor for increased mortality but whether it has a causative role has not been established. Iron supplementation and erythropoietin replacement improve exercise capacity and well-being scores but have not been shown to reduce hospitalisation or mortality.

Modern Medicine – August 2015

August 25, 2015 by Anaemia Cardiology

Treatment Gaps Evident in Heart Disease Patients

Treatment Gaps Evident in Heart Disease Patients – MM1507

Hypertension is the most common condition seen in primary care and leads to myocardial infarction (MI), stroke, renal failure and death if not detected early and treated appropriately. Angiotensin converting enzyme (ACE) inhibitors have significantly decreased cardiovascular MI and hospitalisations for heart failure (HF) in patients with asymptomatic or symptomatic left ventricular (LV) systolic dysfunction.

Modern Medicine – July 2015

July 30, 2015 by Cardiology Heart Disease
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