Cardiac Memory T waves; Learning bite
Persistent deep T wave inversions are seen after return of normal depolarization in leads where the T waves were normal before pacing. These changes are generally recognized to occur in association with artificial pacemakers but may occur with other entities with intrinsic ventricular ectopic focus of depolarization, such as intermittent left bundle branch block. Although consideration of ischemia should be given priority, awareness of the benign nature of cardiac memory may allow some patients to avoid unnecessary work-up and admission. Sometimes the diagnosis cannot be confirmed definitively in the Emergency Department (...
Source: Doc2Doc BMJ Cardiology - June 27, 2016 Category: Cardiology Authors: alaminium Source Type: forums

As a whole, what is your mostly prescribed anti-hypertensive drug?
Dear Alll: Hypertension is according to the World Health Organization the number 1 risk factor for death. And every now and then new guidelines from the USA, Europe, Australia, etc.....are issued for hypertension treatment. Good to have your thoughts - and your votes - on this.  All Best, Joey. @jmariofoliveira   (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 27, 2016 Category: Cardiology Authors: Joey Rio Source Type: forums

Lumps, bumps and sarcomas.
A 50 year old man is referred to his local district general hospital. He has an eight month history of a 10 cm left sided chest wall swelling which is painful and increasing in size. What is the preferred management option for this man? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - May 6, 2016 Category: Cardiology Authors: alaminium Source Type: forums

EKG Question
43 year old man C/O palpitation, Electrocardiogram shown below, the treating physician reduced the dose of  his medication after the ECG result What  does the ECG show, what medication the patient was taking ? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - April 30, 2016 Category: Cardiology Authors: alaminium Source Type: forums

Bridging the gap: cta and ivus of the heart
  CTA or IVUS – which is better? CTA (computed tomography angiography) is currently the gold standard for evaluating myocardial bridging, because it‘s highly accurate. However, recent research has shown that CTA is not all-seeing and all-knowing. IVUS (intravascular ultrasound) may be the better choice. The study included 64 patients with symptoms of ischemia who underwent both CTA and IVUS. CTA earned its gold star, but surprisingly missed the majority of septal branches and soft plaques that could potentially cause serious complications. Interesting? Read more just clicking on ...
Source: Doc2Doc BMJ Cardiology - April 28, 2016 Category: Cardiology Authors: irene357 Source Type: forums

Should we trust INR testing?
  We read with interest the recent BMJ editorial “Rivaroxaban:Can we trust the evidence”.1 which questions the conclusions from the ROCKET AF clinical trial on Rivaroxaban 2. Cohen raises questions about the accuracy of the INRs used for monitoring patients in the warfarin control arm and suggests that they may have compromised the validity of the published conclusions. The ROCKET investigators have defended their conclusions after re assessing the data in light of these concerns 3. The device used for INR testing in the warfarin control arm was not identified in the original publication but subsequen...
Source: Doc2Doc BMJ Cardiology - April 7, 2016 Category: Cardiology Authors: alaminium Source Type: forums

ECG interpretation?
What is the diagnosis? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - April 2, 2016 Category: Cardiology Authors: MoeTomy Source Type: forums

Ecg quiz
24 year old patient complains of fatigue, muscle weakness and confusion, examination showed sluggish reflexes and decreased muscle tone, ECG shown below What is the diagnosis ?   (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 22, 2016 Category: Cardiology Authors: alaminium Source Type: forums

Do you Recommend Insulin Pump For Type 2 Diabetes
Many debates and ongoing researches have not yet come to a conclusion to weigh between the advantages and disadvantages for Insulin Pump specially for diabetes type 2, however many diabetic patients are rushing to aquire the device, irrespective of the main serious side effects such as infection and DKA I think we need  more researches to finalize the usefulness of Insulin Pump , and proper health education for diabetic patients on this subject (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 10, 2016 Category: Cardiology Authors: alaminium Source Type: forums

MRCP part 2 question
44 year old man complians of, cough, shortness of breathing; painful joints and stiffness of the hands, for one year duration, no past history of hospitalisation or medical condition Examination of the hands reavealed painful tender joints and swelling of metacarpophalangeal joints of both  hands and reduced flextion and extension of the fingers, chest examination showed bilateral wheezing and dullness mainly on the bases,  6 month before he was working as a coalminer abroad CXR revealed bilateral scattered nodules varying in size What is the most likely Diagnosis ? What investiga...
Source: Doc2Doc BMJ Cardiology - March 8, 2016 Category: Cardiology Authors: alaminium Source Type: forums

Hidden dangers for the slim
I have grown old - unavoidable. i have not grown fat over the years - avoidable. What interests me is how I am being put at relative risk as well as inconvenience by the latter.  2 examples in health care. 1) For x-rays the standard exposure means an overdiagnosis of bone thinning. This led to bone densitometry - with the verdict that bones better than average for age. 2) For some drugs the dose is administered depending on the eGFR but this test seems very poorly understood and bodyweight is a crucial part of it. The problem is that the lab value is based on a weight I have never achieved even at my heaviest and my...
Source: Doc2Doc BMJ Cardiology - February 25, 2016 Category: Cardiology Authors: sken Source Type: forums

To discharge or not
In a patient with known prior CAD s/p stent, recent improved/ negative nuclear stress test 1 week prior for similar symptoms-presented with some 'atypical' chest pain(on sub-optimal anti-anginal therapy), no EKG changes, ctrop neg X2-chest pain free in ER. Should a patient like this be admitted for diagnostic cath/some other tests or be discharged on optimal medical therapy?To add to the dilemma-this happens on a Friday afternoon(if further work-up needed, pt will have to stay over weekend, with additional LOS/expense/inconvenience etc). (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 12, 2016 Category: Cardiology Authors: Heartfelt Source Type: forums

Is one of the primary problems of the NHS a lack of Hospital beds?
I think that it becomes more and more apparent that there are not enough NHS Hospital beds. I think most of the A and E problems would be made better if there were more  Hospital beds.  Many hospital beds have been lost though hospital closures and amalgamations. There has been great emphasis on community care and early discharge. But there are patients who cannot be managed in the community and need admission. There is a huge pressure not to admit patients and also pressure to discharge patients early. Success in Hospital now seems to be discharging patients from Hospital rather than caring for them and wh...
Source: Doc2Doc BMJ Cardiology - January 17, 2016 Category: Cardiology Authors: PatLush Source Type: forums

Good news or bad news?
For now I think the news that 35% of UK doctors were born elsewhere is good news. This applies to very many of our senior folk - particularly from India - and many with a wealth of Uk qualifications as well. I see this as a recruitment of excellence. But I suspect we are in period of transition and in future the influx will be from Europe. It would be interesting to see the equivalent figures from the USA. If this 35% still applies in 20 years time I would be more concerned (except I won't be around).. Is there really going to be an exodus of UK graduates : I seriously doubt it despite mutterings. Perhaps our projected n...
Source: Doc2Doc BMJ Cardiology - January 2, 2016 Category: Cardiology Authors: sken Source Type: forums

happy new year
  happy new year (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 2, 2016 Category: Cardiology Authors: irsida Source Type: forums

Check how much you can earn!
Get your FREE salary report and compare your earnings to those of other healthcare professionals around the world. Check how much you could be earning. http://salariesinhealthcare.com/   (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - December 20, 2015 Category: Cardiology Authors: SalariesinHealt Source Type: forums

Cardiology Quiz
42 years old patient presented with headache and dizziness one hour after he woke up in the morning, the ECG shown was taken in the A& E  at the same time 1/ What is the diagnosis ? 2 /What is the  differential diagnosis ?   (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - November 26, 2015 Category: Cardiology Authors: alaminium Source Type: forums

Innovations in Cardiology
Hi everyone,  I have heard a lot about interaction between innovations and cardiology supply, but have never seen something concretely new and as much effective as described. Maybe someone has some examples of such innovative cardio medical devices or equipment? I'm pleased to hear any of your useful minds and suggestions about this theme. Thanks:) (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - November 13, 2015 Category: Cardiology Authors: graags12 Source Type: forums

NOAC`s in tripletherapy
New knowledge to low dosed NOAC`s in triple therapy according to european guidelines and the following article: "Comparartive efficacy and safety of novel oral anticoagulants in patients with atrial fibrillation: A network meta-analysis with the adjustment for the possible bias from open label studies", published from Dr. Morimoto T, et al. in the Journal of Cardiology in July, 7 of 2015 . There are statistical significant fewer major bleedings under Edoxaban 30 mg than under Dabigatran 110 mg while both medicines are statistically equal in efficacy. Under Rivaroxaban 15 mg there are statistically significant few...
Source: Doc2Doc BMJ Cardiology - November 1, 2015 Category: Cardiology Authors: Mr.Study Source Type: forums

MRCP question
This ECG from 24 years old cocaine user , what does it show ? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - October 13, 2015 Category: Cardiology Authors: alaminium Source Type: forums

ECG Question
ECG below obtained from 45 years old patient presented with dizziness and palpitations what is the diagnosis ?   (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - September 23, 2015 Category: Cardiology Authors: alaminium Source Type: forums

Icd
Hallo all,  i would like to thank you all for this nice and helpful group, this is my first time using your page even that i dont know how to post a pic , because iam using an ipad but i have an interesting case i saw it today in our ccu , i have an Ecg of a patient with icd i would like to ask you how do i be sure if the pacing comes fromthe left or right , and how can check how many leads , from the ecg and how to read it perfectly , I noted some deference in the ecg i would like to ask u abou them , thank you infront .    Sorry how can i post picturures  (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - September 15, 2015 Category: Cardiology Authors: yazed Source Type: forums

Interesting ECG
This ECG strip was taken from a patient at rest, what is the diagnosis ? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - August 26, 2015 Category: Cardiology Authors: alaminium Source Type: forums

Clinical question of the week: should RBBB be an indication for primary PCI?
In a patient with symptoms suggestive of acute myocardial infarction, a new-onset left bundle branch block (LBBB) is considered an indication for reperfusion therapy i.e. primary percutaneous coronary intervention (pPCI) or thrombolysis. In contrast, a new-onset of right bundle branch block is not considered as an indication for administration of reperfusion therapy in this context. The question arises:  (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - August 24, 2015 Category: Cardiology Authors: Heart Matters Source Type: forums

What your patient is thinking: "My experience of stressed out staff..."
Growing up with pioneering treatment is the latest What your patient is thinking piece from The BMJ. It is written by Liza Morton who was the world's first 11 day old baby with congestive heart failure to be attached to an external cardiac pacemaker for complete heart block. She was fitted with five early implantable pacemakers  by thoracotomy before age 7, she had surgical repair of her atrial septal defect and her first variable rate pacemaker in her early teens, and four further variable rate pacemakers. She describes her childhood memories of being treated for congenital h...
Source: Doc2Doc BMJ Cardiology - August 24, 2015 Category: Cardiology Authors: Sabreena Source Type: forums

Treatment for mini gastric bypass surgery India
The surgeon creates a narrow tube of the stomach and separates the stomach with staples which is remaining. And then the tube is connected to the lower intestine. The hospital excels in delivering World class treatment for mini gastric bypass surgery India via specialised surgeons and technicians having years of experience. (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - August 18, 2015 Category: Cardiology Authors: sunilk Source Type: forums

Prescribing inotropes in heart failure
Hello everyone,   I am on my cardiology rotation and am having trouble coming to grips to prescribing inotropes.  Can someone help me with the following:   1. Dobutamine - What is meant by singe, double triple strength  e.g. consultant asks to prescribe single strength dobutamine, is this 5mcg/kg/hr? and is double strength 10mcg/kg/hr? - How do you calculate the rate e.g. mg/hr, mg/min   2. Dopamine - What is meant by singe, double triple strength  e.g. consultant asks to prescribe single strength dobutamine, is this 5mcg/kg/hr? and is double strength 10mcg/kg/hr? - How...
Source: Doc2Doc BMJ Cardiology - August 15, 2015 Category: Cardiology Authors: callofthewild Source Type: forums

Should more people be encouraged to eat chillli?
A recent BMJ article that purports that intake of higher amounts of spices are associated with decreased mortality has grabbed some attention- http://www.bmj.com/content/351/bmj.h3942 After multivariate adjustment, spicy food consumption was inversely associated with the risks of death due to ischemic heart diseases-which is remarkable. While it suffers from  limitations of measurement error, possible bias, confounding, and reverse causality, which are common problems in epidemiology, the efforts of the authors to minimise some of these limitations are notable. As the linked editorial notes- http://www....
Source: Doc2Doc BMJ Cardiology - August 11, 2015 Category: Cardiology Authors: Heartfelt Source Type: forums

Are spice consumption associated with decreased mortality?
A recent BMJ article that purports that intake of higher amounts of spices are associated with decreased mortality has grabbed some attention- http://www.bmj.com/content/351/bmj.h3942   After multivariate adjustment, spicy food consumption was inversely associated with the risks of death due to ischemic heart diseases-which is remarkable.   While it suffers from  limitations of measurement error, possible bias, confounding, and reverse causality, which are common problems in epidemiology, the efforts of the authors to minimise some of these limitations are notable. As the linked editorial no...
Source: Doc2Doc BMJ Cardiology - August 7, 2015 Category: Cardiology Authors: Heartfelt Source Type: forums

Thrombectomy for stroke-flash in pan or game-changer?
There is emerging evidence that endovascular therapy (EVT) for acute ischemic stroke significantly improved functional outcomes (without compromising safety) in patients with acute ischaemic stroke due to anterior circulation, large artery occlusion, compared with standard therapy.A recent spate of multiple trials have shown this, as did a pooled analysis- http://eurheartj.oxfordjournals.org/content/early/2015/06/11/eurheartj.ehv270 It has also received endorsement from national societies and guidelines- http://stroke.ahajournals.org/content/early/2015/06/26/STR.0000000000000074 It may lead to a paradigm shift...
Source: Doc2Doc BMJ Cardiology - July 29, 2015 Category: Cardiology Authors: Heartfelt Source Type: forums

Clinical question of the week: HCM part 1
A 35 year old patient presented to the emergency department complaining of one episode of syncope while walking. He does not remember details of the episode, but he mentioned full recovery only a couple of minutes after the event. He reported no known diseases, no smoking, drinking or drug use. His family history included an older brother who died suddenly while sleeping at age 38. On physical examination the heart rate was 66 bpm, BP was 140/92 mmHg, respiratory rate 14, temperature 36.2oC. SatO2:97%. Lungs were clear. Heart auscultation a systolic murmur (++/4) was noted on the left sternal border. The ECG show...
Source: Doc2Doc BMJ Cardiology - July 27, 2015 Category: Cardiology Authors: MBittencourt Source Type: forums

Clinical question of the week: HCM part 2
 Which of the following criteria below does not indicate increase risk of sudden death in patients with hypertrophic cardiomyopathy (HCM)? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - July 27, 2015 Category: Cardiology Authors: MBittencourt Source Type: forums

Education for Cardiology Disease Professionals
Hello Everyone, Here, Radcliffecardiology group discusses about online an “Education for Cardiology Disease Professionals” to cardiologists, cardiology students and around the word areas people.  Radcliffecardiology also has an independent eLearning platform that everyone can review and get journals of Arrhythmia & Electrophysiology Review (AER), Cardiac Failure Review (CFR), European Cardiology Review (ECR), hyperlipidemia, Fractional Flow Reserve, Cholestestrol and Interventional Cardiology Review (ICR). You can share your cardiology knowledge, live case, videos and more details at here. Thanks...
Source: Doc2Doc BMJ Cardiology - July 24, 2015 Category: Cardiology Authors: radcliffecardio Source Type: forums

Advanced Clinical Quiz
This is a Coronary angiogrm and ECG of 40 years old man compliaing of chest pain and shortness of breathing, what is the diagnosis ?       (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - July 12, 2015 Category: Cardiology Authors: alaminium Source Type: forums

Clinical question of the week: nausea, vomiting and generalised weakness
A 36 year old Asian male has a chief complaint of nausea/vomiting and generalized weakness. He also endorses muscle cramps  and a history of intermittent fevers at home. He is a non-smoker, denies excess alcohol use, and denies substance use.   He has a past medical history of:   • Extra-pulmonary TB    • HIV diagnosed September 2014     On examination of the paient:   • The only physical exam findings of significance are mild tachycardia (HR-110s-120s)  and mild hypoxemia (SpO2-92-93%)     Labs:   • Only ab...
Source: Doc2Doc BMJ Cardiology - July 6, 2015 Category: Cardiology Authors: Heartfelt Source Type: forums

Lay resuscitation DOUBLES survival
I am indebted to UniVadis for bringing this paper to my attention: http://www.univadis.co.uk/external/exit/?r=http%253A%252F%252Fdx.doi.org%252F10.1056%252FNEJMoa1405796&display_iframe=1&exit_strategy=0&new_window=0 In Sweden, records of over 30,000 out-of-hospital cardiac arrests that happened during twenty years to the end of 2011 were analysed to see the effect of CPR by members of the public before professional services arrived.     The answer was that the 30-day survival increased from 4% to just over 10%, so better than doubled. So why isn't CPR a school subject?  And an autodefibrill...
Source: Doc2Doc BMJ Cardiology - June 18, 2015 Category: Cardiology Authors: John D Source Type: forums

Echo question
This Echo is from 35 years old patient  C/O shortness of breathing and palpitations What is the diagnosis ?   (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 8, 2015 Category: Cardiology Authors: alaminium Source Type: forums

MRCP Part 1 practice question from OnExamination: bradycardia, hypotension, and ST elevation
A 56-year-old man presents to the Emergency department with an inferior myocardial infarction. He has a history of smoking and hypertension and is a poor attendee at the GP surgery. On initial admission he is hypotensive and bradycardic, with clear inferior ST elevation. He is taken to the catheter lab and stented. You are asked to see him a few hours later as he is persistently hypotensive with poor urine output. He has remained pain free since his stenting. On examination his BP is 90/50 mmHg, his pulse is 69, he has an elevated JVP, but his chest is clear. Investigations show Haemoglobin 140 ...
Source: Doc2Doc BMJ Cardiology - June 8, 2015 Category: Cardiology Authors: OnExamination Source Type: forums

MRCP Part 1 practice question from OnExamination: inferior MI
A 56-year-old man presents to the Emergency department with an inferior myocardial infarction. He has a history of smoking and hypertension and is a poor attendee at the GP surgery. On initial admission he is hypotensive and bradycardic, with clear inferior ST elevation. He is taken to the catheter lab and stented. You are asked to see him a few hours later as he is persistently hypotensive with poor urine output. He has remained pain free since his stenting. On examination his BP is 90/50 mmHg, his pulse is 69, he has an elevated JVP, but his chest is clear. Investigations show Haemoglobin 140 ...
Source: Doc2Doc BMJ Cardiology - June 8, 2015 Category: Cardiology Authors: OnExamination Source Type: forums

basic ECG knowledge questions
Dear colleges, I'm studying for an ECG exam and have some basic questions.   -LBB or RBB morfology, is this the same as LBBB of RBBB?  How do I distinguish them? -any tips on recognizing fibrillation and flutter?  I often don't recognize/distinguish them although the theory is quit simple. I seem to be missing the point as I go through exercises and examples. thx and best regards.  Hope these questions aren't too simple and stupid, but I'd doing the course in selfstudy and find it quit hard sometimes. Dr.Bel (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 6, 2015 Category: Cardiology Authors: Dr.Bel Source Type: forums

ECG of patient suffering from Tachycardia even after RadioFrequency Ablation
Following is the ECG of 52 yr old female with no previous heart problems. She has undergone Radio Frequency Ablation just 20 days before the ECG. Can anyone help with diagnosing what she might be suffering from? Also, please suggest treatment. All details will be helpful. Thanks in advance   (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 1, 2015 Category: Cardiology Authors: docwhou Source Type: forums

Screening sporty youngsters for SADS conditions?
Did anyone hear BBC Radio 5 Live’s broadcast on Sudden Cardiac Death in sports on Tuesday 19th May? It’s still available on http://www.bbc.co.uk/programmes/b05xjcmh for another 20 days! It was a good listen. How many more professional football and other players must die (not to mention the much bigger numbers of the non-famous) before sports grounds and other public places have easily accessible AEDs and enough of the public CPR-trained, that someone gets on and starts CPR? And what about screening sporty folk? To screen or not to screen? that is the question. This...
Source: Doc2Doc BMJ Cardiology - May 30, 2015 Category: Cardiology Authors: ED Doc Ffion Source Type: forums

Bleeding Risk in Warfarin-Treated Patients with Kidney Disease
Studies have shown that warfarin-treated patients with substantially impaired renal function require lower warfarin doses   http://www.jwatch.org/na37937/2015/05/20/bleeding-risk-warfarin-treated-patients-with-kidney?query=etoc_jwcard (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - May 28, 2015 Category: Cardiology Authors: Mukhtar Ali Source Type: forums

MRCP part 1 sample question from OnExamination - IHD placebo statistics
A publication reports the outcome of a new statin therapy in a placebo controlled primary prevention of ischaemic heart disease in a diabetic population. 1000 patients were randomised to receive the new therapy and 1000 allocated to placebo. The study was completed over a five year period. In the placebo group there were 150 myocardial infarcts (MI) and in the group treated with the new statin there were 100 myocardial infarcts. (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - May 26, 2015 Category: Cardiology Authors: OnExamination Source Type: forums

MRCP part 1 sample question from OnExamination - placebo statistics
A publication reports the outcome of a new statin therapy in a placebo controlled primary prevention of ischaemic heart disease in a diabetic population. 1000 patients were randomised to receive the new therapy and 1000 allocated to placebo. The study was completed over a five year period. In the placebo group there were 150 myocardial infarcts (MI) and in the group treated with the new statin there were 100 myocardial infarcts. (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - May 26, 2015 Category: Cardiology Authors: OnExamination Source Type: forums

"there is lot of discussion about Sglt2inhibitors in forums, which has an edge Cana. or Dapaglifazone? "
Dear Diabetes spl, It will be nice if you can clarify whether Cana.or Dapaglifazone is better. How? and. Why?share your experience and thoughts. Dr Valluri Ramarao DNB (fam -med) (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - May 16, 2015 Category: Cardiology Authors: Dr valluri Source Type: forums

Mitral Valve Regurgitation
I am soon to be a 35 year old medical student and currently work for an NHS ambulance service as an Emergency Medical Technician. At 15 years of age I was diagnosed with minimal mitral valve regurgitation which has remained asymptomatic since.  I've had had repeat ECG's (the last in 2013) and always get told that it is within normal ranges. Back in 2009 I was told that MVR is common and remains undiagnosed in a large proportion of the population.  A figure for the amount of people who go undiagnosed was thrown in my direction, but I cannot remember what it was...does anyone know what that figure is? Is Tris...
Source: Doc2Doc BMJ Cardiology - May 14, 2015 Category: Cardiology Authors: ph80 Source Type: forums

Appraisal and Revalidation
It's is that time of year again for me. Appraisal in June, and this will be my year for revalidation. I have retired as a partner after 35 years of inner City General Practice. But I still feel I have something to contribute and wish to do a few locums in General Practice for perhaps a couple of years.  The Appraisal and Revalidation system seem to grow year by year. It almost seems that the powers that be want GPs to take retirement and not go back to work. Is this a good idea, when waiting times to see GPs are so long?   (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - May 13, 2015 Category: Cardiology Authors: Pat Lush Source Type: forums

Clinical question of the week: How would you treat this patient w palpitations, dyspnoea, dark stools?
A 75-year-old male with a prior history of hypertension, diabetes and treatment for “arrhythmia” presented to the emergency department complaining of palpitations and dyspnea on exertion over the last two days. The patient also reported dark stools over the last two days. No other symptoms were reported. Current medications included atenolol 50 mg qD, warfarin 5 mg qD, metformin 850 mg BiD.   The patient did not remember his last INR result, but reported no blood tests over the last two months. On examination the heart rate was 140, irregular, BP was 90/70, respiratory rate 22, SatO2: 94%. The patient ...
Source: Doc2Doc BMJ Cardiology - May 11, 2015 Category: Cardiology Authors: MBittencourt Source Type: forums

Clinical question of the week: "Arrhythmia" patient with palpitations, dyspnoea, and dark stools
A 75-year-old male with a prior history of hypertension, diabetes and treatment for “arrhythmia” presented to the emergency department complaining of palpitations and dyspnea on exertion over the last two days. The patient also reported dark stools over the last two days. No other symptoms were reported. Current medications included atenolol 50 mg qD, warfarin 5 mg qD, metformin 850 mg BiD.   The patient did not remember his last INR result, but reported no blood tests over the last two months. On examination the heart rate was 140, irregular, BP was 90/70, respiratory rate 22, SatO2: 94%. The patient ...
Source: Doc2Doc BMJ Cardiology - May 11, 2015 Category: Cardiology Authors: MBittencourt Source Type: forums