GEP Medicine in Society Handbook 2019/20
5. Secondary Care Themed Days
5.5. Day 6 Theme: Cardiovascular 1
Introduction – Coronary Heart Disease (CHD) is the leading cause of adult death in the UK, accounting for ~90,000 deaths per year. However, the mortality rate has been falling over the past decade (45% reduction in CHD mortality in under 65s) since the Government’s implementation of the National Service Framework (NSF) for Coronary Heart Disease in 2000; this was designed to take forward its agenda of primary and secondary prevention, increased investigation, and non-operative and operative intervention for patients with CHD.
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Case History: Mr Mitchell is a 45 year old lorry driver whose wife called the ambulance as he had complained of chest pain in the middle of the night. The ambulance crew did an ECG on arrival and decided to take him directly to London Chest Hospital (LCH). He received primary angioplasty and stenting and was discharged home after 5 days in hospital. He returned for cardiac rehabilitation 2 weeks after discharge. He found the advice and support given by the cardiac rehab team very useful. |
Learning Issues
- How would you take a history from someone with chest pain?
- What is primary angioplasty and how is this service organised at the London Chest Hospital?
- What are the risk factors for coronary heart disease?
- What may be the concerns of the patient or his family after a heart attack?
- What advice would you give to your patient after a heart attack?
- What are the roles of the multidisciplinary team in the investigation and care of an inpatient with CHD?
- What are the DVLA regulations for a person who has had acute coronary syndrome?
Suggested Learning Tasks
- Take a history from a patient admitted with chest pain
- Interview a patient on the ward and ask how his/her illness has affected their work, life and family
- Observe how the cardiac technicians perform an ECG?
- Ask the Cardiac Rehabilitation Nurses about the advice they give out for someone who has had a myocardial infarct
- Read about the NSF for Coronary Heart Disease
References
Heart Disease Statistics (British Heart Foundation, 2010)
http://www.bhf.org.uk/heart-health/statistics/heart-statistics-publications.aspx
NSF for CHD (2000)