Category Archives: Cardiovascular

When Q waves are a normal variant

It seems I’ve been overdiagnosing past MIs on ECGs. A cardiologist has now sent me the helpful information that isolated Q waves in III are a variant of normal. Old inferior MI can only be diagnosed if there are Q … Continue reading

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Bits and bobs

Useful bunch of motley learning points from the 15th April BMJ: A double-blind trial reported in NEJM has looked at the effects of treating borderline thyroid results (raised TSH with normal T4) in the elderly. It didn’t show any benefit … Continue reading

Posted in BMJ, Cardiovascular, Credits 2017, Endocrinology, Hypertension, Medication, Paediatrics, Thyroid | Leave a comment

New evidence on hypertension targets in elderly

The ‘research update’ section in the BMJ alerted me to an interesting study in JAMA – the SPRINT study, comparing different hypertension targets in relatively healthy elderly people. Here’s the information I have from the abstract plus editorial: Population studied … Continue reading

Posted in Credits 2016, Elderly Medicine, Hypertension | Leave a comment

NICE guidance on statin use

This comes from NICE guideline CG181. Lipid checks for primary prevention can now be non-fasting (even for triglycerides), which is going to make life somewhat simpler. Rather than LDL, we should now be focusing on non-HDL, which apparently is simpler … Continue reading

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Rational prescribing

From our CCG’s review of evidence (Rational Prescribing, Sept 2015): On current evidence (which admittedly is somewhat limited), there is no statistically significant benefit from treating Stage 1 hypertension (160/100 or less) Aiming for an HbA1c level of 7.0% vs. … Continue reading

Posted in Credits 2016, Diabetes, Hypertension, Medication, Nephrology | Leave a comment

Palpitations – when to refer

This week’s CPD unit in the BMJ was on palpitations. Looking through it, I saw that the things I would do for history, examination, and basic investigations matched with what the article advised, so it looks as though I’m managing … Continue reading

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HRT post MI

Surprisingly, it appears to be OK. Hulley et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. JAMA 1998; 280: 605 – 13, and follow-up Grady et al, Cardiovascular disease outcomes during … Continue reading

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