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Heart Failure

Heart Failure

Heart Failure is a progressive chronic disorder that results in the inability of the heart to pump blood efficiently to the body’s tissues.

Chronic heart failure is an increasing public health problem; the growing prevalence in industrialised countries means that 1-2% of the adult population of these countries are now thought to have chronic heart failure.1-3 Estimates suggest that the prevalence in Europe, USA and Japan could increase by approximately 16.5% over the next ten years.4

The prevalence of post-myocardial infarction heart failure is less well known as it is difficult to distinguish between pre-existing and incident heart failure. However current estimates suggest that approximately 1 in 5 patients hospitalised with an acute coronary syndrome either present with heart failure or develop heart failure during their hospital stay.5

Many of the signs and symptoms of heart failure are non-specific and vary in severity depending on the disease class. The most common of these are breathlessness, fatigue, exercise intolerance, and fluid retention as evidenced by ankle swelling, peripheral oedema, and an elevated jugular venous pressure.6

Due to the non-specific nature of symptoms, the diagnosis of heart failure can be difficult. Tests can include echocardiogram, ECG, chest X-ray, laboratory tests. Following a positive diagnosis heart failure is classified into functional classes that relate to disease severity.

Management of heart failure involves lifestyle modifications, pharmacological treatment and occasionally surgery. In patients with chronic heart failure, optimal therapy involves treatment with diuretics, ACE inhibitors, certain β-blockers and a mineralocorticoid receptor antagonist.

The Heart Failure Knowledge Centre brings together current information related to chronic heart failure and post-myocardial infarction, including:

  • Epidemiology
  • Symptoms and Diagnosis
  • Classification
  • Treatment Options

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References

  1. Zannad F, et al. Incidence, clinical and etiologic features, and outcomes of advanced chronic heart failure: the EPICAL Study. Journal of the American College of Cardiology 1999; 33(3):734-742.
  2. Cowie MR, et al. The epidemiology of heart failure. European Heart Journal 1997;18(2):208-225.
  3. Mosterd A, Hoes A. Clinical epidemiology of heart failure. Heart 2007; 93:1137-1146.
  4. Decision Resources. Chronic Heart Failure. Cardium Study No.4 A Pharmacor Service. 2008.
  5. Steg PG, Dabbous OH, et al. Determinants and prognostic impact of heart failure complicating acutecoronary syndromes. Observations from the Global Registry of Acute Coronary Events (GRACE). Circulation2004;109:494-9.
  6. NICE Clinical Guideline No 108. Chronic Heart Failure. National clinical guideline for diagnosis and management in primary and secondary care. 2010.

Type 2 Diabetes

,Type 2 Diabetes CME and Knowledge Centre

Based on current estimates, the global prevalence of Type 2 diabetes mellitus has increased almost 10 fold since 1985 and is expected to rise to 552 million by 2030,1 and when absolute numbers of people with diabetes are considered, it is South East Asia and the West Pacific that are expected to experience the highest increases in prevalence over the coming years.2

An EACCME accredited CME is available, awarded 1 European CME credits (ECMEC's). Consisting of 3 modules:

  • A Review of Newer Therapies for Type 2 Diabetes in Combination with Insulin, John Wilding (Chair)
  • Identifying and Managing the Psychosocial Aspects of Type 2 Diabetes Mellitus, Richard Holt (Faculty)
  • Potential Role of Newer Therapies for Type 2 Diabetes in Combination with Insulin: Interactive Case Discussion, Bernard Charbonnel (Faculty)

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The Type 2 Diabetes Knowledge Centre aims to provide clear and concise information based on current accepted guidelines on the treatment and management of patients with this disease. In addition the Knowledge Centre also provides access to key guidelines and a review of treatment options available.

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References

  1. Murea M, Ma L, Freedman BI. Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications. Rev Diabetic Studies 2012;9:6-22.
  2. International Diabetes Federation. Diabetes atlas: second edition. 2002. Available at: www.idf.org/sites/default/files/IDF_Diabetes_Atlas_2ndEd.pdf (accessed 18 November 2013).

 

Obesity CME series

,Obesity series

This EACCME-accredited obesity CME series contains three CME modules, which are ideal for healthcare professionals looking to improve their understanding of obesity as a serious medical illness.

Module 1 – Understanding Obesity
Learn more about obesity as a serious and complex medical illness including comorbidities and complications, the complex factors that influence its development and the cornerstones of an effective weight-management strategy.

Module 2 – Considerations for Individualising Pharmacotherapy
Learn about the complexities of obesity, appropriate use of pharmacotherapy for weight management and how to individualise patient care.

Module 3 – Rationale for Lifelong Behaviour Change
Explore the factors affecting maintenance of weight loss, the importance of implementing permanent behaviour changes to prevent weight regain and the components of a successful long-term weight-management strategy.

Upon successful completion of these modules, participants will receive a combined total of five European CME credits (ECMECs).

Clinical Case Studies

Vascular Graft Infection

Infection: Cardiovascular Infections

Stephanie J. Dancer BSc, MB BS, MSc, MD, FRCPath, DTM&H, Consultant Microbiologist, NHS Lanarkshire, Scotland

Case History
A 72-year-old man was referred by his general practitioner complaining of intermittent pain in the legs on exercise.

MRSA Endocarditis

Infection: Cardiovascular Infections

Christopher D. Pfeiffer, Clinical Fellow, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
Vance Fowler, Associate Professor and Infectious Diseases, Specialist, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA

Case History
A 64-year-old female presented with three weeks of progressive dyspnoea, nausea and vomiting.

Medical Videos

3D Medical Animation - Congestive Heart Failure
3D Medical Animation - Congestive Heart Failure
A Guide to the Coronary Angioplasty Procedure
A Guide to the Coronary Angioplasty Procedure
Animation: New therapy prevents heart failure
Animation: New therapy prevents heart failure
The Lead: Time to Abandon LDL Treatment Targets?
The Lead: Time to Abandon LDL Treatment Targets?
A Discussion of Interventional Cardiology and the Procedures Involved
A Discussion of Interventional Cardiology and the Procedures Involved
Advances in Dual Antiplatelet Therapy for Acute Coronary Syndrome (ACS)
Advances in Dual Antiplatelet Therapy for Acute Coronary Syndrome (ACS)

Recent Drug Updates

Medical Journal Abstracts on Cardiology

Distribution of Subcutaneous Fat and the Relationship with Blood Pressure in Obese Children and Adolescents in Shandong, China

Sat 14 Feb 2015 -  Distribution of Subcutaneous Fat and the Relationship with Blood Pressure in Obese Children and Adolescents in Shandong, China

Background: The association between elevated blood pressure (BP) and childhood obesity has been documented in several studies. However, the association between BP and body fat distribution in ...

Best Practices for Cardiovascular Disease Prevention in Rheumatoid Arthritis: A Systematic Review of Guideline Recommendations and Quality Indicators

Tue 27 Jan 2015 -  Best Practices for Cardiovascular Disease Prevention in Rheumatoid Arthritis: A Systematic Review of Guideline Recommendations and Quality Indicators

Objective: Cardiovascular disease (CVD) is a leading cause of mortality in rheumatoid arthritis (RA). This study systematically reviewed and appraised guidelines and quality indicators (QIs) ...

Online CME

Abnormal ECG findings in athletes: recognising changes suggestive of cardiomyopathy

This module describes ECG findings present in cardiomyopathies afflicting young athletes and outlines appropriate steps for further evaluation of these ECG abnormalities. The ECG findings defined as abnormal in athletes...

Clinical review - Cardiomyopathy

This article covers the diagnosis and management of cardiomyopathy.

Chest pain - Red flag symptoms

This activity covers the causes and management of chest pain in primary care

Clinical Trials

Renal Sympathetic Denervation by Iberis System in Patients With Uncontrolled Hypertension - Iberis-HTN Registry

Mon 17 Nov 2014

The purpose of this study is to document safety and efficacy of renal sympathetic denervation treatment in subjects with uncontrolled hypertension by using Iberis renal denervation ...

Cryoballoon Ablation in Patients With Longstanding Persistent Atrial Fibrillation (CRYO-LPAF)

Wed 12 Nov 2014

Prospective and explorative clinical study. The objective is to assess the clinical efficacy of pulmonary vein isolation using the Arctic Front Advance cryoballoon in patients with longstanding ...

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