Heart, lung & circulation
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Heart, lung & circulation · Jul 2010
Management of atrial fibrillation in the acute setting--findings from an Australasian survey.
Acute atrial fibrillation (AF) is a commonly encountered problem in emergency departments. In this web-based questionnaire study, 242 emergency physicians and 77 cardiologists in Australasia managed seven hypothetical acute AF scenarios. We found wide variation in practice within and between specialties, and a significant proportion of responses inconsistent with best practice guidelines.
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Heart, lung & circulation · Jul 2010
Case ReportsAmiodarone-induced alveolar haemorrhage: a rare complication of a common medication.
Amiodarone pulmonary toxicity (APT) is a common and distinctive form of drug-induced lung injury. Several patterns have been described and the most common pattern of APT is interstitial pneumonitis. ⋯ High suspicion of APT in patients with these non-specific clinical symptoms is needed. Early recognition and treatment are imperative.
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Rates of acute rheumatic fever and chronic rheumatic heart disease in Aboriginal people, Torres Strait Islanders and Māori continue to be unacceptably high. The impact of rheumatic heart disease is inequitable on these populations as compared with other Australians and New Zealanders. The associated cardiac morbidity, including the development of rheumatic valve disease, and cardiomyopathy, with possible sequelae of heart failure, development of atrial fibrillation, systemic embolism, transient ischaemic attacks, strokes, endocarditis, the need for interventions including cardiac surgery, and impaired quality of life, and shortened life expectancy, has major implications for the individual. ⋯ Underpinning these strategies is the need to improve poverty, housing, education and employment. Cultural empathy with mutual trust and respect is essential. Involvement of Indigenous people in decision making, design, and implementation of primary and secondary prevention programs, is mandatory to reduce the unacceptably high rates of rheumatic heart disease.
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Heart, lung & circulation · May 2010
ReviewImproving cardiovascular care for indigenous populations.
The challenges and opportunities for provision of, and access to, reliable chronic cardiovascular health care for Indigenous people were addressed by expert speakers from New Zealand and Australia. It is well recognised that cardiovascular disease is a life-long concern, requiring reliable follow-up, early transition of clinical research into practice and ongoing support of patients. ⋯ This paper summarises the principal issues identified by the expert speakers for the provision of chronic cardiovascular health care to Indigenous peoples in Australia and New Zealand; identifies common challenges and describes important initiatives which the Cardiac Society of Australia and New Zealand (CSANZ), in partnership with health care professionals, communities and governments, can undertake in order to achieve the goals of uniform and equitable health care for chronic cardiovascular disease in all the Indigenous peoples, relevant to the needs of these peoples, in New Zealand and Australia. The issues addressed by the meeting include: 1) Determination of appropriate models for effective delivery of cardiovascular health care. (2) Who should deliver cardiovascular health care and what are the workforce requirements. (3) What support systems and infrastructure are required. (4) How can primary care and secondary specialist services be effectively integrated.
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Heart, lung & circulation · May 2010
ReviewStrategies to improve indigenous access for urban and regional populations to health services.
Lack of appropriate health service provision for Aboriginal and Torres Strait people still remains and important social determinant of ill health. Historically, health services have been absent or inappropriate. Cultural factors, financial factors and distance from health services have been important barriers limiting Indigenous access to mainstream health services. ⋯ The Adult Health Checks provide an opportunity to evaluate health status, identifying chronic disease risk factors and for implementing preventive care. The Inala Indigenous Health Service has access to the Healthy for Life Program, a Commonwealth funded quality improvement program that has improved health outcomes for patients over the past three years. All primary health care services working in Aboriginal and Torres Strait Islander health settings should have access to funded continuous quality improvement activities.