Description

Medicine changes rapidly and Cardiology is often at the peak of this rate of change. Huge
resources, both human and financial, are brought to bear to develop new improvements in care and
validate and optimise current treatments. Perhaps, cynically, device and pharmacological
companies see cardiac conditions as common, important and amenable to intervention above all
other illnesses. In addition there is a significant political imperative to develop, standardise and
prioritise care for ischaemic heart disease and other cardiac conditions.

The outcome of these drivers is that technology, guidelines, treatments and opinions in this field
of medicine move faster than any other. It is on this background that Professor Dhillon asked me to
bring together a series of articles of interest to GPwSIs in Cardiology to update you on a number of
important aspects of the management of cardiac diseases. This is the first of a planned series of
themed clinical focus publications and I hope will prove of interest.

In order for care to all patients to be optimised I believe it imperative that clinicians at the coalface
of primary care are provided with the most up to date and well argued advice available. One
way to distil the best of current evidence and opinion is in the form of the consensus documents that
are produced as guidelines by professional bodies. As always judgement is important to apply
guidelines to individuals, but that notwithstanding they do provide an excellent basis for care. In this
clinical focus we have an excellent review of the changing and current guidance on the treatment of
hypertension clearly a very common condition in all parts of clinical medicine.

Arrhythmias and palpitations make up a significant amount of the clinical work-load of busy
general practitioners. With an aging population atrial fibrillation is becoming increasingly common
and its management can be very variable. To help to improve this we have included a review of
current best practice in the management of this condition, including an indication of when further
advice may be required and also the role of advanced technologies in the optimisation of care.

Advances in imaging techniques often drive forward change in cardiology and therefore we have
included a review of the role of CT and MRI scanning in cardiology which explains these relatively
new technologies in superb detail.

Heart failure is, to a large extent, a community disease and it is well known that optimising care
of patients in their homes dramatically reduces the use of hospital resources and improves the
quality of patients lives. Changes in the best care of this group of patients has been dramatic over
recent years and included is an article on these.

Finally a special addition on cardiology would not be complete without my pet subject of
interventional cardiology. Two aspects of this subject have achieved attention in this publication,
firstly the (at times) vehement debate about the role of angioplasty in stable patients and equally
importantly the latest views on the effectiveness and methods used in cardiac rehabilitation for all
cardiac patients.
I trust this collection of articles is of interest to you and sparks further enthusiasm for the ideal
management of these very commonplace and yet often challenging patients. Feedback is as always
is very helpful and feel free to bend the ear of the contributors or myself if you take issue either
positively or negatively with what you find.