The 24th Annual Cardiovascular SIG event was held on 24 January 2020 in London.
Ambulatory Care and the Older Person - Dan Lasserson
This talk will cover the background and current UK context for acute care of the older person with frailty. We will discuss screening for frailty, extent of provision of ambulatory care for older people, outcomes for older patients treated on ambulatory pathways and the variation in models of hospital at home care. Research on the impact on patients with frailty and their carers during ambulatory treatment for acute illness will be discussed, along with implications for designing models of care.
Monitoring in Ambulatory Care - Matt Reed
Many patients present to the ED and acute medicine units with palpitations, syncope and pre-syncope. Investigating this patient group relies on correlating symptoms with ECG findings which is challenging due to lack of access to appropriate ECG monitoring beyond the cardiology clinic setting. Novel smartphone and patch ambulatory ECG monitors enable focussed investigation in the Ambulatory Care setting. This talk will discuss these possibilities in the context of the recently published IPED and PATCH-ED studies.
PE: Investigation and Management - Robin Condliffe
We will review current approach to management of acute pulmonary embolism including the importance of risk stratification, management issues related to higher risk PE and the role for ambulatory management in patients at lower risk.
Chest pain assessment and management in the older person - Adam Timmis
Chest Pain in Older People. Clinical assessment plays a central role in the patient presenting with chest pain. It is particulalry important in older people because the prevalence of coronary artery disease increases steeply with age. This has two important consequences for diagnosis:
1. The sensitivity of diagnostic stress testing declines progressively as people get older.
2. Coronary artery disease is commonly a bystander diagnosis in older age groups.
Management decisions must also take account of age, recognising that quality of life is often more important to older patients than surgical interventions aimed at prolonging life. These complex diagnostic and treatment considerations will be discussed in my talk.
Diagnosis and Management of TIA: An Update - Ajay Bhalla
1) Importance of making the right diagnosis and future risk of stroke
2) Excluding TIA mimics
3) Risk Stratification
4) Secondary prevention measures