Cardiovascular diseases

The failure of health technology assessments to bridge the federal–state divide contributes to public–private access gaps

Jonathon B Ryan

Anti-inflammatory drugs can reduce cardiovascular events, but risks, benefits and mediating mechanisms are still uncertain

Samia Kazi · James J H Chong · Clara K Chow

A 41-year-old G1P1 woman presented with two days of dyspnoea four weeks postpartum

Jessica V Yao · Joshua Wong · Anu Aggarwal

We need inexpensive methods for distinguishing between people with hypertension who have primary aldosteronism and those who do not

John W Funder

Screening test results for primary aldosteronism were positive for about one-quarter of urban Indigenous and non-Indigenous participants

Elisabeth Ng · Stella M Gwini · Michael Stowasser · Morag J Young · Peter J Fuller · Gurmeet R Singh · Jun Yang

Choosing therapies well, with the patient’s preference, requires an understanding of the temporal risk profile of coronary artery disease

Derek P Chew · Sarah Zaman

The availability of evidence-based therapies should be seen as a call to action to urgently streamline and unify the diagnosis of HFpEF at the clinical interface

Sandhir B Prasad · David J Holland · John J Atherton

A 76-year-old woman presented to a regional hospital with COVID-19-related symptoms

Gabriela Strey

Improving diagnostic capabilities in rural areas will require a commensurate increase in clinical decision-making and therapeutic capacity

Taylor Strube · Derek P Chew

Local assessment could improve access to cardiac services in rural centres and reduce the costs associated with sending patients to Perth

Mikhail Alexander · Nick S R Lan · Michael J Dallo · Tom G Briffa · Frank M Sanfilippo · Andrew Hooper · Helen Bartholomew · Loletta Hii · Graham S Hillis · Brendan M McQuillan · Girish Dwivedi · James M Rankin · Abdul Rahman Ihdayhid

Selecting a suitable CVD risk equation for the Australian population

Sinan Brown · Emily Banks · Mark Woodward · Natalie Raffoul · Garry Jennings · Ellie Paige

A national framework could be beneficial to provide sites with evidence, possible models, and business cases

Kenneth K Cho · John K French · Gemma A Figtree · Clara K Chow · Rebecca Kozor

To survive a sudden cardiac arrest, you need to be in the “right place at the right time”; but should someone’s chance of surviving a sudden cardiac arrest really come down to a roll of the dice?

Elizabeth Paratz · Gregory J Page · Garry LR Jennings

A 60-year-old woman presented to the emergency department with confusion and memory loss on the day of her father’s death

Nikolaos Papadopoulos · Ashleigh Dind · Karam Alzuhairi · Peter Caspari

Accurate peri-operative risk assessment is important to enable shared decision making and to optimise the multidisciplinary management of patients undergoing major non-cardiac surgery

Shehane Mahendran · Aravinda Thiagalingam · Graham Hillis · Richard Halliwell · Henry CC Pleass · Clara K Chow

Awareness that the myocarditis risk in children with SARS-CoV-2 infections differs from that for adults should inform vaccination strategies

Patrick Walker · Timothy C Lai · Silja Schrader · Nigel Crawford · Daryl R Cheng

A 12-year-old girl presented to a general practitioner with a two-day history of progressively worsening blurry vision

Nandini Singh · Kanika Chaudhri · Caroline Catt

Pregnancy can be seen as a stress test for cardiometabolic conditions, where the physiological demands of pregnancy can unmask women at risk for CVD

Simone Marschner · Anushriya Pant · Amanda Henry · Louise J Maple‐Brown · Lisa Moran · N Wah Cheung · Clara K Chow · Sarah Zaman

Widespread, inexpensive CAC scanning could economically expand access to statin therapy to those at highest risk

Erfan Tasdighi · Michael J Blaha

Expanding eligibility for statin therapy should selectively target people with subclinical atherosclerosis rather than simply lowering treatment thresholds

Prasanna Venkataraman · Amanda L Neil · Geoffrey K Mitchell · Tony Stanton · Stephen Nicholls · Andrew M Tonkin · Gerald F Watts · Thomas H Marwick

To the Editor: Over 26000 Australians experience out‐of‐hospital cardiac arrest (OHCA) each year, with almost nine in ten of these patients not surviving to hospital discharge or 30 days.1 Although it is known that swift defibrillation increases the possibility of patient survival in these situations, and that initial defibrillation by first responders (regardless of training) is associated with greater survival than initial defibrillation by emergency medical services,2 in Australia, less than 2% of OHCA cases receive defibrillation by a bystander.1 It is likely that this is driven by the limits to publicly accessible automated external defibrillators (AEDs) in Australian communities.3 On 30 November 2022, South Australia took a major step to deal with this problem and reduce death from OHCA. The SA Parliament passed the Automated External Defibrillators (Public Access) Bill 2022,4 making SA the first state or territory in Australia, and one of few in the world, to mandate the public provision of AEDs. The legislation, introduced by Member of the Legislative Council, the Hon Frank Pangallo of the SA‐BEST party, had bipartisan political support and backing from various organisations, and follows a recent public health campaign to install AEDs in Adelaide. The Bill will come into effect for government and public buildings in 2025 and a variety of private buildings in 2026, with awareness campaigns, grant programs, and communication with organisations being the focus of the interim period. The expected cost to the SA government of $7.2 million across four years is weighed against the $2 billion gross domestic product loss that Australia incurs annually as a result of sudden cardiac arrest.5 The health and economic benefits of public access defibrillation to Australian society are large. For the benefit of all Australians, other states and territories should follow the example set by SA and move to implement similar laws mandating the public availability of AEDs in their communities.

Joshua G Kovoor · Gregory J Page · Pramesh Kovoor

Data on the expected effectiveness of a formal cardiovascular risk screening are needed

Ellie Paige · Natalie Raffoul · Emma Lonsdale · Emily Banks