Cardiovascular diseases

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

Restrictions should be accompanied by advice about appropriate locations for seeking medical care, by condition severity and type

Amy L Sweeny · Gerben Keijzers · Andrea Marshall · Emma J Hall · Jamie Ranse · Ping Zhang · Gary Grant · Ya‐Ling Huang · Dinesh Palipana · Yang D Teng · Benjamin Gerhardy · Jaimi H Greenslade · Philip Jones · Julia L Crilly

AF self-screening in general practice waiting rooms is feasible, and could reduce the number of AF-related strokes

Katrina Giskes · Nicole Lowres · Jessica Orchard · JiaLin Li · Kirsty McKenzie · Charlotte Mary Hespe · Ben Freedman

A 44-year-old man presented to the emergency department with left knee monoarthritis

Caitlin Paul · Joseph O'Brien · Sarah Huffam · Daryl Ridley

Cardiovascular disease mortality is not increased in women undergoing IVF, but vigilant surveillance is nonetheless required

Robert J Norman

Reassuringly, fertility treatment does not increase long term all-cause or CVD mortality risk

Stephanie R Yiallourou · Dianna Magliano · Tilahun N Haregu · Melinda J Carrington · Daniel L Rolnik · Luk Rombauts · Andre Rodrigues · Jocasta Ball · Fiona J Bruinsma · Fabricio Da Silva Costa

A 58-year-old man presented with 4–6 weeks of lower limb muscle weakness, an elevated serum creatine kinase level of 344 U/L, painful paraesthesia, and weight loss

Laura Bywater · Anthea C Gist · Rahul G Muthalaly · Joanna Loh · Ian Simpson · Anthony J White · Andy KH Lim

Prioritisation for unloading, once obvious cardiac emergencies have been excluded, disadvantages women and older people

Gao Jing Ong · John D Horowitz

Refining the assessment of symptoms in women in pre-hospital emergency services care could improve patient outcomes

Xia Wang · Cheryl Carcel · Benjumin Hsu · Sultana Shajahan · Matthew Miller · Sanne Peters · Deborah A Randall · Alys Havard · Julie Redfern · Craig S Anderson · Louisa Jorm · Mark Woodward

New recommendations for the pharmacological management of heart failure

Andrew P Sindone · Carmine De Pasquale · John Amerena · Christine Burdeniuk · Alicia Chan · Andrew Coats · David L Hare · Peter Macdonald · Aaron Sverdlov · John J Atherton

SGLT2 inhibitors show promise in improving metabolic and cardiovascular health in type 1 diabetes, yet ideal candidates for therapy require careful selection

Jennifer R Snaith · Jerry R Greenfield

Longer ambulance offload times are associated with greater 30-day risks of death and ambulance re-attendance

Luke P Dawson · Emily Andrew · Michael Stephenson · Ziad Nehme · Jason Bloom · Shelley Cox · David Anderson · Jeffrey Lefkovits · Andrew J Taylor · David Kaye · Karen Smith · Dion Stub

Emergency department presentations are opportunities to discuss cardiovascular risk factors while the patient’s awareness of their importance is heightened

Christopher Zeitz · Angus Baumann

A 32-year-old man with 15 years of intermittent bloody diarrhoea was diagnosed with ulcerative proctosigmoiditis

Kenneth K Cho · Yanna Ko · Kelly Nilsen · Christine Verdon · Giuseppe Femia

Aboriginal and Torres Strait Islander people may benefit from culturally appropriate cardiac risk factor management

Jaimi H Greenslade · Sara Berndt · Laura Stephensen · Katrina Starmer · Greg Starmer · William Parsonage · Victor Lau · Tileah Drahm‐Butler · Tania Davis · Virginia Campbell · Richard Stone · Robert Bonnin · Sarah Ashover · Tanya Milburn · Elizabeth Mowatt · Karlie Proctor · Anthony Brazzale · Louise Ann Cullen

Overcoming problems that impede the delivery of evidence-based care is needed to bridge gaps between science and improving health

Sher May Ng · Jiliu Pan · Ajay K Gupta