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Cardiology
Case report 14/03/2018

Problematic pacemaker placement

Problematic pacemaker placement

Time to read article: 2 mins
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Mr U, a 29-year-old teacher, was referred to Dr N, a consultant cardiologist, with a history of several episodes of dizziness, perspiration and palpitations. A 24-hour ECG had shown episodes of tachycardia and bradycardia, and second-degree Mobitz type II heart block was demonstrated when symptomatic.

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05/11/2015

Ask the expert – DNACPR orders and communication

Ask the expert – DNACPR orders and communication

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Recently a patient with terminal pancreatic cancer presented acutely with bowel obstruction and was admitted to hospital under our team. We discussed DNACPR with the patient, and he was in agreement that this would be appropriate to have in place. The following day, however, his wife was very unhappy this had not been discussed with her, and she asked to have the DNACPR order removed. To what extent are we as clinicians obliged to discuss a DNACPR decision with relatives, having already discussed this with the patient?

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Factsheet 01/10/2013

HSC complaints procedure – Hospital setting

HSC complaints procedure – Hospital setting

Time to read article: 5 mins
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Complaints in health and social care: standards and guidelines for resolution and learning (2009) aims to provide a simple, consistent approach for staff who handle complaints, and for patients who raise complaints across all health and social care services.

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Case report 14/05/2012

Where is the consultant?

Where is the consultant?

Time to read article: 2 mins
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A 48-year-old driver, Mr W, was sent to hospital by his GP with a one-week history of unremitting back pain and associated mild shortness of breath. On direct questioning, he also reported non-specific malaise for at least three months with half a stone weight loss but no symptoms of fever. There was no previous history of cardiac problems and no recent dental or other invasive procedures.

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Case report 01/09/2010

A bloody epidural

A bloody epidural

Time to read article: 3 mins
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Mrs M, a 70-year-old woman, was admitted to the local hospital’s cardiac surgery unit. Six years ago, a triple coronary artery bypass graft (CABG) had given her a new lease of life, but since then the grafts had gradually become blocked, and she could no longer exercise. As a result, she had put on weight and was now obese. She had always been hypertensive.

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Case report 01/01/2008

A sticky situation

A sticky situation

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Mr R was a healthy 17-year-old student who suffered with a severe form of palmar hyperhidrosis. Mr R’s GP referred him to Mr F, a cardiothoracic surgeon. Following discussion about possible alternative treatment, Mr R was very keen on the surgical option, so Mr F placed him on the waiting list for a right-sided transthoracic endoscopic sympathectomy.

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Case report 01/11/2005

Ultrasound, antibiotic prophylaxis and endocarditis

Ultrasound, antibiotic prophylaxis and endocarditis

Time to read article: 2 mins
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Mrs N had a complex medical history; in her early twenties she had a splenectomy, chemotherapy and radiotherapy for treatment of Hodgkin’s disease. This caused ovarian failure and she then developed a pelvic abscess which left her fallopian tubes occluded.

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Case report 01/02/2004

Vein or artery?

Vein or artery?

Time to read article: 3 mins
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Mrs T, a housewife in her thirties, was in the first trimester of pregnancy. She’d had trouble with lower back pain, which suddenly intensified one Sunday morning. She attended her local out-of-hours co-operative and coincidentally saw her own GP, Dr F.

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