THE ANGINA PLAN COMES TO WINDSOR, ASCOT AND MAIDENHEAD

Once again THROB has stepped in to assist with a new service for cardiac patients locally. Angina has been one area that has often had to take a back seat in terms of prevention and education compared with the needs of people suffering from heart attacks or having surgical interventions on the heart. Cardiac rehabilitation at Wexham Park and Heatherwood has never managed to find the extra time that would be needed to include angina sufferers in their education and exercise programmes and the local Primary Care Trust (PCT) has been concerned for some time that there is a gap in the service.

Slough PCT introduced The Angina Plan as a pilot project last year and produced some encouraging results when patients who were guided through the Plan found that they could increase their exercise and reduce the number of episodes of angina at the same time. I therefore approached THROB on behalf of Windsor Ascot and Maidenhead PCT and requested the initial funding in order to get myself qualified as an Angina Plan Facilitator and for THROB to purchase a supply of Angina Plan manuals for the patients. By the time you read this I should be fully qualified and ready to start seeing patients. Patient will be newly-diagnosed angina patients referred to me via the Rapid Access Chest Pain Clinic at Wexham Park.

The Angina Plan uses what is called a 'cognitive-behavioural' approach to managing angina. In simple terms this just means the patient uses a self-help manual over a period of 3 months, assisted by the facilitator, which aims to alter the thinking process (cognitive) that may be restricting patients in their activities and therefore to change their behaviour which will in turn assist them to reduce or manage their angina better and prevent progression to heart attack.

For those of you with computer access there is a website about it here - www.anginaplan.org.uk - but if you want to know more I shall be doing a 30-40 minute presentation on this at the next AGM in April, so I look forward to seeing many of you there.

Lesley Richards

INTERESTING MEDICAL RESEARCH ABOUT HEART ATTACKS

1. The Japanese eat very little fat and suffer fewer heart attacks than Australians, British or Americans.

2. Mexicans eat a lot of fat and suffer fewer heart attacks than the Australians, British or Americans

3. Africans drink very little red wine and suffer fewer heart attacks than the Australians.

4. Italians drink large amounts of red wine and suffer fewer heart attacks than the Australians, British and Americans.

5. Germans drink a tot of beer and eat lots of sausages and suffer fewer heart attacks than the Australians, British or Americans.

Medical Conclusion:

Eat and drink what you like. Speaking English is apparently what kills you!

DIAL 999

One of our members was talking recently with a local GP who was very concerned that patients either do nothing or call the surgery rather than making a 999 call. It is timely that the local Ambulance Trust have just issued the following statement on a 999 call for cardiac emergencies. The complete reference is on the web http:/berkshire.nhs.uk/rbat/community/community-5.asp

"Someone in the United Kingdom will have a heart attack every two minutes. Half these people will die as a result. Recognising that you or someone else is having a heart attack and calling 999 immediately could save a life.

SIGNS AND SYMPTOMS of a heart attack can vary depending on which part of the heart is being affected; the victim of a heart attack may only have a few signs and symptoms.

- Chest pain

- Pain or numbness radiating down the arm, into the jaw, back or upper abdomen

- Dizziness or passing out

- Shortness of breath

- Nausea (feeling sick)

- Pale/grey, cold and clammy skin

- Profuse sweating

- A strong feeling that they are going to die

REMEMBER: Many people leave it several hours before calling for help. If you suspect a heart attack dial 999 immediately. Many people still call their doctor's surgery first when they suspect a heart attack. Doctors are not always immediately available and can get stuck in traffic on the way to a call. The ambulance service carry all the necessary resuscitation equipment and drugs required in a heart related emergency and can usually get to you faster. In a suspected heart attack dial 999 first, then the surgery.

WHAT TO DO NEXT Well, a heart attack rneans just that. The person's heart is under attack and this means it could stop altogether. Keeping the heart at rest gives it the best chance of keeping going until help arrives. The key is rest and reassurance.

- Keep the person in a comfortable relaxed position,which.will reduce the work of the heart..A half sitting position with the head and shoulders supported and the knees bent is often preferred.

- Never move a person suspected of having a heart attack unless they are in danger.

- Make the least amount of fuss, although the situation is scary to you, try not to convey your fears or sense of urgency to the person concerned as the heart beat will be raised if they are frightened. If you are in a public piece, try to reduce embarassment by clearing unwanted onlookers away.

- Do not leave the person, they may stop breathing and their heart may stop. If you suspect this has happened call back again on 999 and follow the advice of the ambulance service, you will be given advice on CPR over the telephone.

Improve your confidence and life saving skills by learning what to do in an emergency The Royal Beiks,hire Ambulance SeMce and other organisations such as the Red Cross and St. John Ambulance all run courses.

WHAT THE PAPERS SAY

A caution

According to an American study, men who take drugs for impotency, such as Viagra or Cialis, and who have previously had a heart attack may have a tenfold increased risk of damaging their eyesight. The eye condition is known as non-arteric anterior ischemic optic neuropathy - but you probably knew that already - can be sudden, cause complete loss of vision and the damage is irreversible. Well they've always said that too much sex can send you blind!

Non-steroidal anti-inflammatory drugs (NSAIDs)

These drugs are widely used to relieve the pain of arthritis and have been found to cause an increase risk of heart attack and stroke. Nottingham University have been studying this link and identified 9,000 men and women who had suffered first heart attacks and looked at their medication in the preceding four years to see whether they had been taking NSAIDs including ibuprofen, diclofenac, naproxen, celecoxib and rofecoxib. Ibuprofen was the only over-the-counter drug. The University stresses that the work was an observational study and not a trial and patients should not stop taking their drugs. The worst offender appeared to be diclofenac which increased risk by 55% meanin that there would by one extra patient for every 521 would have a heart attack inked to the drug.

(Makes you think, though - I had diclofenac for a number of years before I had my MI, and then I had a mini-stroke. Ed.)