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Volume 19, No.10
November / December 2003

ARTICLES

Feature
Peripheral Arterial Disease:
How to Diagnose, When to Refer

Peripheral arterial disease affects 12% of the general population. How is it diagnosed and when do you refer your patients to a specialist?.

By Gerrit B. Winkelaar, MD, MSc, FRCSC


Feature
Breathing Life into Pulmonary Embolism

Unfractionated heparin is one of the treatment options for patients with pulmonary embolism. What other treatments are available?

By Walter Ageno, MD; and Alexander G. Turpie, MD, FRCP, FRCPC, FACC)


Feature
Fever and a New Heart Murmur

Prosthetic valve endocarditis afflicts 2% to 4% of patients with prosthetic valves. Learn more about the diagnosis and treatment of this possibly fatal affliction.

By Subodh Verma, MD, PhD; Mitesh V. Badiwala, BSc; and Nicole Look Hong, BSc


Cardiovascular Reporter
ICDs for Preventing Sudden Death

By Gregory P. Curnew, MD, CM, FRCPC


CardioCase of the Month
Cholesterol concerns

By Alkykhan S.M. Abdulla BSc, MD, CM, LMCC, CCFP(C); and Faiza Abdulla, CDA


ECG of the Month
A Sack of Trouble

By Martin S. Green, MD, FRCPC


Cardiovascular News
Leenen is first recipient of Pfizer Chair; New data in cardiovascular disease prevention; Plavix® has limited use listing in Ontario.

Volume 19, No.9
October 2003

ARTICLES

Feature
Atrial Fibrillation
Rate or Rhythm Control Could be the Key

DECK: Recent studies have proven that an option of pharmacologic and non-pharmacologic therapy is available to patients who suffer from AF.
.
By Paul Dorian, MD, FRCPC and Nilofar Islam, MD


Feature
The Innocence of Innocent Heart Murmurs

DECK:
Family physicians and parents alike need clarification on what innocent heart murmurs are and how they can be diagnosed.

By By John Dyck, MD, FRCP(C); and Murray A. Robertson PhD, MD, FRCP(C)


Feature
How HRT Hurts the Heart

DECK: Coronary artery disease is a killer and recent studies have come up with evidence that HRT might have a role in increasing CAD among women. Why?

By Zaheer Lakhani, MD, FRCP


Cardiovascular Reporter
Vaccinations and Heart Disease

By Gregory P. Curnew, MD, CM, FRCPC


CardioCase of the Month
“How can I control atrial fibrillation?”

By Paul Dorian, MD, FRCPC and Nilofar Islam, MD


ECG of the Month
“Two for one”

By Martin S. Green, MD, FRCPC


Cardiovascular News
DECK: COMET trial shows efficacy of carvediol: More findings come out of Val-HEFT: Perindopril saves lives: Benefits of Atacand®.

Volume 19, No. 8
September 2003

ARTICLES

Feature
Stroke Prevention in the Office: What’s My Role?


DECK: Many physicians will encounter stroke on a daily basis in their office practice. They may be consulted by patients at risk of a first stroke or by survivors of a prior event who wish to avoid a recurrence.

By F. O’Rourke, MD, MRCP(UK); N. Dean, MD; MRCP(UK);
N. Akhtar, MD; and A. Shuaib, MD, FRCPC


Feature
Chronic CAD & Antiplatelets: What’s the Fit?

DECK:
Platelets are essential to the thrombotic process that leads to myocardial
Infarctions.

By C. Russell Mao, MD; Gwen Liu, BScPhm; and
Arthur Dodek, MD, ABIM, FACC, FACP, FRCPC


Feature
Vitamin Supplements: Do They Help?

DECK: According to one study, over 40% of American cardiologists have routinely taken antioxidants, and have prescribed them to their patients. Over 30% of the U.S. population currently uses supplements.

By David Wood, MD; and Ken Gin, MD, FRCPC, FACC


Cardiovascular Reporter
Ascot Eases the Heart

By Gregory P. Curnew, MD, CM, FRCPC


CardioCase of the Month
“Will vitamin supplements save me?”

By David Wood, MD; and Ken Gin, MD, FRCPC, FACC


ECG of the Month
“I feel a little irregular”

By Martin S. Green, MD, FRCPC


Frequently Asked Questions
FAQs on this month’s feature articles


Do you have a question for our medical experts?


Cardiovascular News
DECK: Canadian brings heart to climbing expedition; Hypertension; Mitral valvuloplasty; Intricate heart procedure; and stroke research.

Volume 19, No. 7
August 2003

ARTICLES

Feature 1
Cerebral Aneurysms: Early Detection is Key to Survival

DECK: Due to its devastating mortality rates, physicians should remain on high alert for early signs and symptoms of cerebral aneurysms.

By John J. Kelly, MD;
Deon F. Louw, MD, FRCSC; and
Garnette R. Sutherland, MD, FRCSC


Feature 2
Congestive Heart Failure: How do I Manage my Outpatients?

DECK: CHF affects up to 2% of the population. It is a very disabling and debilitating illness.

By Michael C. Y. Chan, MD, FRCPC;
and Rosa Gutierrez, MN, NP


Feature 3
ALLHAT: Is it All That?

DECK:
The results of the hypertension arm of ALLHAT introduced the notion that an old, less expensive drug could come out looking better than its newer, more expensive counterparts. But what are the limitations of ALLHAT?

By Henry Chung, MD; and
Brett Heilbron, MB ChB, FRCPC, FACC


Cardiovascular Reporter
Devices for End-Stage Heart Failure Management

By Gregory P. Curnew, MD, CM, FRCPC


CardioCase of the Month
CHF Leaves Hiker Panting

By Michael C. Y. Chan, MD, FRCPC;
and Rosa Gutierrez, MN, NP


ECG of the Month
Faster and Faster

Bruno Martin, MBBS, FRACP; and Martin S. Green, MD, FRCPC


Frequently Asked Questions
FAQs on this month’s feature articles


Cardiovascular News
DECK: Altace® reduces heart failure; Medication for “bad”cholesterol; Good news for obese patients; and Lipitor® and diabetes.

Volume 19, No. 6
June / July 2003

ARTICLES

Extending the Scope of Statins:
Recent Clinical Trials
By Daniel G. Hackam, BSc, MD
Dr. Hackam discusses the most recent major statin trials, and who will benefit from statin therapy.


Reclaiming Clinical Confidence
The Systolic Murmur
By T.K. Fenske, MD, FRCPC, FACC, FCCP
Dr. Fenske discusses key palpatory and auscultory techniques, and how to differentiate common systolic murmurs in a physical exam.


What’s New in Hypertension?
The 2003 Canadian Hypertension Education Program Recommendations
By Ross Feldman, FRCPC
Hypertension remains a major public health problem in Canada. These recommendations are tools to improve the management of hypertension.


DEPARTMENTS

Cardiovascular Reporter
By Dr. Gregory Curnew, MD, CM, FRCPC
(In collaboration with Hamilton Health Science Corporation)
Heart Disease in Patients Under 40


CardioCase of the Month
By Anita W. Asgar, MD, FRCPC; and
Jonathan Howlett, MD, FRCPC
Gasping For Air: Atrial Septal Defect


ECG of the Month
By Martin S. Green, MD, FRCPC
(In collaboration with University of Ottawa Heart Institute)
K-Light


Cardiovascular News
Altace® Reduces Heart Failure And is Cost-Effective, Zetia™ Helps Reduce C-Reactive Protein, and much more

Volume 19, No.5
May 2003

ARTICLES


Keeping Up the Pace
Atrial Fibrillation in Clinical Practice
By Indranill Basu Ray, MBBS, MD, DNB
Atrial fibrillation (AF) is the commonest arrhythmia in clinical practice. There are many therapeutic approaches, each one suited to a particular type of AF or to the patient being treated.


Staying on the Attack
Getting to Transient Ischemic Attacks Early
By Vanessa Palumbo, MD; Alastair M. Buchan, MB, FRCPC; and
Michael D. Hill, MD, FRCPC
The risk of stroke is very high following a transient ischemic attack. Early diagnosis and treatment is key in reducing this risk.


DEPARTMENTS

Cardiovascular Reporter
By Dr. Gregory Curnew, MD, CM, FRCPC
(In collaboration with Hamilton Health Science Corporation)
Heart Disease in Women: A Look at Some Major Studies


CardioCase of the Month
By Peter Hum, BSc, MD, CCFP
Getting on Track and Staying There: Treatment Post-Myocardial Infarction


ECG of the Month
By Martin S. Green, MD, FRCPC
(In collaboration with University of Ottawa Heart Institute)
The Great Escape


Clinical Issues in Hypertension
By George J. Fodor, MD, PhD, FRCPC
(In collaboration with the Canadian Coalition for High Blood Pressure Prevention and Control)
Putting Your Heart at Risk: Hypertension and Dyslipidemia


Cardiovascular News
Lipitor® reduces coronary events; Scientific advances for Canada; Are estrogen patches less risky than pills?; Vasotec® reduces diabetes in heart failure patients

Volume 19, No.4
April 2003

ARTICLES

Does Your Patient Need Cardiac Surgery?
What to Expect Before and After
By Arvind Koshal, MB, BSc, MS, FRCSC; and Nitin Ghorpade, MBBS, MS, MCh Patients who are facing some form of cardiac surgery need to understand the risks and benefits involved. Some procedures can prolong life without many complications, while others have mortality rates as high as 25%.

Gaining a New Outlook
Diet and Coronary Artery Disease
By Jean G. Dumesnil, MD, FRCPC, FACC
Obesity has reached epidemic proportions in North America, increasing the incidence of coronary artery disease and Type 2 diabetes. Understanding the effects of diet modifications plays a huge role in preventing this growing problem.


DEPARTMENTS

Cardiovascular Reporter
By Dr. Gregory Curnew, MD, CM, FRCPC
(In collaboration with Hamilton Health Science Corporation)
A New Way to Diagnose Congestive Heart Failure

CardioCase of the Month
By Anita W. Asgar, MD; and Jonathan Howlett, MD, FRCPC
Heart Failure with Gouty Arthritis: Are nonsteroidal anti-inflammatories the answer?

ECG of the Month
By Martin S. Green, MD, FRCPC
(In collaboration with University of Ottawa Heart Institute)
An Interval Difference

Clinical Issues in Hypertension
By Elinor Wilson, RN, PhD; and Norman R.C. Campbell, MD, FRCPC
(In collaboration with the Canadian Coalition for High Blood Pressure Prevention and Control)
A Mounting Risk: Hypertension and the World Health Report 2002

Cardiovascular News
Is kidney disease becoming an epidemic?; A new standard for angioplasty treatment; & more.

Volume 19, No.3
March 2003

ARTICLES

Weighing Benefits and Risks
Clot Prevention in Cardiac Care
By Jay Biem, MD, MSc, FRCPC; and Thomas Wilson, MD, MSc, FRCPC
Cardiovascular diseases are extremely prevalent in Western society and oral medications are plentiful. From hypertension to atrial fibrillation, each affliction has a drug treatment that is most effective.

Stopping a Silent Killer: Aortic Stenosis
Detection and Evaluation
By Annie Dore, MD, FRCPC
Its symptoms are quiet and progress late in life, but its effects are deadly. Early detection of aortic stenosis is the best chance for survival.


DEPARTMENTS

Cardiovascular Reporter
By Dr. Gregory Curnew, MD, CM, FRCPC
(In collaboration with Hamilton Health Science Corporation)
Modern-Day Management of Angina Pectoris

CardioCase of the Month
By Norman R.C. Campbell, MD, FRCPC
Managing Hypertension Post-ALLHAT

ECG of the Month
By Martin S. Green, MD, FRCPC
(In collaboration with University of Ottawa Heart Institute)
Fast-Paced!

Cardiovascular News
New Test Could Predict Risk of Heart Attack; A Partnership to Improve Health in Canada; Curbing Youth Smoking; Slow Adoption of Medical Research.


February 2003
Volume 19, No.2

Volume 19, No.2
February 2003

ARTICLES

The Impact of C-Reactive Protein
A Look at the Most Recent Studies and Trials
By By Davinder S. Jassal, MD, FRCPC; and Blair O’Neill, MD, FRCPC, FACC
Ischemic heart disease is the world’s leading killer, but new insights involving inflammatory markers could lead to quicker and more precise diagnosis of its cause.

New Beginnings
How to Counsel Lifestyle Changes Effectively
By Gerry Brosky, MD, CCFP
Motivational interviewing is an effective way for physicians to help patients modify their lives and make negative lifestyle habits a thing of the past.

Fibrates in Perspective
Answering an Age-Old Question
By T.K. Lee, FRCPC, MSc, MB, BSc
Although fibrates have been used to treat dyslipidemia since the 60s, recent studies have shown their effectiveness in the treatment of hypercholesterolemia, low HDL cholesterol, high triglycerides, and overall cardiovascular risk reduction as well.

DEPARTMENTS

Cardiovascular Reporter
By Dr. Gregory Curnew, MD, CM, FRCPC
(In collaboration with Hamilton Health Science Corporation)
The Power of Food

CardioCase of the Month
By Miroslaw Rajda, MD, FRCPC; Peter Hooley; and Jonathan Howlett, MD, FRCPC
A Case of Hyperthyroid Cardiomyopathy

ECG of the Month
By Martin S. Green, MD, FRCPC
(In collaboration with University of Ottawa Heart Institute)
Left to Right

Cardiovascular News
Ramipril effective in treating kidney disease and hypertension in African-Americans; Children with high cholesterol could start treatment early with simvastatin; Pre-hospital treatment with tenecteplase accelerates treatment of heart attack; & more.

January 2003
Volume 19, No.1


ARTICLES

Let’s Get Physical
Exercise Guidelines for Cardiac Patients
By Donald A.N. Meldrum, MDCM, FRCPC, FACC
Even the simplest physical activities can increase the quality of life for cardiac patients.


Clinical Outcomes in Patients With Congestive Heart Failure
The Age of Improvement
By Gordon Moe, MSc, MD, FRCPC, FACC
Congestive heart failure is associated with significant morbidity and mortality rates. However, recent studies using linked patient databases have provided evidence that clinical outcomes are improving.

Adults With Congenital Heart Disease
An Expanding Population
By Brian W. McCrindle, MD, MPH, FRCPC
Continued progress in diagnosing and managing infants and children with congenital heart disease will likely result in a better prognosis and improved survival rate for adults with the affliction.


DEPARTMENTS

Cardiovascular Reporter
By Dr. Gregory Curnew, MD, CM, FRCPC
(In collaboration with Hamilton Health Science Corporation)
Is Heart Disease Infectious?


CardioCase of the Month
By Luc Trudeau, MD
Hypertension in the Elderly


ECG of the Month
By Saad Mahmoud, MD and Martin Green, MD, FRCPC
(In collaboration with University of Ottawa Heart Institute)
The Atrial Double-Cross?


Cardiovascular News
Atorvastatin calcium beneficial in reducing heart attacks and strokes, a new drug approved for treatment of cholesterol, the release of the 2002 Hypertension Treatment Guide, and more.