Cardiology Update, Victoria Hospital, Kirkcaldy, 5th May 2016

SHARP held a Fife regional meeting in the Victoria Hospital, Kirkcaldy in May 2016.

The title of the meeting was “Cardiology Update” on the back of recent SIGN guideline updates for Acute Coronary Syndromes and Heart Failure. This meeting was chaired by Dr Mark Francis, Consultant Cardiologist in NHS Fife.

There were 85 delegates at the meeting who were all local clinicians including 30 GPs, practice nurses, ambulance staff and a number of secondary care staff including consultants and nurse specialists.

Dennis Sandeman, SHARP Chairman and Cardiology Nurse Consultant, presented findings from a 17 months Fife study looking at the use of high-sesnsitivity cardiac troponin T for patients who presented to NHS Fife with suspected acute coronary syndrome. This found that patients who present with an initial Troponin of <5ng/L with symptoms greater than 3 hours do not go on to have a myocardial infarction and can be safely considered for early discharge. This work has influenced the new NHS Fife guideline for patients with suspected ACS which was presented at the meeting.

Professor Dave Newby, Consultant Cardiologist for Royal Infirmary of Edinburgh presented the updated SIGN guidelines for patients with Acute Coronary Syndromes. Prof Newby chaired the SIGN development group for these guidelines and was perfectly placed to update the audience. The guidelines have been updated rather than re-written and he covered new aspects in the guideline including the use of high sensitivity troponin assays for rule-out and rule-in of acute coronary syndromes, dual anti-platelet agents and intra-aortic balloon pumps.

Dr Martin Denvir, Consultant Cardiologist at Royal Infirmary of Edinburgh finished the meeting with an update of the recent SIGN Heart failure updated guidelines. As part of the development group he was able to present their new recommendations around diagnosis of heart failure, medications, device therapy and end of life care. For diagnosis he included use of BNP and a Male Infarction Crepitations Edema (MICE) scoring system. Medications included results from the PARADIGM-HF study and clinical use of Sacubitril-Valsartan and use of pharmacy service. He updated the audience on indications for device therapy and good practice points when considering the deactivation of defibrillators at end of life. The guideline recommendations around palliative care and psychological care were also covered.