Latest news with #cardiachealth
Telegraph
4 days ago
- Health
- Telegraph
Half of heart attacks occur in patients told they are not at risk
Most heart attacks occur in patients who were falsely reassured they were in good cardiac health, research has found. New NHS pilot schemes using artificial intelligence have revealed that almost half of at-risk patients are being missed by standard diagnostic tests. Early findings from pilot schemes at five NHS trusts shows almost half of patients had their treatment plans changed after their scans were reassessed using the new technology - with far more being put on statins. Prof Simon Ray, Britain's top heart doctor, said the new AI tool, which assesses standard heart scans, could be 'a complete game-changer'. The NHS chief added that the use of 'incredibly clever scans' could find warning signs that were otherwise undetectable and 'turbocharge' efforts to save lives. Research found the technology can reduce fatal heart attacks by 12 per cent – and cut other serious events like strokes and heart failure by nearly a third. Every year, around 300,000 people in the UK undergo coronary CT scans after suffering problems such as chest pains or breathlessness. Around 80 per cent are told there's little or nothing to worry about. But in the years that follow, two-thirds of heart attacks happen in that same group, research has found. Now, the new technology is offering a clearer picture. The AI tool, developed by medics from Oxford, can spot dangerous inflammation in the fat around the arteries – something invisible to the human eye. Cardiologists said far too many patients were currently being 'wrongly reassured' that they had no problem, after being referred for scans because of cardiac symptoms. The AI analysis was able to identify far more patients who could benefit from treatments such as statins, and to pick out those who needed a higher dose, or other forms of treatment. Medics said that patients were also far more likely to take their tablets, or make necessary lifestyle changes, after seeing their risk of a fatal cardiac risk, backed by images showing the inflammation around the arteries. The technology was developed by Oxford spinout company Caristo Diagnostics, co-founded by Prof Charalambos Antoniades, the University of Oxford chair of cardiovascular medicine, with grant funding from the British Heart Foundation. Prof Antoniades said the impact of the breakthrough could be 'massive' given that most heart attacks come from patients who have undergone scans, only to be told they have little to worry about. The leading cardiologist said: 'Two thirds of the heart attacks happen among those 80 per cent of people who have been reassured'. He said: 'Every year, around 300,000 patients are having coronary CT scans; we are finding that approximately 45 per cent of the individuals that have these scans today in the NHS are being under-treated, and underdiagnosed; they are being reassured wrongly that they have no problem, and essentially they are discharged. 'These are exactly the patients that we identify; and we guide them towards preventive treatments so that we we can reduce risk.' The new tool, which analyses conventional scans, at a cost of around £270 per case, is able to detect far more subtle changes in the fat around the coronary arteries, which result in plaque rupture and heart attacks. Pilot schemes at Oxford University Hospitals NHS Foundation trust, Liverpool Heart and Chest Hospitals NHS Foundation trust, University Hospitals of Leicester NHS Trust, Milton Keynes University Hospital NHS Foundation trust and Royal Wolverhampton NHS trust, funded by NHS England, have now assessed 1425 scans, using the 'CaRI-Heart' AI analysis. Patients who were shown the detailed images were also far more likely to comply with treatment regimes, and to overhaul their lifestyles, medics found. Heart disease is the one of the biggest killers in the UK, with one in eight men and one in 14 women dying from coronary heart disease. Analysis suggests that using the technology in 300,000 patients a year would prevent almost 5,760 heart attacks, 7,740 cardiac deaths, 4080 heart failures and 1,320 strokes; meaning almost 19,000 cardiovascular events prevented in total. Prof Ray, NHS national clinical director for heart disease, said: ' Heart disease is one of our biggest killers and this new tool could be a complete game-changer based on its early findings – using incredibly clever scans to spot inflammation in the arteries that was previously undetectable and helping turbocharge NHS efforts on prevention. 'By using technology like AI to support clinicians and enhance the care our expert teams can offer, we can help more people lead healthier lives and potentially prevent thousands of serious health incidents like heart attacks and strokes, which is fantastic for patients and their families and vital for the NHS as we move from treatment to prevention as part of the 10 Year Health Plan.' 'Traffic light' assessment system Dr Tim Fairbairn, a cardiologist at Liverpool Heart and Chest Hospital, said the technology could provide medics with a simple 'traffic light' assessment of risk, informing decisions about medications and lifestyle. 'This a patient group which is already being investigated for coronary artery disease – so its patients with chest pains, angina, breathlessness; this is about preventing future events such as heart attacks.' The leading medic said the NHS was good at dealing with patients with the most obvious signs of blocked arteries but struggled to identify the vast majority of patients at increased risk. Dr Fairburn said: 'A lot of the rest will be told you're fine, don't worry and that can mean they don't change their diet, they carry on smoking, they don't increase their exercise. We need to be more aggressive about treating these cases and helping people to change their lifestyles.' The new technology can spot details on scans which cannot be seen by the human eye, in an assessment which also takes account of other clinical data, such as cholesterol levels. The cardiologist said the pilot NHS schemes has shown the technology could dramatically change not just the decisions being made by doctors, but also by patients. The National Institute for Health and Care Excellence is currently evaluating the new technology, meaning it could be rolled out far more widely.
Medscape
25-06-2025
- Health
- Medscape
NICE Backs Leadless Pacemakers for Some Heart Patients
The National Institute for Health and Care Excellence (NICE) has provisionally recommended leadless cardiac pacemaker implantation for patients with bradyarrhythmias who require single-chamber pacing. In draft guidance, NICE said there was insufficient evidence to support their use for dual-chamber pacing outside of research settings. Benefits Over Traditional Pacemakers The recommendation is based on an evidence review involving over one million patients across multiple studies. These included a randomised controlled trial, four systematic reviews with meta-analyses, five registry studies, four prospective studies, and two retrospective studies. Leadless pacemakers were found to be effective at detecting abnormal heart rhythms, restoring normal pacing, and improving quality of life. Unlike conventional transvenous pacemakers (TVPs), they do not require a chest incision, reducing the risk of infection and other complications, the regulator noted. 'The evidence demonstrates that leadless pacemakers can effectively regulate heart rhythm while reducing the risk of complications associated with traditional pacemakers, particularly infections and lead-related issues,' said Dr Anastasia Chalkidou, HealthTech programme director at NICE. How Leadless Pacemakers Work Bradyarrhythmias, which affect around 1 in 1000 people are typically treated with TVPs. These devices consist of a subcutaneous pacemaker box and leads that connect to the heart. For single-chamber leadless pacemakers, the proximal end is attached to a deflectable delivery catheter system. It is usually inserted percutaneously through the femoral or jugular vein using an introducer sheath. It is then moved into the right atrium, through the tricuspid valve, and into the right ventricle. Dual-chamber systems, which are still under evaluation, involve placing two devices — one in the right atrium and another in the right ventricle — during a single procedure. NICE highlighted that TVPs are known to carry risks, including lead failure and generator-related complications. Leadless pacemaker implantation may be preferable for patients with a history of device infection, endocarditis, immunosuppression, limited vascular access, or high infection risk. Call for Further Research While the draft guidance supports leadless pacemakers for single-chamber pacing, NICE said that more evidence is needed before endorsing their wider use. This includes research on patient selection — such as age, comorbidities, and the underlying cause of bradyarrhythmia — as well as data on implantation sites and clinical outcomes. Long-term durability of leadless devices also remains an area for investigation. 'The incidence of bradyarrhythmias increases with age, making this guidance particularly relevant to our ageing population,' said Professor Tom Clutton-Brock, chair of NICE's interventional procedures advisory committee. The draft guidance is open for public consultation until 23 July 2025. The advisory committee will meet again on 11 September 2025 to review feedback and finalise recommendations.
Daily Mail
30-05-2025
- Business
- Daily Mail
Doctors sound alarm over massive spike in Americans suddenly dropping dead from unexplained heart attacks
Americans are dropping dead from heart attacks at home at alarming rates, doctors warn. Researchers at Mass General Brigham, a Harvard-affiliated hospital, found that heart-related deaths gone up to 17 percent in the years following the Covid pandemic. And while the exact number is unknown, in many of these cases heart attacks have been at home, despite deaths in hospitals decreasing. This suggests patients are being 'missed' — until it is too late. Dr Jason H Wasfy, study author and director of Outcomes Research at the at Massachusetts General Hospital, said: 'Lots of reports have shown that there have been fewer heart attacks in hospitals since 2020 — but something seems to be missing from that data. 'We now show that if you account for deaths at home, cardiac deaths are going up and have stayed up for years. Today there are a lot more people having cardiac deaths at home, which also raises the concern that people with heart disease haven't been getting the care they need since the pandemic.' The Covid virus — which is thought to have infected over 100million Americans — has been shown to cause damage to the heart and blood vessels which may be a factor. But doctors say more factors must be at play, which are still being understood — including diet and lifestyle factors. For example, a study this week found smoking marijuana or consuming edibles may raise the risk. Though the full findings have not yet been released, the experts believe the pandemic could also be linked to a mystery rise in young Americans suffering heart attacks. The study, published Friday in JAMA Network Open, looked at 127,746 death certificates from people who died in Massachusetts between January 2014 and July 2024. The average age was 77 and about 52 percent were men. The researchers then made population estimates based on US Census data from 2014 to 2023. Using death certificate and census data, the team set an expected cardiac death rate for 2020 to 2023. They found cardiac deaths were 16 percent higher than expected in 2020, 17 percent higher in 2021 and 2022 and six percent higher in 2023. The amount of monthly cardiac deaths at home also exceeded expected levels between 2020 and 2022 and in hospitals between 2020 and 2023. However, they cited additional data showing heart attack hospitalizations decreased by 20 to 34 percent after the start of the pandemic. This suggests many of these excess deaths occurred at home. The researchers wrote: 'In this population-based cohort study of Massachusetts decedents, we found cardiac deaths increased substantially starting in 2020, with exaggerated seasonal patterns and increases in deaths at home. 'While numerous other studies have found fewer admissions for cardiac emergencies in countries across the world, these studies may have missed events occurring outside of hospitals.' The researchers suggested this increase could be due to more people avoiding hospitals during the pandemic or being dismissed by doctors. CDC research from 2020, for example, found 40 percent of Americans delayed or avoided seeking medical care at the start of the pandemic, and 12 percent stayed away from emergency rooms. However, emerging research also shows the Covid virus itself may cause long-term heart issues, increasing the risk of cardiac deaths. Data shows that heart attack cases are on the rise in young Americans Covid has been linked to myocarditis, inflammation of the heart muscle, and pericarditis, inflammation of the sac-like lining surrounding the heart. With myocarditis, it's thought that Covid causes the immune system to attack itself and cause inflammation of the myocardium, the heart's muscle. This same mechanism has been linked to pericarditis. While most cases are mild, in rare instances, myocarditis can damage the heart and make it difficult for it to pump blood, eventually leading to heart failure, heart attack, and stroke. In cases as rare as one in 200,000, the mRNA in Covid vaccines may trigger a similar immune response and cause myocarditis or pericarditis. Covid-induced inflammation also alters the heart's electrical signals, leading to irregular heartbeats called arrhythmias. Research released this week also pointed to smoking weed or taking edibles at least three times a week as a potential cause of heart attacks. That team found endothelial cells, which line the blood vessels and regulate blood flow, released less nitric oxide in people who regularly smoked marijuana or took edibles. Nitric oxide helps blood vessels dilate and deliver vital oxygen throughout the body. This impaired function affects the blood vessels' ability to dilate, increasing the risk of atherosclerosis, heart attacks, and strokes. Dr John Hsu, senior study author of the new study and director of the Program for Clinical Economics and Policy Analysis at Mass General, said: 'Healthcare systems around the world have experienced multiple shocks since 2020. Our findings suggest that both patient choices about seeking care and outcomes after experiencing a cardiac emergency also have changed. 'Had we not examined mortality using death certificate data, the increases in population cardiac mortality could have gone unnoticed.' There were several limitations to the study, including the lack of data on the causes leading to cardiac death. It's unclear when the full findings will be released. The study was partially funded by the National Institutes of Health.
Forbes
30-05-2025
- Health
- Forbes
Twins' Doctor Must Face Player Malpractice Claim Due To Florida Workers' Comp Exception
Photo byRyan Costello was a promising young baseball player. After being drafted in the 31st round of the 2017 Major League Baseball (MLB) Draft by the Seattle Mariners, and later traded to the Minnesota Twins, he worked his way through the clubs' A and AA affiliates. Sadly, his career was cut short when he was found dead in his hotel room in November 2019 while in New Zealand preparing to participate in the Australian Baseball League. In an ongoing lawsuit in Florida state court, Costello's family alleges that malpractice by Dr. David Olson, a Twins' team doctor, led to Costello's death. The lawsuit has pushed forward on some close legal calls. A Missed Diagnosis According to their December 2021 complaint, Costello's parents allege that as part of a 2019 spring training physical, an electrocardiogram (EKG) revealed that Costello had cardiac abnormalities. Further, Costello's parents claim that Costello should have undergone more testing before being allowed to participate in any strenuous activities. Nevertheless, Dr. Olson allegedly marked Costello's health report as 'Normal' with 'No Further Action Necessary,' clearing Costello to return to spring training. Costello's parents claim that the abnormalities were later determined to be Wolff-Parkinson-White syndrome, 'a cardiac condition that is treatable but that can make vigorous physical activity dangerous and potentially fatal.' Indeed, Costello's death was apparently caused by a cardiac arrythmia, a condition connected with Wolff-Parkinson-White syndrome. Evading Arbitration Dr. Olson first moved to compel the action to arbitration according to the arbitration provision in the Major League Agreement (MLA), also known as the Major League Constitution. The MLA was incorporated by reference into Costello's minor league player contract. Before going further, it is important to understand the context of this arbitration provision. MLB players have long been unionized and, as a result, negotiate collective bargaining agreements governing the terms and conditions of their employment, including relevant arbitration clauses. Minor league players did not unionize until 2022 and did not have a collective bargaining agreement until 2023. Consequently, prior to that point, minor league players were subject to the terms unilaterally imposed by MLB, its major league clubs, and their minor league affiliates. Some of those terms, like the arbitration provision, are included in the MLA, which is simply an agreement among the 30 MLB clubs. The arbitration provision at issue stated as follows: 'All disputes and controversies related in any way to professional baseball between Clubs or between a Club(s) and any Major League Baseball entity(ies) (including in each case, without limitation, their owners, officers, directors, employees and players), other than those whose resolution is expressly provided for by another means in this Constitution, the Major League Rules, the Basic Agreement with the Major League Baseball Players Association, or the collective bargaining agreement with any representative of the Major League umpires, shall be submitted to the Commissioner, as arbitrator, who, after hearing, shall have the sole and exclusive right to decide such disputes and controversies and whose decision shall be final and unappealable.' Major League Constitution, Art. VI, Sec. 1. Consequently, as eventually explained by the District Court of Appeal of Florida, 'the arbitration provision applies to disputes that are related in any way to professional baseball and that are between either: (1) two or more Clubs; or (2) one or more Club(s) and one or more Major League Baseball entity(ies).' Importantly, the court reiterated that '[b] The trial court granted Dr. Olson's motion to compel, relying on Wolf v. Rawlings Sporting Goods, a 2010 case in which the Southern District of New York, applying the same arbitration provision, also granted a motion to compel arbitration. In Wolf, a former minor leaguer sued MLB, Minor League Baseball and a variety of other parties after his skull was fractured by a pitch that he said was the result of a defective helmet. In a December 8, 2023 decision, the District Court of Appeal of Florida, Sixth District, disagreed and reversed. In its reading, the present action 'is a dispute between a player of a Club and an employee of the same Club.' It is an 'intra-Club dispute' and such disputes are not within the scope of the arbitration provision. The court also differentiated Wolf, asserting that the claims there 'plainly fell within the scope of the arbitration provision.' Evading Workers' Compensation Law Following the case's remand back to the trial court, Dr. Olson argued that the Costellos' claims were barred by workers' compensation laws, which generally provide the exclusive avenue for resolving disputes over workplace injuries, including deaths. Workers' compensation laws also generally bar lawsuits against coworkers. Instead, the injured worker is intended to be fully compensated by the workers' compensation insurance system. As an initial matter, Dr. Olson's argument hinged on a surprising fact – that he was a co-employee of Costello. While athletic trainers are typically employees of professional sports clubs, doctors are usually independent contractors. Indeed, in several cases brought by players, athletic trainers have successfully asserted the workers' compensation defense while doctors have not (see chapters 2 and 3 of this report for discussion of such litigation). In a March 11, 2025 decision, the court denied Dr. Olson's motion for summary judgment based on the workers' compensation defense. The result turned on the application of Florida rather than Minnesota law. The court determined that Florida law – where Dr. Olson examined Costello – should apply. Florida's workers' compensation law, however, does not cover professional athletes. In other words, because professional athletes cannot be compensated by the workers' compensation system, they (or, in this case, their estate representatives) are not barred from bringing claims against their employers or co-employees arising out of workplace injuries. Dr. Olson has appealed the court's decision, which has resulted in a stay of the proceedings until an appellate decision is rendered. If the appeal is unsuccessful, expect Dr. Olson and his insurer to seek a settlement rather than face the exorbitant amounts often awarded to professional athletes by juries in medical malpractice cases.
The Independent
21-05-2025
- Health
- The Independent
Scientists raise alarm over sudden deaths among professional body builders
Male bodybuilders are facing a high risk of sudden death from heart problems, scientists warn in a new study. The research, published on Wednesday in the European Heart Journal, highlights the health risks associated with professional bodybuilding and calls for greater awareness and preventive strategies within this community. Sudden cardiac death is when someone dies unexpectedly due to a heart problem and is generally rare among young individuals. However, the new study found that the condition kills an unusually high proportion of male bodybuilders, including young ones, with professional ones at the highest risk. In the study, an international team of researchers looked for reports of deaths among 20,286 male bodybuilders who had competed in at least one bodybuilding event between 2005 and 2020, and had these reports verified by doctors. They particularly looked for reports of deaths of any of these named competitors in five different languages across different web sources, including official media reports, social media, bodybuilding forums and blogs. Reported deaths were then cross-referenced using multiple sources and verified and analysed by doctors to establish the cause of death. Overall, researchers found 121 deaths among the over 20,000 professional bodybuilders, with the average age at death of 45 years. Cardiac death accounted for nearly 40 per cent of these 121 mortalities, according to the study. Professional bodybuilders experienced a fivefold greater risk of cardiac death compared to amateurs, scientists found. Autopsy reports of some of the deceased bodybuilders that were available showed signs of thickening or enlargement of the heart and coronary artery disease. Some also seemed to have abused anabolic substances, researchers found. 'Bodybuilding involves several practices that could have an impact on health, such as extreme strength training, rapid weight loss strategies including severe dietary restrictions and dehydration, as well as the widespread use of different performance-enhancing substances,' study co-author Marco Vecchiato said. These practices place significant strain on the heart and may lead to structural changes over time, researchers warned. 'Professional athletes had a markedly higher incidence of sudden cardiac death, suggesting that the level of competition might contribute to this increased risk,' Dr Vecchiato said. 'The risk may be greater for professional bodybuilders because they are more likely to engage intensively in these practices over prolonged periods and may experience higher competitive pressure to achieve extreme physiques,' he explained. Scientists call for proactive heart screening and counselling among bodybuilders, 'even in young and apparently healthy athletes'. 'For bodybuilders, the message is clear: while striving for physical excellence is admirable, the pursuit of extreme body transformation at any cost can carry significant health risks, particularly for the heart,' Dr Vecchiato said. 'Awareness of these risks should encourage safer training practices, improved medical supervision, and a different cultural approach that firmly rejects the use of performance-enhancing substances,' he said. The findings highlight the need for a cultural shift in bodybuilding, including stronger anti-doping measures and education campaigns about the risks of drug abuse. About 15 per cent of the 121 deaths assessed in the study were categorised as 'sudden traumatic deaths', including car crashes, suicides, murders and overdoses. 'These findings underline the need to address the psychological impact of bodybuilding culture,' scientists concluded.
