CRY (Cardiac Risk in the Young) is an organisation dedicated to preventing Sudden Cardiac Death (SCD) in young athletes. A variety of inherited heart disorders such as Hypertrophic Obstructive Cardiomyopathy (HOCM) are known to cause abnormal heart rhythms which can result in collapse or sudden death. Whilst these conditions are rare it is possible to detect them by a screening program involving taking a history, examination and recording the electrical activity of the heart with an ECG. 

05/02/2010 Some herbal treatments have been shown to interact with a number of cardiac medications,according to a review in the Journal of the American College of Cardiology. Examples cited include St John's Wort (pictured right) which is used for mild depression which may reduce the effectiveness of Cyclosporine, a drug used to prevent rejection after heart transplantation and Warfarin which is used to thin the blood in patients with Atrial Fibrillation or mechanical heart valves.

Ginkgo biloba, sometimes used to boost the immune system, prevent memory loss and for energy, can have the effect of increasing the bleeding potential of drugs such as Aspirin and Warfarin.

Even grapefruit juice can have the effect of increasing the levels of calcium channel blockers, used for blood pressure and statins which lower cholesterol levels.

The authors warn that not all herbal remedies are necessarily completely safe although they are often perceived to be low risk by patients. The oversight and regulation of herbal remedies is lacking and the authors recommend that doctors should ask about herbal medicines when making prescribing decisions.

22/12/2009    A new study based in Seattle has demonstrated that bystanders who begin chest compressions on patients who have collapsed with a cardiac arrest improve the chances of survival with good outcomes. Some bystanders are put off trying to resuscitate a patient because they are anxious about the need for mouth to mouth resuscitation but the study suggests that chest compressions on their own are helpful. There was a minimal risk of causing harm to the patient which is more than offset by the potential benefit of such an approach.

In the DART study published this week in Circulation, bystanders who rang for emergency help were asked by Dispatchers (Ambulance Control personnel) whether the patient was conscious and if they were breathing.

If the answer was no to these questions and if the attempts at resuscitation had not been started the bystanders were instructed how to start resuscitation either with chest compressions on their own or with mouth to mouth resuscitation.

The evidence suggests that starting chest compressions on their own is helpful and is unlikely to cause any significant harm. Bystanders are more likely to start resuscitation if efforts to ventilate the patient are not required. This mirrors the results of a similar study from Japan published in Lancet in 2007.

This suggests that bystanders may be able to assist patients who have a cardiac arrest by calling for emergency help and starting chest compressions. The risk of harm from this is small compared to the potential benefit.