Laura Å pejeraitÄ— has completed her MD from Vilnius University, Faculty of Medicine. She also completed her 6 months long Internship in various departments and has done her Residency in Family Medicine. Now she is working as a Senior Doctor Resident at Vilnius University Hospital Santariskiu Clinics.

Heart attack is one of the leading causes of death and disability between European cardiovascular patients, actively becoming a great strain to society. The aim of this study was to assess the knowledge in reference to cardiovascular risk factors and heart attack warning signs among Lithuanian adults. Via questionnaire, provided by investigators, and offering multiple close-ended right and wrong answers about cardiovascular risk factors and heart attack warning signs, a total of 490 adults (aged 25-65 years) were surveyed. Data was collected at Primary Care Center “Vilniaus Centro Poliklinika” between January and October 2015 face-to-face during routine doctor visits. Demographic and personal medical material was collected as well. Responses from only (n=408) participants were included into final analysis. The mean age was 44.09±11.9 and (53.2%) were women. Respondents recognized on average 5.59 of 10 risk factors (SD±1.81) and 3.46 of 6 heart attack signs (SD±1.15). Respectively only (2.2%) and (3.4%) were able to identify all correct risk factors and heart attack signs. Knowledge of risk factors is significantly higher among women, highly educated adults and those aged 25-35 years (p=0.015; p=0.013; p<0.001). Elderly (>55 years) were largely aware of heart attack warning signs (p=0.006). No differences found by self-reported risk factors and smoking. These findings show insufficient public knowledge of cardiovascular risk factors and heart attack warning signs. It is necessary for authorities to consider present gaps in public health education and generate new measures for improving cardiovascular risk factors and heart attack recognition.

To be updated soon...

Heart attack and acute stroke are prevailing causes of death in the eastern European countries. The goal of this study was to determine whether encountering a heart attack or stroke influences the knowledge of these acute cardiovascular disease complications among urban Lithuanian adults. Data about cardiovascular disease risk factors, heart attack and stroke warning signs was collected by developing close-ended questions at “Vilniaus Centro Poliklinika” primary health care center in 2015. The knowledge levels were compared between control group and the following three: heart attack or stroke survivors; those who have heart attack victims among family members or close friends; those having stroke victims in their close surroundings. In total, answers from (n=408) respondents aged 25-65 years was analyzed. The main age was 44.09±11.9 and (53.2%) were women. Those whose family members and close friends suffered from stroke had better knowledge of stroke warning signs (p<0.001) and cardiovascular disease risk factors (p=0.02) whereas those who had heart attack victims among close acquaintances, were significantly better in recognizing only heart attack warning signs (p<0.001). Adults, who underwent heart attack or stroke personally, were more familiar only with cardiovascular disease risk factors (p=0.015), but knowledge level about heart attack or stroke warning signs had no difference in comparison to control group. Since heart attack and stroke survivors usually are elderly people, having limited educative facilities primary health care providers should be concerned about transferring repeated health-protecting messages to their high risk cardiovascular patients.

Laura Å pejeraitÄ— has completed her MD from Vilnius University, Faculty of Medicine. She also completed her six months long Internship in various departments and has done her Residency in Family Medicine. Now, she is working as a Senior Doctor Resident at Vilnius University Hospital Santariskiu Clinics.

Diseases of circulatory system are the principle cause of death within European countries. As Lithuania takes top positions of this unfavorable statistics for several years, we purposed to investigate public awareness of stroke warning signs and response to stroke onset. Adults aged 25-65 years were surveyed at “Vilniaus Centro Poliklinika” primary health care center during their regular doctor appointments in 2015. Knowledge about stroke symptoms, action to take and time gap for effective treatment after stroke onset was determined via close-ended questions, offering multiple right and wrong answers. Additional demographic and personal medical history was collected. Data from (n=408) respondents were studied. The main age was 44.09±11.9 and (53.2%) were women. Respondents recognized on average 4.29 stroke symptoms of 6 possible (SD±1.12). Frequent adult knew 4 or 5 signs, but only (14%) recognized all correct stroke signs. The most prevalent stroke symptom was “confusion, trouble speaking” (76.72%) accompanied by “sudden acute head pain” (76.47%). Barely (5.63%) participants listed the correct “three-hour time period for effective stroke treatment” and all six stroke signs. Almost all respondent would “call ambulance” at particular condition. Knowledge of stroke symptoms was significantly higher among men than women (p=0.006). No difference found by age, education, self-reported risk factors and smoking history. Adequate response to stroke onset is principal component in time sensitive outcomes but it is not efficient among Lithuanian urban adults. There is a great necessity for stroke managing programs such as mass media or role of primary care providers to be strengthened.

Imran Tahir completed his MBBS from National University of Science and Technology at the age of 23 years. Currently training in medicine in West Midlands United Kingdom.

Background: Every four minutes someone is admitted to hospital suffering from a heart attack or a chest pain event in the UK, totaling over 150,000 hospitalizations a year. Chest pain is one of the most common presentations in the emergency department and quite a few of them get admitted as low risk ACS patients. With the developments in technology, we have increasingly sensitive troponin assays available. Previous-generation troponin assays have been used as diagnostic and prognostic markers in acute coronary syndrome patients and for risk stratification to guide triage decisions and aid in treatment selection. New, high-sensitivity troponin assays represent an important advance with added sensitivity for cardiac myocyte necrosis. High-sensitivity troponin assays detect concentrations of the same proteins that conventional sensitivity assays are aimed at detecting, just in much lower concentrations.\r\n\r\nObjective: Can high sensitivity troponin avoid unnecessary admission and save money.\r\n\r\nMethod: We did the retrospective data analysis for 100 patients presenting in the emergency department of University Hospital Birmingham in the month of March 2016. All adult patients admitted with the diagnosis of ACS were included in the study.\r\n\r\nResults: We included 100 patients admitted with the diagnosis of ACS under the medical team in the month of March 2016. 86% patients had a serial troponin done during the admission. Rest of the 14% had a single troponin done. Only 8% patients had a raise in the serial troponin, rests of them were discharged home. The average length of stay was 33 hours. \r\n\r\nDiscussion: Based on the results of this data analysis, it has been highlighted that considering the use of high sensitivity troponins at 0 and 2 hours coupled with appropriate risk stratification of patients presenting with chest pain in the Emergency department, can possibly help in safely discharging a major percentage of patients and avoiding unnecessary admissions to the hospital. At the same time making it possible to achieve the above objectives within the NHS policy of 4 hours breech time for the Emergency department\r\n\r\nConclusion: We have 5-10 patients every day presenting to the emergency department with chest pain. About 50% of them get admitted with the diagnosis of ACS. 86% of our patients could have been potentially discharged home by using high sensitivity troponin at 0 and 2 hours and hence could have avoided 86% admissions. This in turn could have saved quite some money. With the growing pressure in the emergency departments due to ever increasing number of patients all these high sensitivity tests could potentially make some difference.\r\n