Professor Geoffrey Tofler, Cardiologist at North Shore Private Hospital. Our message to people is while the absolute risk that any one episode will trigger a heart attack is low, they need to be aware that a respiratory infection could lead to a coronary event. So consider preventative strategies where possible, and don’t ignore symptoms that could indicate a heart attack. The Ramsay Way 2017 | 02 15 RESEARCH@RAMSAY Respiratory infections can trigger a heart attack New research from the co-located North Shore Private/ Royal North Shore Hospital Cardiac Catheterisation Laboratory in Sydney finds the risk of a heart attack is increased 17-fold in the week following a respiratory infection such as influenza or pneumonia. Published in the May 2017 edition of Internal Medicine Journal, this is the first study to report an association between respiratory infections such as pneumonia, influenza and bronchitis and increased risk of heart attack in patients confirmed by coronary angiography (a special X-Ray to detect heart artery blockages). “Our findings confirm what has been suggested in prior studies that a respiratory infection can act as a trigger for a heart attack," said senior author Professor Geoffrey Tofler, cardiologist at North Shore Private and Royal North Shore Hospitals, and Honorary Medical Director of Heart Research Australia. “The data showed that the increased risk of a heart attack isn't necessarily just at the beginning of respiratory symptoms, it peaks in the first 7 days and gradually reduces but remains elevated for one month. This association is a likely contributor to the known winter peak in heart attacks.” The study was an investigation of 578 consecutive patients with heart attack due to a coronary artery blockage, who provided information on recent and usual occurrence of symptoms of respiratory infection. Patients were interviewed about their activities before the onset of their heart attack, including if they experienced a recent “flu-like illness with fever and sore throat”. They were considered HOW WELL IS YOUR FITNESS TRACKER MONITORING YOUR SLEEP? Queensland researchers have found that fitness tracking devices generally lack accuracy when it comes to estimating total sleep time, sleep efficiency and how long it takes the wearers to fall asleep. Specialists at Greenslopes Private Hospital’s Sleep and Lung Centre, University of Queensland, and Snore Australia studied the accuracy of five different Consumer Grade Sleep and Fitness devices by comparing them to a sleep study (polysomnography). These devices were: Fitbit Charge HR, Peak Basis, Microsoft Band 2, Beddit, and ResMed S+. Participants underwent a full overnight sleep study test, while being monitored by the consumer tracking devices at the same time. Researchers measured five categories: patients’ sleep onset latency, total sleep time, wake after sleep onset, sleep efficiency and time in bed. “While the devices were useful for measuring the amount of time spent in bed, they were not particularly useful for calculating sleep onset – in other words, how long it takes for a person to fall asleep,” said Dr Sean Tolhurst, Respiratory and Sleep Physician at Greenslopes Private Hospital. “This means although a person may be lying awake in bed for an hour before dozing off, a tracking device will count some of this period as sleep,” said Dr Tolhurst. “We also found the tracking devices were not especially accurate at picking up short periods of wakefulness.” The research also found these tracking devices were more accurate when recording sleep patterns of patients who did not have sleeping disorders compared to those who did. The new research has just been presented at SLEEP 2017 in Boston USA. This conference, which involves more than 5,000 sleep medicine professionals and scientists, is the premier world forum for discussion of the latest developments in clinical sleep medicine and sleep circadian science. Dr Tolhurst said it is important to understand the role of tracking devices for both personal health monitoring and clinical purposes. “The results confirm that polysomnography is still the most reliable method for diagnosing and monitoring sleep disturbances because it measures a patient’s breathing, heart rate, brain waves, and blood oxygen levels,” said Dr Tolhurst. “However, we now know that these tracking devices can be used to help us gain better insight into our patients’ day-to-day sleeping habits when they are at home over a period of several weeks or longer. We used to ask patients to keep a sleep diary, but these tracking devices are accurate enough to produce a creditable snapshot of their sleeping trends over time,” said Dr Tolhurst. Sleep Study: Greenslopes Private Hospital Respiratory and Sleep Physician, Dr Sean Tolhurst, with patient Lucas José. affected if they reported sore throat, cough, fever, sinus pain, flu-like symptoms, or if they reported a diagnosis of pneumonia or bronchitis. Flu and pneumonia vaccines, where appropriate, are an important way to lower risk. Besides those eligible for free vaccine, including people aged over 65 years, or with known cardiac or respiratory disease, the flu vaccine is recommended for hospital staff and others who come in contact with people at higher risk of influenza complications. Professor Tofler added: “Possible reasons for why respiratory infection may trigger a heart attack include an increased tendency towards blood clotting, inflammation and toxins damaging blood vessels, and changes in blood flow.” “The next step is to identify treatment strategies to decrease this risk of heart attack, particularly in individuals who may have increased susceptibility.” Further information on this research and other heart related issues is available on the Heart Research Australia website www.heartresearch.com.au
The Ramsay Way - Winter 2017
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