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Background Heart failure and left ventricular systolic dysfunction (LVSD) are increasingly common disorders, with outcomes worse than many cancers. Evidence-based therapies, such as ACE inhibitors and beta-blockers, improve prognosis and symptoms, and reduce healthcare expenditure. However, despite the high prevalence and malignant prognosis, few studies have reported the impact of heart failure and LVSD on overall quality of life and, more crucially, have not researched the elderly or those in the community.Methods All patients attending the Echocardiographic Heart of England Screening (ECHOES) study of the prevalence of heart failure and LVSD in the community were assessed by clinical history and examination, electrocardiogram and echocardiography, and also completed the SF36 health status questionnaire. Quality of life in patients found to have heart failure, LVSD, and other cardiac and medical conditions are compared with the randomly selected general population sample. Data are generalisable to the UK.Results 6162 people in the community were screened in the ECHOES study, of whom 5961 (97%) completed the SF36. The health perceptions of 3850 people aged 45 years or older selected randomly from the population were compared with those of 426 patients diagnosed as having definite heart failure. Those with heart failure had significant impairment of all the measured aspects of physical and mental health, in addition to declines in physical functioning. Significantly worse impairment was found in those with more severe heart failure by NYHA class: indeed, NYHA functional class was closely correlated to SF36 score. Patients with asymptomatic left ventricular dysfunction and patients rendered asymptomatic by treatment had similar scores to the random population sample. Those with heart failure reported more severe physical impairment of quality of life than people giving a history of chronic lung disease or arthritis, with less impact on mental health than patients reporting depression.Conclusions Patients with heart failure have statistically significant impairment of all aspects of quality of life, not simply physical functioning. The physical (role and functioning) health burden was significantly greater than that suffered in other serious common chronic disorders, whether cardiac or other systems. Optimising treatment to improve NYHA class appears to improve perceptions of quality of life for patients with heart failure. Given the dramatic decline in quality of life with heart failure, this end-point should be a much more important target for healthcare interventions, especially treatments such as ACE inhibitors and beta-blockers that are shown to improve quality of life. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved [ABSTRACT FROM PUBLISHER]

Deals with the use of digoxin and other inotropes, beta blockers, and antiarrhythmic and antithrombotic treatment on patients with chronic heart failure. Evidence of symptomatic benefit from digoxin; Increase of mortality in chronic heart failure patients taking inotropic drugs; Aggravating factors that lead to death in severe heart failure caused by ventricular arrhythmias.

Examines the efficacy of the West Midlands Ambulance Service policy of applying CPR and manual ventilation to all unwitnessed cardiac arrests in preference to immediate defibrillation. Application of advanced life support in patients; Acquisition of return of spontaneous circulation; Percentage of discharge rate.

Oculocutaneous syndrome, sclerosing peritonitis, and pulmonary fibrosis may result from practolol treatment[1 2] but liver disease has not been implicated as an adverse effect. We have recently seen two patients with oculocutaneous lesions typical of practolol sensitivity who also had clinical and laboratory features of primary biliary cirrhosis (PBC, primary non-suppurative destructive cholangitis). [ABSTRACT FROM AUTHOR]

Focuses on Atropa belladonna, a poisonous plant named after one of the Fates, Atropus, who cut the thread of life. Presence of atropine in its leaf and berries; Studies showing the effect of atropine on heart rate in digitalized patients in atrial fibrillation.

Highlights a stamp featuring the medicinal opium poppy. Alkaloids found in the opium poppy; Use of opium for the treatment of heart diseases.