‘White coat’ impact on blood pressure confuses heart disease diagnostics

When you develop symptoms such as a head ache should you not do anything? Take some pain killers? See your pharmacist? Consult your GP? See a specialist or other health professional privately? Go to the nearest Accident and Emergency department – or, in the worst case, should you phone 999 for an ambulance? To stay healthy and get the best available medical advice and treatment when you fall ill, you need to be able to make rational decisions about your health. Doing so can at times be tricky and even a bit scary. In many cases you’ll be able to make the right decision just by using common sense, but it’s easy to feel out of your depth.

Atrial fibrillationAbnormally fast and uneven contractions of the heart muscle, so that blood cannot be pumped efficiently is the most common heart rhythm disorder in the developed world and it is estimated 1 million people in the UK have this condition. Atrial fibrillation, or AFAn abbreviation for atrial fibrillation for short, is the leading cause of strokeAny sudden neurological problem caused by a bleed or a clot in a blood vessel. in the country and may also cause heart failureFailure of the heart to pump adequately. in some patients. It results from abnormal electrical impulses in the top chambers of the heart, the atriaThe two upper chambers of the heart., which can lead to rapid, irregular palpitationsThe feeling when you become aware of your heartbeat - when frightened, for example., breathlessness, chest pain light-headedness and tiredness. AF increases with age and is very frequently associated with having high blood pressureThe pressure of blood within the arteries. but can also occur in patients with no other medical problems.

In order to understand how cardiacRelating to the heart rhythm abnormalities occur and how different treatments can be effective, it is firstly important to appreciate how the normal heart works.

Introduction

To most people a standard pathology laboratory list of results is more akin to an Egyptian obelisk than anything actually meaningful or useful i.e. four columns of hieroglyphics! It is therefore useful to have our own plain English equivalent of the Rosetta Stone in order to translate some of the pathological hieroglyphs, and that is the purpose of this article.