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Cardiology Institute

Unit 109, 119 Apollo Drive, Albany, Auckland
consult@cardiologist.co.nz
P: xxx-xxxx; F xxx-xxxx
Unit 109, 119 Apollo Drive, Albany, Auckland. P: 000-0000. F: 000-0000. consult@cardiologist.co.nz. EDI: cardinst

T 09-980-6363. M 022-672-8255. F 09-929-3248. consult@cardiologist.co.nz. EDI: CARDINST

North Shore - Suite 109, Level 1, 119 Apollo Drive, Albany

Silverdale - Northern Specialist Centre @Beyond; 5 Painton Road, Silverdale.

Central Auckland - 110 Specialist Centre @ Beyond;v110 Grafton Road, Grafton

East Auckland - East Care Specialist Centre, 260 Botany Road, Howick, Manukau

Cardiology Institute

  • Our Team
  • GP Symposium 2025
  • GP Heart Blog
  • Patient Info
  • New patient form
  • Contact

Aspirin for Primary Prevention

May 6, 2022 Andrew To

Aspirin - chemical structure

Aspirin use in primary prevention is controversial, contrasting that of secondary prevention. It may offer benefit in some, but for most, risk-benefit analysis may argue against its use. Here is the discussion.

Read more
In Coronary artery disease Tags aspirin, coronary artery disease, primary prevention

My approach to chest pain

September 7, 2019 Andrew To
Severe coronary non-calcified atherosclerosis with severe stenosis, on CT coronary angiography

Severe coronary non-calcified atherosclerosis with severe stenosis, on CT coronary angiography

Chest pain presentations are common, but management can be variable and difficult to understand. Here is my approach:

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In Coronary artery disease, Cardiac Investigations, Myocardial infarction Tags coronary artery disease, chest pain, Risk assessment, exercise stress ECG, stress echcoardiography

Beta-blockers in Hypertension

September 5, 2019 Andrew To

70-year-old asymptomatic man with hypertension but not cardiovascular disease presented for a routine check. His pulse rate was 40bpm.  His son, aged 45, recently had an MI in Australia.

His medications include

  • Doxazosin 8mg OD

  • Metoprolol 95mg CR OD – since 2006

  • Cilazapril 5mg / Hydrochlorothiazide 12.5mg OD

ECG shows sinus bradycardia, with normal PR interval, QRS duration.

Read more
In Drug Treatment Tags hypertension, beta-blocker, calcium channel blocker, ACE inhibitor, angina, coronary artery disease, heart failure

Fish oil supplement? - update 2018

September 3, 2018 Andrew To
Monterey Aquarium

Monterey Aquarium

Daily supplementation with marine-derived omega-3 fatty acids has been promoted for its potential health benefits in cardiovascular diseases. We blogged about this last year with a meta-analysis from Oxford. Here is the update.

The promised randomized controlled trial has now come out after the European Society of Cardiology Congress in Munich last week.

Read more
In Coronary artery disease Tags coronary artery disease, Dietary intervention, cardiac rehabilitation

Individual risk assessment - a common scenario

September 4, 2016 Andrew To
1906 San Francisco Fire Sacramento Street; Photo from Arnold Genthe from the Library of Congress

1906 San Francisco Fire Sacramento Street; Photo from Arnold Genthe from the Library of Congress

A 40-year-old Maori man came for routine review concerned because his 38-year-old brother, who was a smoker, died suddenly of a heart attack. The patient was athletic, previously played professional rugby, without clinical risk factors.

-      BMI 28

-      LDL 4.9; TC/HDL ratio 4

His calculated cardiovascular risk on these parameters was low. A reasonable approach would include

1)     reinforcing healthy living and reassessing in 5 years

2)     reinforcing healthy lifestyle and starting a statin

3)     reinforcing healthy lifestyle, getting a CTCA, starting a statin

4)     all of the above

Read more
In Drug Treatment Tags Statins, coronary artery disease, CT coronary angiography, Risk assessment

CT coronary angiography - Cases

March 6, 2016 Andrew To
Curved reconstruction in CT coronary angiography

Curved reconstruction in CT coronary angiography

A 45-year-old man with no prior cardiac history, but with cardiovascular risk factors including a 10-pack-year smoking history stopped last year, 5-year history of Type II diabetes on Metformin, obesity with BMI of 37, without a family history of premature coronary artery disease, now presented with exertional but inconsistent central chest tightness.

He was investigated extensively, including a negative exercise tolerance ECG at 13 minutes without symptom or ECG change.  Despite reassurance, his chest pain continued at random, and has not resolved with a course of Omeprazole for presumed non-cardiac (possibly gastrointestinal reflux) chest pain.

What should we do?

-       Reassure him that this pain is almost certainly non-cardiac

-       Perform a stress echocardiogram as it has a higher sensitivity than an exercise ECG

-       Perform an invasive angiography

Read more
In Cardiac Investigations Tags CT coronary angiography, chest pain, echocardiography, stress echcoardiography, coronary artery disease

CT coronary angiography - How good is it?

March 6, 2016 Andrew To
CT coronary angiography - volume rendered image of the left anterior descending artery and its branches

CT coronary angiography - volume rendered image of the left anterior descending artery and its branches

CT coronary angiography has now been routinely performed, at least in the Waitemata area since 2011, where we were the first to implement CTCA in the workup of acute chest pain in New Zealand.

Read more
In Cardiac Investigations Tags coronary artery disease, chest pain, CT coronary angiography, echocardiography, stress echcoardiography, exercise stress ECG

Copyright @2024 Cardiology Institute; All photos copyright @2024 Andrew To