ISCHAEMIC HEART DISEASE

A little heparin can be a bad thing ▸ Heparin induced thrombocytopenia (HIT) is a rare complication of unfractionated and even more rarely of low molecular weight heparin treatment. It usually occurs between 5–8 days after starting heparin treatment, although may occur earlier if there has been previous exposure. This study of 12 patients highlights that even courses of heparin for only three days can initiate HIT and thrombosis. Presentation may be as late as three weeks after the exposure. Checking for antibodies to the platelet-factor-4/heparin complex is vital to diagnosis.

Risk of sepsis after coronary angiography ▸ Of 22 006 invasive cardiac procedures carried out in Madrid from 1991 to 1998, 25 blood stream infections were documented within 72 hours. Overall incidence of bacteraemia was 0.11% (0.24% after percutaneous transluminal coronary angioplasty, 0.6% after diagnostic cardiac, and 0.8% after electrophysiologic studies). Bloodstream infection was detected a median of 1.7 days after the procedure, and was more common in the elderly and …