Dr Martin's Blog

Tuesday, February 14, 2012

Valentine’s Day, affairs of the heart and blocked arteries

As today is Valentine’s Day and February is National Heart Month, this blog entry concentrates on the romance of the moment – the courtship between the FA and Harry Redknapp.


It’s no secret that Harry recently had heart surgery to open blocked arteries. He’s also just spent the most stressful three weeks of his life in the dock at Southwark Crown Court. Is the stress of taking on ‘football’s impossible job’ really the best thing for his health?


Heart attacks are the leading cause of death for men and women in the UK, with over 100,000 people dying each year. The good news is that this number is falling, as more and more excellent treatments become available.


A heart needs its own blood supply. This comes through the coronary arteries. When these arteries get blocked the heart muscle is starved of oxygen and begins to die, resulting in a ‘heart attack’, also known as a ‘coronary’, or in medical parlance; acute myocardial infarction.


The common symptoms are pains in the centre or left side of the chest which don’t go away, aching feeling in the arms, neck, jaw or upper stomach; sometimes accompanied by breathlessness, nausea, vomiting, light-headedness and cold sweats.

The diagnosis is confirmed by looking for tell tale signs on an electrocardiogram (ECG), and blood tests looking for higher levels than normal of certain proteins in the blood, called troponins.


Detailed pictures of the coronary arteries are then taken, using special x-rays and dye injections via thin tubes passed from the groin back up the arteries to the heart (coronary angiography).   Once the blockage is found, it may be reopened by angioplasty, when the cardiologist inflates a fine balloon inside the artery to widen it back out and restore the blood flow to the injured heart muscle. The cardiologist may then put a wire mesh tube (stent) into the artery to keep it open for hopefully years to come.


If you’ve had a heart attack you are at risk of another one. However, with successful rehabilitation and sensible lifestyle changes (stopping smoking, being physically active and keeping a healthy weight) you should be able to return to an active, fulfilling life, with no restrictions on stressful activities.


So Harry, when they call, you can say yes!

Posted by Martin Errington on 02/14 at 07:33 AM

Friday, February 03, 2012

Matthew Rees and Luke Narraway to miss 6 Nations openers due to calf strain

Wales hooker Matthew Rees and England flanker Luke Narraway are set to miss the opening matches of the RBS 6 Nations this weekend, due to calf strains picked up in training.


Calf strainA calf strain injury - also known as a 'pulled calf', 'pulled muscle' or even ‘tennis leg’ - is common in many sports. It is caused when the muscle is stretched beyond its limits and the muscle tissue is torn.

There are three main muscles at the back of the calf: the medial gastrocnemius, the lateral gastrocnemius and the soleus, and a further small muscle called the plantaris. All of which come together above the back of the ankle to form the Achilles tendon.

Gastrocnemius strains are most common, thought to be due to the muscle crossing two joints (knee and ankle) and because the muscle contains a particular type of fast twitch muscle fibre. It is difficult to distinguish this from the less common plantaris strain, unless diagnostic imaging is used. The soleus muscle only crosses the ankle joint, and is mostly made up of slow twitch fibres, so is considered low risk for strain injury.

Depending on its severity, a calf injury is classified as a first, second or third degree strain. The grading can be done by medical examination and by diagnostic imaging, most commonly diagnostic ultrasound and MRI scanning.

It sounds like Matthew and Luke are suffering from a first or second degree strain. They will initially be prescribed ‘RICE’: rest, ice, compression and elevation. Followed by gentle muscle stretching, through to muscle strengthening exercises, for about 10 days. Massage and ultrasound are often added at this stage.

We wish them both a speedy recovery.


For more in-depth information: Curr Rev Musculoskelet Med. 2009 June; 2(2): 74–77. Gastrocnemius vs. soleus strain: how to differentiate and deal with calf muscle injuries


Posted by Martin Errington on 02/03 at 04:17 PM