13th April 2023, NIA Diagnostic Imaging
A few months ago, we explored the role of coronary artery calcium score (CAC) as a cardiovascular risk assessment tool, and its importance in the prediction of future cardiovascular heart disease events and atherosclerotic cardiovascular disease (9). However, limited by the inability to assess the burden of non-calcified plaque which has low radiological attenuation, CT coronary angiography (CTCA) can be performed in conjunction with a CAC (6).…
9th April 2023, Dr Chee L Khoo
One of the most important contributor to atherosclerosis is elevated cholesterol levels. Familial hypercholesterolaemia (FH) is a genetic disease that manifests as a disorder of cholesterol metabolism by mutations in hereditary genes usually in an autosomal dominant manner. Data suggest that 1 in 200 Caucasians are heterozygous for FH and that 1 in 160,000–300,000 are homozygous, which are much higher prevalence than those estimated a decade earlier (1).…
1st April 2023, Dr Chee L Khoo
Two months ago, we explored heart failure in cancer survivors exposed to anthracyclines in a dose dependent manner. Anthracyclines are a common agents used in chemotherapy against breast cancer and lymphomas. Heart failure may appear as early as within 12 months of receiving anthracyclines and the incidence continues to grow over time. There have been a lot of work done on the possible molecular pathways in the development of the cardiotoxicity, the prevention strategies explored and the development of “safer” anthracycline derivatives.…
30th March 2023, Spectrum Medical Imaging
We are used to ordering chest CT when we suspect an inflammatory or infective condition in the lungs. Sometimes, we need more information than that. A HRCT CHEST is a CT technique in which thin-slice images of the chest are obtained and post-processed in a high-spatial-frequency reconstruction algorithm. When do you order a HRCT of the chest and when do you order an ordinary CT of the chest?…
26th March 2023, Dr Chee L Khoo
We have always known that revascularisation for coronary artery disease (CAD) improve symptoms (and quality of life) but sadly does not always improve survival. Mounting evidence indicates that non-epicardial coronary causes of angina and ischaemia, including coronary microvascular dysfunction, vasospastic disorders, and derangements of myocardial metabolism, are more prevalent than flow-limiting stenoses, raising concerns that many important causes other than epicardial CAD are neither considered nor probed diagnostically.…
25th March 2023, Dr Chee L Khoo
It’s not really an article you want to read at the eve of a major event. I am off to Paris this week for my second overseas marathon. My cardiologist thinks I am medically crazy to do a marathon at all. So far, I have kept up my side of the bargain by keeping my heart rate to the recommended maximal heart rate during my training (and mostly during the events).…
13th March 2023, NIA Diagnostic Imaging
Over the last few weeks, we have explored the many issues relating to metabolic dysfunction associated fatty liver disease (MAFLD). We looked at what else we need to do after you diagnosed MALFD. In particular, we highlighted the need to assess the degree of fibrosis in each patient with MAFLD. With the continuous advances in technology, a wide range of new techniques and imaging modalities have emerged, thus allowing for improved diagnosis of various diseases and pathologies.…
12th March 2023, Dr Chee L Khoo
Myopia, especially high myopia is associated with increased risk of irreversible blinding conditions, including myopic retinopathy, retinal detachment, choroidal neovascularisation, and glaucoma (1-4) leading to a heavy cost burden on individuals and communities (5). So, it makes sense to see whether we could prevent or delay the onset of myopia or at least slow its progression.…
11th March 2023, Dr Chee L Khoo
Where did it come from? You would have fielded questions from more than a few patients about this new wonder cholesterol lowering drug that is coming to Australia “soon”. That’s what one of the current affairs media was hinting during the week. Of course, they make it sound as if everyone on statins is crying with muscle aches and pains.…
Spectrum Medical Imaging, 28th February 2023
Uterine fibroids are benign (non-cancerous) tumours of the
uterus. They are clinically apparent in up to 25% of women
and, with newer imaging techniques, the true clinical
prevalence may be higher (up to 77% ). Although most do
not cause symptoms, uterine fibroids can cause severe
problems for some women who have the condition.…
27th February 2023, Dr Chee L Khoo
We might see one case every 5 years in primary care. It might not be common but a missed diagnosis can be devastating. Patients rarely present to emergency department or the vascular surgeon without presenting to primary care first. Giant cell arteritis (GCA) is now thought of as a systemic inflammatory disease. Although glucocorticoids remain the mainstay of treatment , in the last few decades, new knowledge have dramatically changed the way we diagnose and treat GCA.…
27th february 2023, Dr Chee L Khoo
We have covered many aspects of the diagnosis, definition and management of heart failure quite extensively over the last 18 months on GPVoice. If you have been following the conversation, you will realise that the diagnosis previously very subjective. We depended much on symptoms according to the New York Heart Association (NYHA) classification to guide diagnosis, investigations and most importantly, management.…