The edition · Family Medicine
After a complicated pregnancy, heart-risk follow-up has to fit family life; and AI on the routine ECG finds hidden low EF
A BJGP review of 18 qualitative studies explains why women rarely act on cardiovascular risk after pre-eclampsia or gestational diabetes. Three trials show AI reading of routine ECGs finds one extra case of low ejection fraction per 204 screened.
The edition in brief
A BJGP qualitative systematic review of 18 studies and 339 women found that slow recovery, childcare and work crowded out cardiovascular risk reduction after adverse pregnancy outcomes, while personal advice from clinicians, awareness of risk and family-friendly changes helped; proactive follow-up mattered most for disadvantaged and minority-ethnic women. A meta-analysis of three randomised trials (37,467 adults) found AI analysis of routine ECGs increased new diagnoses of low ejection fraction (RR 1.36, number needed to screen 204) without increasing echo referrals overall. A single 12-lead ECG in 357 adults aged 65 or over at a Turkish family health centre found atrial fibrillation in 11.8%, half previously unknown, and most of those not anticoagulated despite meeting the threshold. An American Family Physician review sets out primary care management of alcohol use disorder: screening with AUDIT-C, brief counselling for all, treatment or referral, and attention to co-occurring mental illness. The pearl: record pregnancy complications as cardiovascular risk factors.
Why women rarely act on heart risk after pregnancy complications — and what helps
After a complicated pregnancy, explain the cardiovascular risk personally and offer proactive, family-centred follow-up rather than one postnatal conversation.
One routine ECG found atrial fibrillation in one in eight over-65s, half of it unknown
Opportunistic pulse or ECG checks in over-65s find substantial unrecognised AF, most of it meeting the threshold to consider anticoagulation.
Alcohol use disorder is a primary care condition, and treatment there works
Screen for alcohol use with a short tool, give brief counselling to everyone with alcohol use disorder, and treat or refer — it is effective in primary care.
Put pregnancy complications on the problem list
Record pregnancy complications as long-term cardiovascular risk factors so they shape care for decades.
AI reading of routine ECGs found more low ejection fraction without more echo referrals
Where validated AI-ECG reading is available, it finds about one extra case of low ejection fraction per 204 routine ECGs; follow each flag with an echo.
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