The heart of the matter

There is an old joke where different parts of the body argue amongst themselves about which is the most important. The brain, lungs and heart naturally see themselves as being above the rest. The punchline is when the anus goes on strike to prove that the remainder can’t cope without it.  


Dr Joe Kosterich, Clinical Editor
Dr Joe Kosterich, Clinical Editor

Jokes aside, the general definition of extinct life is when the heart stops beating. Thus, the cardiovascular system, whilst perhaps not more important than other body systems, does hold a particular place in the eyes of both the public and the medical profession. Chest pain does strike more fear into all of us than abdominal pain or leg pain.

AIHW data shows coronary heart disease was the leading cause of death in Australian males in 2018 and the second leading cause for female deaths. Cerebrovascular disease is third for females and fourth for males. There is no doubt we have made progress over the years, but we can do better.

This edition has a focus on cardiovascular health in a broad sense. We look at WA research into possible new markers for cardiovascular disease, treatment of hypertrophic cardiomyopathy and potential ways to reduce risk through improving management of diabetes. From a completely different angle, better utilisation of potential donor hearts for transplant is examined.

When I was in medical school there was very little that could be done to treat strokes. Today we are in a whole new world with early treatment. Having recently had a patient undergo such treatment, the article on hyperacute strike management, including the development of algorithms, was fascinating.

AIHW data shows coronary heart disease was the leading cause of death in Australian males in 2018 and the second leading cause for female deaths.


The cardiac implications of COVID-19 are examined and as a change of pace we look at lung cancer screening. Smoking of combustible tobacco (cigarettes) remains the biggest risk factor for heart disease and lung cancer. Sadly Australia’s smoking rates have largely plateaued since 2013.

It is one year since COVID hit our shores in a major way with lockdowns and border closures beginning in early April 2020. At time of writing all state borders are (effectively) open. The vaccination program, which will be into phase 1b by the time you read this, will be the biggest program of its type ever undertaken in this country. The experience in the US is encouraging. The drop in cases there points to light at the end of the tunnel. Perhaps it will be ‘Italy here I come’ in 2022.