Cardiovascular & Renal · Full case

MI — Secondary Prevention

NICE NG185CG148DAPT
MI
MI Secondary Prevention · Clinical Reasoning Framework v2
GP & SCA · NICE NG185 · CG148 · DAPT · Atorvastatin 80mg · ACEi · Beta-blocker · Cardiac Rehab · DVLA · Smoking · PDE5 inhibitors
DAPT 12 months → aspirin lifelongDual Antiplatelet Therapy (DAPT) after ACS: aspirin 75mg PLUS a P2Y12 inhibitor (ticagrelor 90mg BD or prasugrel 10mg OD or clopidogrel 75mg OD) for 12 months post-ACS. After 12 months: aspirin 75mg daily lifelong (monotherapy). Never stop DAPT early without cardiology advice — high risk of in-stent thrombosis, which is fatal in ~30% of cases. If a patient on DAPT develops acute chest pain: A&E immediately (possible in-stent thrombosis). Ticagrelor preferred over clopidogrel in ACS (PLATO trial); prasugrel only with PCI (TRITON-TIMI 38 trial).
Atorvastatin 80mg — LDL target <1.8 mmol/LHigh-intensity statin (atorvastatin 80mg OD) for all post-MI patients regardless of baseline cholesterol (NICE NG185). LDL-C treatment target: <1.8 mmol/L OR >50% reduction from baseline (NICE 2023 update). Review LDL-C at 3 months post-initiation. If LDL-C above target despite maximum tolerated atorvastatin: add ezetimibe 10mg OD. If still above target: consider PCSK9 inhibitor (evolocumab 140mg SC fortnightly or inclisiran 284mg SC 6-monthly) via cardiology referral. LFTs at baseline and 3 months. Myopathy warning: unexplained muscle pain — stop statin; check CK.
DVLA: Group 1 = 1 week; Group 2 = 6 weeks + notifyPost-MI / post-PCI DVLA rules: Group 1 (car/motorcycle): 1 week off driving if successful PCI or uncomplicated MI; 4 weeks if CABG. Group 2 (HGV/bus/taxi): 6 weeks minimum AND must notify DVLA AND must satisfy DVLA medical standards before returning. Group 2 drivers must NOT drive until DVLA approves return. GP must advise Group 2 patients to notify DVLA immediately — failure to do so is a criminal offence. Lorry (LGV) and bus (PCV) drivers: stricter requirements; may need exercise tolerance test and cardiology review before return.
Never stop ticagrelor without cardiology adviceIn-stent thrombosis (IST): occurs when DAPT is stopped early, especially in the first 3–6 months after PCI stent insertion. IST is life-threatening (30% mortality). Risk is highest in the first 3 months (bare metal stent) and up to 12 months (drug-eluting stent). Patients on DAPT should be warned: never stop without medical advice; if they are having surgery, the operating surgeon must discuss with cardiologist before stopping ticagrelor. If ticagrelor is not tolerated (dyspnoea — common side effect; bradycardia; bleeding): switch to clopidogrel 75mg OD (not stop).
Smoking: most impactful modifiable risk factorSmoking cessation post-MI reduces relative risk of a further MI or death by 36% — greater benefit than any single drug intervention. First-line cessation: combination NRT (patch + gum or lozenge) OR varenicline (first-line; most effective; CI in severe renal impairment; monitor mood). Bupropion: second-line. GP should offer brief advice at every contact — even 3 minutes of advice increases quit rates. Refer to NHS Stop Smoking Service (self-referral available). If patient has relapsed: normalise; do not shame; re-engage with cessation plan. CO monitoring at each review.
PDE5 inhibitors: safe post-MI; contraindicated with nitratesSildenafil (Viagra), tadalafil, vardenafil: safe to use after MI (typically after at least 4–6 weeks of cardiovascular stability). ABSOLUTE CONTRAINDICATION: combination with nitrates (GTN spray; isosorbide mononitrate) — severe, potentially fatal hypotension. Patients taking long-acting nitrates cannot take PDE5 inhibitors. If GTN spray used for angina AND patient wishes to use PDE5 inhibitor: discuss with cardiologist (may be able to switch to a different antianginal). Sexual health should be proactively raised in post-MI reviews; fear of sex causing a further MI is very common but the risk is very low (equivalent to climbing 2 flights of stairs).
Eplerenone if EF <35% post-MI + HF signsEplerenone (aldosterone antagonist / MRA): indicated post-MI in patients with LV systolic dysfunction (EF <35%) AND signs of heart failure (EPHESUS trial). Starting dose 25mg OD; titrate to 50mg OD. Monitor: renal function and potassium at 1 week, 1 month, then 3-monthly. Hyperkalaemia risk: especially with ACEi + eplerenone combination; monitor closely (K+ >5.5 = reduce dose; K+ >6.0 = stop). Not indicated if no heart failure or EF preserved. Spironolactone can be used as alternative (cheaper; more side effects — gynaecomastia).
Cardiac rehabilitation: reduces mortality 20–25%Cardiac rehabilitation (CR): all post-MI patients should be offered a structured programme (NICE NG185; Class I recommendation). Evidence: reduces all-cause mortality by 20–25% (Cochrane meta-analysis 2016). Components: supervised exercise; education about cardiac disease; psychological support; risk factor management. UK standard: Phase II CR begins 4–6 weeks post-discharge. Duration: 6–12 weeks. Completion rates are low (40–50%); GP should actively follow up non-attendance. Remote/online CR available. Exercise prescription at 40–70% maximum heart rate; 30 minutes, 5 days/week when graduated to full activity.
📋 Clinical Stem — MI Secondary Prevention
A 58-year-old HGV driver attending his 6-week post-NSTEMI review, back on cigarettes, LDL-C above target, blood pressure elevated, anxious about sex, and wanting to know when he can return to his lorry
Mr. James Henderson, 58, was discharged from hospital 6 weeks ago following an NSTEMI. He underwent successful PCI with drug-eluting stent insertion to his left anterior descending artery. He was discharged on aspirin 75mg OD, ticagrelor 90mg BD, atorvastatin 80mg OD, ramipril 5mg OD, and bisoprolol 2.5mg OD. Today’s 6-week review bloods show: LDL-C 2.1 mmol/L (target <1.8 mmol/L); total cholesterol 4.6 mmol/L; eGFR 78; U&E normal; LFTs slightly elevated (ALT 52, upper limit of normal 45). His blood pressure today is 142/86 mmHg. He admits he has been smoking again — “about 15 a day” since 2 weeks after discharge. His wife is anxious about him resuming physical activities. He is worried about sex but “didn’t want to bring it up.” He drives an HGV for a living and wants to know when he can go back to work. He has not attended cardiac rehabilitation.
This stem tests nine sequential post-MI review tasks: medication reconciliation and checking DAPT adherence; recognising that ticagrelor must not be stopped at 12 months without transition to aspirin monotherapy; addressing LDL-C above target; addressing hypertension; smoking cessation; DVLA Group 2 driving restrictions (HGV driver — must notify DVLA and cannot drive until cleared); cardiac rehabilitation; sexual health post-MI; and psychological wellbeing assessment. The SCA challenge is doing all nine efficiently in 12 minutes while maintaining a patient-centred, empathetic tone.
Scenario A — STEMI review Different clinical pathway: STEMI treated with primary PCI (pPCI) — same secondary prevention medications (DAPT; atorvastatin 80mg; ACEi; BB – some guidance continues BB longer after STEMI); echo at 6–8 weeks to assess LV function (ejection fraction); if EF <35% with HF signs: add eplerenone 25mg titrated to 50mg OD (EPHESUS criteria); if EF <40%: consider ICDl (implantable cardioverter defibrillator) assessment at 40 days (NICE guidance). LFT elevation on statin: mild transaminase elevation (up to 3× ULN): continue and recheck; if >3× ULN: reduce dose or switch statin.
Scenario B — Statin myopathy Patient attending with muscle aches and weakness starting 3 weeks after initiation of atorvastatin 80mg. CK 2400 U/L (normal <200 U/L). Statin-induced myopathy: CK <4× ULN = myalgia (continue with monitoring; low-dose; consider alternative); CK 4–10× ULN = myositis (stop; rechallenge at lower dose or different statin); CK >10× ULN = rhabdomyolysis (stop immediately; IV fluids; hospital; monitor renal function). If statin must be stopped: switch to alternative statin (rosuvastatin; pravastatin); ezetimibe 10mg (non-statin LDL-lowering); PCSK9 inhibitor via cardiology if statin-intolerant and high risk.
Scenario C — DAPT and elective surgery Patient on ticagrelor 90mg BD due to have an elective cholecystectomy in 4 weeks. Surgeon wants to stop ticagrelor. Task: do not stop DAPT without cardiology agreement; discuss with cardiologist; options are: postpone surgery (most common; wait until 12 months of DAPT); proceed with DAPT if bleeding risk acceptable (general surgeon decision); or bridging strategy with unfractioned heparin (specialist decision). Never stop DAPT 4 months post-PCI with a drug-eluting stent without cardiology input — in-stent thrombosis risk.
Scenario D — NSTEMI with preserved EF, on nitrates Patient post-NSTEMI on isosorbide mononitrate for residual angina, now asking about erectile dysfunction. PDE5 inhibitors (sildenafil) absolutely contraindicated with nitrates. Options: (1) discuss with cardiologist about whether nitrate is still needed; (2) if angina controlled: consider stopping nitrate (with cardiologist advice); (3) if nitrate essential: cannot use PDE5 inhibitor safely; (4) alternative approaches to ED (psychological support; vacuum devices). Key SCA point: never prescribe sildenafil to a patient currently on nitrates.
Scenario E — LDL-C above target on maximum statin Patient on atorvastatin 80mg for 6 months; LDL-C still 2.4 mmol/L (target <1.8 mmol/L). Step-up: add ezetimibe 10mg OD (non-statin lipid-lowering; reduces LDL by additional 15–20%). If still above target on atorvastatin 80mg + ezetimibe: refer to cardiology/lipid clinic for PCSK9 inhibitor (evolocumab 140mg SC fortnightly; inclisiran 284mg SC 6-monthly). PCSK9 inhibitors reduce LDL by 50–60% additionally; significant cardiovascular outcome evidence (FOURIER; ORION trials). Inclisiran: GP initiation not available; cardiology or PCSK9 clinic.
Key variables to adapt for Type of MI and intervention (STEMI vs NSTEMI; PCI vs CABG vs medical management — each has different DVLA timeline; different monitoring); LV function (EF <35%: eplerenone; EF <40%: ICD assessment; EF preserved: DAPT + statin + ACEi + BB still indicated); specific DAPT agent (ticagrelor vs prasugrel vs clopidogrel — each has different contraindications and monitoring); statin tolerance (myopathy; LFT elevation; statin-intolerant patients require ezetimibe or PCSK9 inhibitor); occupational factors (Group 2 drivers; pilots; other safety-critical roles require strict DVLA notification); comorbidities (diabetes; CKD; AF on top of DAPT; cardiac rehab completion status)
Steps:
1
Step 1
History Taking — Medication Review · Symptoms · Risk Factors · DVLA · Psychological Wellbeing · ICE
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The 6-week post-MI review is one of the most clinically dense GP consultations: it must cover medication reconciliation, risk factor targets, DVLA obligations, cardiac rehabilitation, sexual health, and psychological wellbeing. For Mr. Henderson, the agenda is driven by what he brings (work; smoking; worry about sex) and what the GP must proactively address (DVLA Group 2; ticagrelor adherence; LDL-C above target; BP above target; cardiac rehab non-attendance; depression screen).
🎓 SCA opener — acknowledge the event before the drug list
"Mr. Henderson — good to see you. Six weeks since your heart attack. Before I go through the review, I want to ask how you are doing in yourself — how have the last six weeks been, beyond the physical stuff?"
SCA: opening with a global emotional check-in before listing medications and targets distinguishes passing from failing communication. Mr. Henderson may be carrying significant anxiety about recurrence, guilt about smoking relapse, embarrassment about sex, or fear about his livelihood. None of these will emerge from a medication checklist. A 30-second open question at the start changes everything.
1A — Open question, then structured post-MI history
QuestionWhy it mattersChanges what?
🏲 OPEN QUESTION"How have you been since you came out of hospital? And what are the things you most want to get sorted today?"The open question at a structured post-MI review serves two functions: it checks in on the whole person (not just the labs), and it reveals the patient’s hidden agenda before the GP’s clinical agenda dominates. Mr. Henderson may lead with the driving question (his livelihood); or with the sex question (which he says he didn’t want to bring up); or with anxiety about recurrence. Whatever he leads with tells the GP what matters most and what, if unaddressed, will be the barrier to everything else — including medication adherence.SCA: Global Skills for open-question-first data gathering; Relating to Others for patient-centred approachPatient agenda revealed; hidden concerns may emerge (sex; anxiety; smoking guilt)
Medication adherence — all five drugs"Are you taking all the tablets from hospital? Anything you’ve missed, or stopped, or that doesn’t agree with you?"The most dangerous medication non-adherence in post-MI secondary prevention is ticagrelor: stopping DAPT within 12 months carries a 30% mortality risk from in-stent thrombosis. But 20–30% of post-MI patients stop medications within the first few months — often because they feel better, have side effects, or can’t afford prescriptions. Each drug must be specifically checked. Ticagrelor causes dyspnoea in 10–15% of patients (via prostaglandin-mediated mechanism, not bronchoconstriction — safe to continue in most cases; switch to clopidogrel if intolerable). Ramipril causes cough in 15% (switch to candesartan). Bisoprolol: fatigue; erectile dysfunction.Ticagrelor stopped early: urgent cardiology advice; restart today if <12 months post-PCI. Side effects: switch within class rather than stop. Non-adherence to statin: reinforce; check LFTs
Symptoms — angina; chest pain; palpitations; breathlessness; ankle swelling"Have you had any chest pain, tightness, or pressure since discharge? Any palpitations or racing heartbeat? Any breathlessness more than expected? Any ankle swelling?"Red flags requiring urgent cardiology review: (1) new angina or returning chest pain (possible stent failure, incomplete revascularisation, or new disease); (2) palpitations with haemodynamic compromise (possible post-MI arrhythmia; bradycardia from bisoprolol); (3) progressive breathlessness at rest or on minimal exertion + ankle swelling (possible heart failure; check LV function — if not yet done, arrange echo or refer). Angina after NSTEMI and PCI: does not always indicate stent failure (may be incomplete revascularisation); requires stress testing or cardiology review. New palpitations: 12-lead ECG in surgery.New chest pain: same-day ECG; urgent cardiology; do not wait. Palpitations: ECG; 24h tape. Ankle swelling + breathlessness: heart failure; echocardiogram; consider loop diuretic
Smoking status — current; pack years; relapse"Are you still not smoking? I want to ask directly because a lot of people find it very hard to stay stopped in the early weeks."Smoking cessation post-MI reduces further MI and mortality risk by 36% — equivalent benefit to aspirin, statin, and ACE inhibitor combined. It is the single most impactful modifiable risk factor. Mr. Henderson has relapsed — 15 cigarettes/day. Key approach: do not shame; normalise relapse (majority of smokers need multiple attempts); acknowledge the stress of a post-MI period as a major trigger for relapse; offer support with warmth: “Most people find this incredibly hard. I want to help you try again, in a way that might work better.” Options: varenicline (most effective; monitor mood); combination NRT (patch + short-acting); bupropion; e-cigarettes (harm reduction; evidence emerging). NHS Stop Smoking Service referral.Smoking cessation: varenicline (first-line; most effective); combination NRT; e-cigarettes (harm reduction); stop smoking service referral. Every contact should include brief smoking advice (3-5 minutes)
Sexual activity and concerns"I want to ask about something that a lot of people wonder about after a heart attack but often don’t feel comfortable raising — have you been able to think about or get back to sexual activity yet? It’s something I want to make sure we cover."Sexual health is almost universally a concern post-MI and almost universally not raised unless the GP raises it first. Fear of sex triggering another MI is very common — and the actual risk is very low (sexual activity in a stable partner is equivalent to climbing 2 flights of stairs; risk of MI from sex = 2.5 per million person-hours). Mr. Henderson wants to ask but “didn’t want to bring it up” — the GP who proactively raises sexual health is immediately perceived as more competent and caring. Key clinical points: sildenafil and PDE5 inhibitors are safe post-MI (after cardiovascular stabilisation); ABSOLUTE CI with nitrates (GTN spray; isosorbide mononitrate) — severe hypotension. Bisoprolol causes erectile dysfunction in 10% — if this is the cause, consider alternative.PDE5 inhibitors: safe if not on nitrates. Bisoprolol + ED: switch to nebivolol (vasodilatory; less ED risk). Reassurance: risk of MI from sexual activity is very low in stable, treated cardiac disease
1B — Red flags: symptoms requiring urgent action
🚨

Red Flags — post-MI symptoms requiring urgent assessment

Red flagWhy dangerousAction
Acute chest pain or pressure on DAPTIn-stent thrombosis (IST): catastrophic occlusion of the stented coronary artery; occurs in 1–3% of patients post-PCI, usually when DAPT has been stopped or interrupted. Mortality 30%. Presents as STEMI. Also: incomplete revascularisation (treated vessel open but other vessels have disease); new MI. Any acute chest pain in a patient on DAPT = 999; treat as STEMI until proven otherwise.999 immediately; aspirin 300mg loading if not already on antiplatelet; do not delay
Palpitations with presyncope or syncopePost-MI arrhythmia: ventricular tachycardia (VT) and ventricular fibrillation (VF) risk is highest in the first 48 hours but persists, especially if LV function is impaired. Sustained VT/VF post-MI may require ICD implantation. Brady-arrhythmia from bisoprolol or complete heart block (if inferior MI): AV node damage. Syncope post-MI is a cardiology emergency. ECG immediately in surgery; if VT/VF: 999.12-lead ECG immediately; same-day cardiology referral if ECG abnormal; if haemodynamically unstable: 999
Breathlessness at rest or on minimal exertion + peripheral oedemaPost-MI heart failure: LV remodelling after MI (especially STEMI; large territory infarct) causes systolic dysfunction; heart failure develops in 15–25% of post-MI patients within months. Signs: breathlessness; orthopnoea; PND; bilateral ankle oedema; raised JVP; third heart sound. Echocardiogram needed (if EF <35%: eplerenone + ICD assessment; if EF <40%: ACEi + BB + consider sacubitril-valsartan).Urgent echocardiogram; loop diuretic if HF confirmed; cardiology referral; eplerenone if EF <35% + HF
Severe muscle pain or weakness on statin (CK >10× ULN)Statin-induced rhabdomyolysis: severe myopathy with CK >10× upper limit of normal; myoglobin release causes acute kidney injury. Rare but serious. Symptoms: severe proximal muscle pain; dark urine (myoglobinuria). Stop statin immediately; IV fluids; hospital if severe. Mild myalgia (CK normal or <4× ULN): continue; reassess; consider switching to alternative statin (rosuvastatin; pravastatin lower myopathy risk).Stop statin immediately; check CK; if CK >10× ULN or renal impairment: hospital admission; IV fluids
Major bleeding on DAPT (GI; intracranial)DAPT increases bleeding risk 2–3× compared to aspirin alone. Major GI bleeding: haematemesis or melaena; requires hospital admission and urgent cardiology advice before DAPT is stopped (stopping increases thrombosis risk; a haemostatically-treated patient may need DAPT restarted quickly). Intracranial haemorrhage: stop all antiplatelets immediately; 999; neurosurgical emergency. For GI bleed: PPI (omeprazole 40mg OD) should have been prescribed at discharge — if not, add now.Major GI bleed or intracranial haemorrhage: 999; urgent hospital; cardiology + gastroenterology / neurosurgery co-management
🛡️

Post-MI Vulnerability — Psychological and Social Considerations

A heart attack is a traumatic life event. 20–30% of post-MI patients develop clinically significant depression within 3 months; another 20–30% develop anxiety. Both independently increase the risk of a further cardiac event. Mr. Henderson is also facing a major occupational threat: his HGV licence. The GP who addresses these dimensions is providing genuinely comprehensive post-MI care.
💔 Post-MI Depression and Anxiety
  • PHQ-9 and GAD-7 at 6 weeks and 3 months post-MI — not optional; should be part of the review template
  • Depression post-MI is underdiagnosed: fatigue and reduced activity are attributed to cardiac disease rather than mood
  • Treatment: SSRIs are safe in post-MI depression (sertraline has the best cardiac safety data); do NOT use tricyclics (QTc effects)
  • Cardiac rehabilitation has a significant psychological benefit component — non-attendance worsens mood outcomes
🚘 Occupational Impact — DVLA and Livelihoods
  • Mr. Henderson cannot drive his HGV until DVLA approves return — this directly threatens his income and identity
  • The GP must be honest and clear about DVLA obligations without being punitive
  • DVLA notification is a legal obligation: GP should document that the patient has been advised
  • Occupational health referral: explore what alternative work may be available while not cleared to drive; employer may have sedentary roles
🪝️ Cardiac Rehabilitation Non-Attendance
  • Mr. Henderson has not attended cardiac rehabilitation — this is very common (40–50% non-completion nationally)
  • Barriers: work commitments; embarrassment; practical barriers (transport; time); minimising the event (“I feel fine now”)
  • Evidence: cardiac rehabilitation reduces mortality 20–25%; equivalent benefit to adding a drug
  • GP should actively chase non-attendance: phone call; explore barriers; offer remote/online alternative if practical barriers
💑 Relationship and Sexual Health Impact
  • Mr. Henderson’s wife is anxious about him resuming activities — partner anxiety is extremely common; both members of the couple need information and reassurance
  • Consider inviting the partner to a review appointment to discuss prognosis and exercise tolerance
  • Sexual dysfunction post-MI: from depression; anxiety; beta-blocker; altered body image; fear
  • Proactively raising sex normalises it; if GP doesn’t raise it, it will not be discussed
Post-MI review must include: PHQ-9 + GAD-7 at 6 weeks and 3 months; DVLA obligations communicated and documented; cardiac rehabilitation attendance followed up actively; smoking cessation offered with warmth not judgement; sexual health raised proactively; partner involvement encouraged; occupational health referral if work return is affected.
1C — PMH · Drug history · Social history
🥐 Post-MI history — what changes management
FactorWhy it mattersImpact
LV ejection fraction (EF)Echo post-STEMI (or large NSTEMI) at 6–8 weeks: if EF <35% + HF signs: add eplerenone (EPHESUS); if EF <40%: cardiology review; consider ICD assessment at 40 days; if EF <35% persists at 3 months: ICD implantation (MADIT-II criteria). For Mr. Henderson (NSTEMI; no HF signs): echo may not be mandated unless symptomatic — but worth requesting if any breathlessness or question about LV function.EF <35% + HF: add eplerenone 25mg OD (titrate to 50mg); monitor K+. EF <40%: extended BB therapy; cardiology review. ICD: if EF <35% persistent at 40 days post-MI.
Diabetes mellitusPost-MI patients with T2DM: higher recurrence risk; more aggressive risk factor targets (LDL-C <1.4 mmol/L with DM + ASCVD in some European guidelines; UK NICE uses <1.8 mmol/L). HbA1c target: <53 mmol/mol generally; individualise. SGLT2 inhibitors (empagliflozin; dapagliflozin): significant cardiovascular outcome benefit post-MI with T2DM — discuss with diabetologist. Metformin: safe to continue if eGFR >30; if eGFR <30: stop (lactic acidosis risk).T2DM + post-MI: consider SGLT2 inhibitor (cardiovascular protection); LDL-C aggressive target; HbA1c optimisation. GLP-1 agonist (semaglutide): also cardiovascular benefit in T2DM with ASCVD (SELECT trial).
Prior statin therapy or intoleranceStatin-intolerant patients (myopathy; LFT elevation): post-MI requires maximising LDL-C lowering. Options: (1) rosuvastatin (different cytochrome P450 metabolism; lower myopathy risk); (2) pravastatin (hydrophilic; lowest myopathy risk); (3) ezetimibe 10mg OD (non-statin; reduces LDL-C 15–20% additionally); (4) inclisiran or evolocumab (PCSK9 inhibitors; via cardiology/lipid clinic). Never leave a post-MI patient without LDL-C lowering.Statin intolerant: switch statin class; add ezetimibe; refer to lipid clinic for PCSK9 inhibitor. Never use no statin as default in post-MI — always find a tolerable LDL-lowering regimen.
Atrial fibrillation (AF)Post-MI + AF: anticoagulation (DOAC preferred; e.g. apixaban 5mg BD; rivaroxaban 20mg OD) + aspirin 75mg (clopidogrel, not ticagrelor/prasugrel, preferred as P2Y12 inhibitor in AF + ACS — triple therapy bleeding risk). Duration: triple therapy for 4 weeks (or 1 month post-PCI); then dual therapy (OAC + clopidogrel) for 12 months; then OAC monotherapy (aspirin usually stopped). Reduce bleeding risk: PPI; avoid NSAIDs; consider lower-dose rivaroxaban (15mg OD) in high-risk. ORBIT score for bleeding risk (NICE NG196 prefers ORBIT).AF + post-MI: complex antithrombotic regime; cardiology input essential; OAC + antiplatelet balance; shorter duration triple therapy; PPI essential.
📜 Social and occupational history
FactorWhy it mattersImpact
HGV driver — Group 2 DVLAMr. Henderson is a commercial lorry driver (Group 2 DVLA licence). Post-NSTEMI/PCI: Group 2 standard = 6 weeks off driving minimum AND must notify DVLA AND DVLA must grant permission to return. This is a legal obligation: failure to notify DVLA is a criminal offence. The GP must document that the patient has been advised. DVLA assessment for Group 2: may require exercise tolerance test; resting ECG; cardiologist report; for some cases DVLA may require sustained release nitrate (SRN) protocol. This could affect Mr. Henderson’s livelihood permanently — handle with compassion and practical support.DVLA Group 2: cannot drive HGV until DVLA notified and approved return; notify DVLA ASAP; occupational health referral; employer discussion; explore alternative roles during the period off driving; document advice given.
Smoking — relapsed 2 weeks post-dischargeSmoking relapse post-MI is very common (50% relapse within 12 months). Psychological trigger: the extreme stress and disruption of the post-MI period is a very high-risk time for relapse. The GP’s response: warm; non-judgemental; acknowledge that the MI itself was a major stressor; focus on next attempt. Evidence: each smoking cessation attempt increases the probability of eventual success. A shame-based approach reduces the likelihood of engaging with cessation support.Smoking cessation: warm re-engagement; varenicline (most effective); combination NRT; NHS Stop Smoking Service referral; CO monitoring at each review; set a quit date; follow up at 4 weeks.
Wife’s anxiety about activityPartner anxiety post-MI is very common and has important consequences: it leads to overprotection (patient becoming unnecessarily sedentary); further deconditioning; increased patient anxiety (reflecting the partner’s anxiety back at them); reduced sexual activity; worsened depression. Interventions: invite partner to the 6-week review; cardiac rehabilitation (partner welcome at information session); clear exercise guidance (exercise is safe and recommended; specific targets); reassurance about sex.Invite wife to a review; cardiac rehabilitation partner session; specific exercise prescription; sexual activity guidance including partner; consider joint referral for counselling if anxiety persisting in both.
BMI and diet (BMI 29 — overweight)Overweight/obesity is a risk factor for recurrent MI. Post-MI: Mediterranean diet is the best-evidenced dietary pattern for secondary CVD prevention (Lyon Diet Heart Study; PREDIMED trial). Saturated fat reduction reduces LDL-C. Omega-3 supplements: NICE 2020 update does NOT recommend routine omega-3 supplementation post-MI (ORIGIN; ASCEND trials did not show benefit at standard doses). Practical dietary advice: oily fish 2 portions/week; olive oil; vegetables and fruit; limited red processed meat.Mediterranean diet: primary dietary recommendation post-MI; weight management programme if BMI >30; omega-3 supplements not routinely recommended (NICE 2020); salt restriction if hypertensive; alcohol: <14 units/week.
1D — ICE
💡 Ideas
"What do you think caused your heart attack — and what do you think you need to do differently to reduce the risk of it happening again?"
Mr. Henderson’s illness model determines his engagement with every aspect of secondary prevention. If he believes the MI was bad luck and he is now “fixed” by the stent — he will not engage with smoking cessation, lifestyle changes, or medication adherence. Understanding his model allows the GP to gently challenge it: “The stent has opened the artery, which is fantastic — but what made the arteries furry in the first place is still there. The tablets and lifestyle changes are what address that underlying process.”
😟 Concerns
"What worries you most about the future — in terms of your health? And is there anything specific you are concerned about but haven’t mentioned yet?"
Mr. Henderson’s primary concerns are likely: (1) having another heart attack (fear of recurrence); (2) losing his HGV licence (livelihood threat); (3) whether he can have sex (which he was too embarrassed to raise). The GP who creates space for him to name these — and who then addresses each one specifically — will have an engaged patient. The GP who hands him a list of targets without exploring these concerns will have a patient who nods and then does nothing.
🎯 Expectations
"What did you hope we would be able to tell you at this review? And is there anything you were hoping I could help you get sorted?"
Mr. Henderson wants to be told he is “fine” and can return to normal life. The GP’s job is to give him that reassurance where it is warranted (sex is safe; the stent is working well; exercise is beneficial) while being honest about what still needs to change (smoking; BP; LDL-C; DVLA) and what the timelines are. Validating what is going well — before listing what still needs work — maintains engagement and trust.
1E — Psychosocial context: the threat to identity and livelihood
🧑‍🏫 A heart attack at 58 threatens everything Mr. Henderson has built his life around: his work; his identity as a physically capable man; his role as a husband

Post-MI recovery is not just a physical process — it is a psychological renegotiation of identity. Mr. Henderson has been a lorry driver: physically capable, independent, reliable. The MI has introduced a profound uncertainty: will he ever drive his lorry again? Can he have sex without triggering another attack? Is he now “the kind of person who has heart attacks?” The GP who understands this identity context approaches secondary prevention not as a checklist, but as a conversation about who Mr. Henderson wants to be and what he needs to do to get there.

🚘 Work Identity and DVLA

Lorry driving is not just a job for Mr. Henderson — it is his identity and his livelihood. The DVLA obligation is not just an administrative inconvenience; it is a potentially permanent threat to the work he has done for decades. The GP who delivers this message must do so with compassion and practical support: occupational health referral; employer discussion; alternative roles; realistic timeline for DVLA return.

"I know this is not what you want to hear about the driving. The rule exists because we need to be sure your heart is stable enough for the demands of driving a lorry. I want to help you get back there as quickly as safely possible — and I can explain what the process looks like."
♥️ Fear of Recurrence

Fear of having another heart attack is universal post-MI. It drives excessive caution (avoiding exercise; avoiding sex; avoiding excitement) which is itself harmful. The GP’s counter-message is evidence-based reassurance: “The treatment you received — the stent, the tablets — significantly reduces your risk. We know that. Exercise does not increase your risk — it reduces it. Sex at this stage does not meaningfully increase your risk.” Specific, concrete reassurance outperforms vague encouragement.

"I want to address the fear directly. The risk of having another heart attack while having sex is extremely small — similar to climbing two flights of stairs. The medications are doing their job, and being active is part of your recovery, not a risk."
💑 Relationship Impact

Mrs. Henderson is anxious about her husband’s activities. This is protective in one sense but harmful in another: it creates a dynamic where normal activity is perceived as dangerous, which increases the patient’s anxiety and prevents rehabilitation. The couple need joint information — ideally at a cardiac rehabilitation family session — about what activities are safe, what the warning signs are, and how to recognise if something needs urgent attention. Excluding the partner from post-MI information leaves them as an anxiety amplifier rather than a recovery supporter.

"Would it be helpful to bring your wife in to one of these appointments? I’d like to be able to reassure you both together — because it sounds like she is also finding this very worrying, and I think hearing the information from me might help her as well."
🩺 Smoking Relapse Without Shame

Mr. Henderson knows he has relapsed on smoking. He may be expecting to be told off. A shame-based approach reduces engagement with future cessation attempts. The GP who responds with normalisation and re-engagement is more effective: “Most people who quit after a heart attack — even those who really wanted to — find themselves starting again. The post-MI period is one of the most stressful of a person’s life. The question isn’t why you started — it’s how we help you stop again in a way that actually works.”

"Restarting smoking after a heart attack is more common than people think — this is not something to feel bad about. It just means we need to try something that might work better this time. Can I tell you about some of the options?"
🎓 SCA Checkpoint — Step 1TasksRelating to OthersGlobal Skills
Key phrases
"I want to make sure we cover everything today — so let me start by asking how you’ve been getting on generally since you came out of hospital." [Then listen; let him lead before proceeding to the structured review]
"I want to ask about something I always bring up at these appointments — and a lot of people are a bit embarrassed to ask: have you been thinking about, or tried, getting back to sexual activity? It’s completely normal, and there are good things I can tell you about the risk."
"I want to be honest with you about the driving. Because you drive a lorry — that puts you in a different category from regular car drivers. The DVLA need to be told, and they need to clear you before you go back to the lorry. I know that’s hard to hear. Can we talk about what that process looks like?"
Deductions
  • Starting immediately with drug checklist without emotional opener
  • Not raising sexual health (patient said he “didn’t want to bring it up” — the GP must raise it)
  • Not addressing DVLA Group 2 obligations — legal duty and Tasks criterion
  • Shaming response to smoking relapse — reduces re-engagement with cessation
🔴 Red
Drug checklist only; no emotional opener; DVLA not mentioned; sexual health not raised; smoking relapse shamed; cardiac rehab not discussed
🟠 Amber
Empathetic opener; medications reviewed; smoking addressed without shame; DVLA mentioned but Group 2 obligations not fully explained; sexual health not raised; cardiac rehab not followed up
🟩 Green
Emotional opener; all 5 medications reviewed; smoking cessation re-engaged warmly; DVLA Group 2 explained clearly and documented; sexual health raised proactively; PDE5 inhibitor/nitrate rule explained; cardiac rehab non-attendance followed up with exploration of barriers; PHQ-9; wife invited to join
2
Step 2
Triage — Acute Recurrence · Urgent Cardiac Review · Routine Secondary Prevention
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Triage in post-MI secondary prevention is primarily about distinguishing stable recovery (managed in GP) from symptoms suggesting recurrence, stent failure, or heart failure requiring urgent cardiology input. Mr. Henderson is stable today. But any symptom of chest pain, palpitations with presyncope, or progressive breathlessness requires urgent escalation.
🔴 Emergency

999 / A&E now

Immediate escalation
  • Acute chest pain / pressure on DAPTPossible in-stent thrombosis — do NOT wait; 999; aspirin 300mg if available
  • Palpitations with collapse or loss of consciousnessVT/VF post-MI — cardiac arrest risk; 999 immediately
  • Rhabdomyolysis — severe muscle pain + dark urine on statinStop statin; IV fluids; 999
  • Major GI or intracranial bleed on DAPTHospital immediately; do NOT stop DAPT without cardiology advice
🟠 Urgent

Same-Day Cardiology

Same-day assessment
  • New angina or atypical chest pain post-MIECG; troponin; same-day cardiology
  • Palpitations with ECG abnormality (VT; complete heart block)Same-day cardiology; may need monitoring
  • Breathlessness + ankle oedema (possible HF)BNP; echocardiogram; consider loop diuretic urgently
🟩 Routine Review — Mr. Henderson

GP-managed

Secondary prevention
  • 6-week post-MI review — stable, asymptomaticMedication review; risk factor targets; cardiac rehab; lifestyle
  • LDL-C above target; BP above targetOptimise; review in 3 months; escalate if persisting
  • Smoking relapseRe-engage cessation programme; varenicline; NRT
  • DVLA Group 2 notificationAdvise patient; document; DVLA referral if needed
🎓 SCA Checkpoint — Step 2Tasks
Triage for Mr. Henderson
"I want to check — no chest pain at all? No episodes of your heart racing, or feeling faint? No swelling in your ankles? Good — that tells me the stent is doing its job. Today we are going to focus on the things that reduce your risk going forward, and I want to make sure we address the driving question and a few other things."
Deductions
  • Not checking for symptoms of recurrence (new angina; palpitations; breathlessness) before proceeding to the lifestyle review — a symptom review is the safety-critical first check at every post-MI review
3
Step 3
Examination — BP · Heart Rate · Weight · Heart Failure Signs
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Examination in a post-MI review is targeted: blood pressure and heart rate (medication efficacy and titration), weight (BMI; risk factor), and signs of heart failure (JVP; ankle oedema; lung bases). A full cardiovascular examination is not needed at every routine review — it is indicated if new symptoms emerge.
ExaminationWhat to findFinding changes managementChanges?
Blood pressure (both arms; sitting)Target post-MI: <130/80 mmHg (NICE NG136 standard; some guidelines <130/80 specifically in secondary prevention)Mr. Henderson’s BP today: 142/86 mmHg — above the <130/80 mmHg post-MI target. This is a medications titration trigger. Current: ramipril 5mg OD (can be titrated to 10mg OD). Check: is he taking it reliably? Is he still smoking (raises BP)? Any salt intake changes? If BP not controlled on maximum ramipril: add second agent (amlodipine 5–10mg if not on CCB) or revisit lifestyle (smoking; alcohol; diet; exercise). The BP target <130/80 is consistent across post-MI, T2DM, and CKD (NICE NG136; NICE NG28).BP 142/86 on ramipril 5mg: titrate ramipril to 10mg; recheck in 4 weeks; if still above target after maximising ACEi: add amlodipine 5mg. If ACEi-cough: switch to candesartan. Smoking cessation: will also contribute to BP reduction.YES — BP above target triggers medication titration
Heart rateTarget: resting HR 50–60 bpm (for LV protection post-MI on beta-blocker)Bisoprolol 2.5mg is the starting dose: many post-MI patients need titration. Resting HR on beta-blocker should ideally be 50–60 bpm for LV remodelling benefit (data from post-MI trials). If HR >70 at rest on bisoprolol 2.5mg: consider titrating up to 5mg or 10mg (provided no symptomatic bradycardia; no heart block). Beta-blocker duration after MI: NICE currently recommends “up to 12 months in patients with normal LV function” — the evidence for ongoing benefit beyond 12 months is less clear for patients with preserved EF; continue indefinitely if reduced EF or HF.HR >70 on bisoprolol 2.5mg: consider titrating to 5mg (if tolerated; no bradycardia). HR <50 or symptomatic bradycardia: reduce dose. 12-month review: if EF preserved and no HF: cardiology guidance on beta-blocker continuation beyond 12 months.YES — HR guides bisoprolol dose titration
Weight and BMIMr. Henderson: 94 kg; BMI 29 (overweight). Weight is a risk factor for both recurrent MI and hypertension. Post-MI: weight loss of 5–10% reduces BP; reduces LDL-C; reduces T2DM risk; reduces exercise intolerance. Target: BMI <25 or 5–10% weight loss if overweight. Structured weight management programme referral (Tier 2 or Tier 3 service). Mediterranean diet advice. Alcohol consumption check (contributes to calories and BP).BMI >30: Tier 2 weight management referral; structured programme. BMI 25–30 (Mr. Henderson): dietary advice; Mediterranean diet; PA prescription. Weight loss improves BP; LDL-C; exercise tolerance for cardiac rehabilitation.Context — contributes to BP and LDL-C; target in lifestyle management
Heart failure signs — JVP; ankle oedema; lung basesPost-MI heart failure: occurs in 15–25% at 6 months, especially after large territory MI. Signs: raised JVP; bilateral ankle oedema; bibasal crepitations; displaced apex. If present: echocardiogram urgently; add loop diuretic; refer cardiology; check BNP. Mr. Henderson: no HF symptoms reported — but targeted examination at every review for early signs. HF changes medication: eplerenone if EF <35%; consider sacubitril-valsartan (ARNI) if EF reduced despite ACEi + BB.HF signs present: urgent echo; BNP; loop diuretic; eplerenone if EF <35% + HF; cardiology referral. No HF signs (Mr. Henderson): routine secondary prevention; continue current medications.YES — HF signs change medication (eplerenone; ARNI; loop diuretic)
🎓 SCA Checkpoint — Step 3Tasks
Examination communication
"Let me just check your blood pressure — that is the main thing I need to review today, along with your heart rate to make sure the bisoprolol dose is working. I am also going to have a quick listen to your chest and check your ankles for any swelling."
Deductions
  • Not measuring BP at a post-MI medication review — BP is both a risk factor target and the basis for medication titration; it is a non-negotiable examination finding at every secondary prevention review
4
Step 4
Investigations — LDL-C · LFTs · Renal Function · PHQ-9 · Echocardiogram
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Blood tests at 6-week post-MI review are targeted: LDL-C (statin efficacy); LFTs (statin safety); renal function (ACE inhibitor safety); fasting glucose or HbA1c if diabetes risk; and CK only if myopathy symptoms.
InvestigationWhy indicatedResult changes management
LDL-C (fasting lipid profile)Target: <1.8 mmol/L or >50% reduction from baseline (NICE NG185 2023 update)LDL-C is the primary efficacy measure for statin therapy. Mr. Henderson’s LDL-C at 6 weeks: 2.1 mmol/L — above the 1.8 mmol/L target. Atorvastatin 80mg is already the maximum dose. Next step: check adherence (is he taking it every day?); check drug interactions (reduces atorvastatin effect: rifampicin; some antibiotics). If adherence is confirmed: add ezetimibe 10mg OD to atorvastatin 80mg (non-statin mechanism; reduces LDL-C by additional 15–20%). If still above target: refer to lipid clinic for PCSK9 inhibitor. Recheck LDL-C 3 months after any dose change.LDL-C 2.1 (above 1.8 target): confirm adherence; add ezetimibe 10mg OD if confirmed taking atorvastatin 80mg; recheck in 3 months. If LDL-C >2.6 on maximum tolerated statin + ezetimibe: PCSK9 inhibitor referral via cardiology.
LFTs (ALT; AST; alkaline phosphatase)Baseline before statin; at 3 months; annually (NICE guidance); Mr. Henderson: ALT 52 (ULN 45)Mildly elevated LFTs on statin (ALT up to 3× ULN = <135 U/L): do NOT stop the statin — mild transaminase elevation is common and usually transient. Continue and recheck LFTs at 3 months. ALT 3–5× ULN: consider dose reduction. ALT >5× ULN: stop statin; investigate other causes (alcohol; NAFLD); rechallenge at lower dose when normalised. Other causes of elevated LFTs in Mr. Henderson: alcohol; NAFLD (BMI 29); medication interactions. Check alcohol history. Mr. Henderson’s ALT 52 is only 1.15× ULN — continue atorvastatin; recheck at 3 months.ALT 52 (<3× ULN): continue atorvastatin 80mg; check alcohol; recheck LFTs in 3 months. ALT >3× ULN: dose reduction; exclude other causes. ALT >5× ULN: stop statin; investigate.
Renal function (U&E; eGFR; creatinine)ACE inhibitor monitoring: at initiation; 1–2 weeks after each dose change; annually when stableRamipril safety monitoring: eGFR can decline when ACEi started (acceptable if <25% decline from baseline; stable thereafter). Hyperkalaemia risk with ACEi (especially if also on eplerenone or in CKD). Mr. Henderson’s eGFR at 6 weeks: 78 (normal) — reassuring. If ramipril is now being titrated to 10mg: recheck renal function and electrolytes 1–2 weeks after the dose increase. Eplerenone (if EF <35%): check K+ and creatinine at 1 week, 1 month, then 3-monthly.eGFR stable (78): safe to titrate ramipril to 10mg; recheck in 1–2 weeks after dose change. eGFR <30: caution; reduce ACEi dose; nephrology referral if rapid decline. Hyperkalaemia (>5.5 mmol/L): reduce ACEi; stop eplerenone if prescribed.
PHQ-9 depression screeningNICE recommends at 6 weeks and 3 months post-MI; part of post-MI review templateDepression post-MI: occurs in 20–30% of patients; independently increases the risk of further MI and mortality (hazard ratio 1.8 for mortality if untreated). Mr. Henderson: smoking relapse; reluctance to raise concerns (sex); wife’s anxiety — all are risk factors for depression. PHQ-9 should be administered as a structured questionnaire. If PHQ-9 ≥10: SSRI (sertraline preferred in post-MI — best cardiac safety data from SADHART trial; do NOT use tricyclics); CBT; cardiac rehabilitation psychological component. Do not dismiss PHQ-9 findings as normal reaction to a major life event.PHQ-9 ≥10: clinical depression; start sertraline 50mg (titrate to 100–200mg); refer for CBT; ensure cardiac rehabilitation attendance. PHQ-9 <10: reassurance; review at 3 months; note watchful waiting if 5–9.
🎓 SCA Checkpoint — Step 4Tasks
Investigations review
"Your blood tests from last week — I want to go through them with you. Your kidney function is looking good — that is reassuring with the ramipril. Your cholesterol — it is better than before you had the heart attack, but it is not quite where I would like it to be. The target is 1.8 or below, and yours is 2.1. The main tablets you are taking are doing a lot of work — I want to make sure you are taking the cholesterol tablet every day. Is that something you have been managing?"
Deductions
  • Not reviewing LDL-C and giving the target explicitly — patients cannot engage with an abstract blood test result; they need to know the target, their current number, and what the plan is to close the gap
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Step 5
Post-MI Status — Risk Factor Targets · Stent Status · LV Function · Secondary Prevention Goals
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The “diagnosis” in a post-MI review is not a new diagnosis — it is an assessment of where the patient stands against each secondary prevention target, and an explanation in plain language of why each target matters. Mr. Henderson needs to understand that the stent fixed the pipe but not the disease that furred it up — and what that means for the next 20 years.
🗣️ Explaining secondary prevention in plain language

"I want to explain something important. The stent has opened the artery that was blocked — and that has been really successful. But the process that caused the artery to become blocked in the first place — the build-up of cholesterol and damage to the artery wall — is still there in your other arteries. What the tablets are doing is slowing that process down and preventing it from causing another blockage. That is why the medications are not just for now — they are for life. And it is why the lifestyle changes — particularly the smoking — are so important. Smoking speeds up exactly the process the tablets are trying to slow down."

💬 Addressing common misconceptions

"I feel fine now — do I still need all these tablets?"
"Absolutely. The tablets are doing their job precisely because you feel fine. If you stop them, you won’t feel different for a while — but your risk of another heart attack goes up immediately. The aspirin and the ticagrelor in particular: stopping those could cause a blockage in the stent, which is very serious. These are not tablets you can take a break from."

"The stent is fixed now — surely that means the problem is sorted?"
"The stent has fixed one part of the problem — the blocked artery. But it doesn’t change the underlying condition, which is atherosclerosis: the furring up of the blood vessels. That process is in all your arteries, including the stent site. The tablets and lifestyle changes are what manage the wider disease — and they are just as important as the stent."

Risk Factor Targets — Mr. Henderson
Secondary prevention targets
LDL-C: current 2.1 mmol/L; target <1.8 mmol/L — above target ⇒ add ezetimibe
BP: 142/86 mmHg; target <130/80 mmHg — above target ⇒ titrate ramipril
Smoking: 15/day — target: complete cessation
BMI: 29 — target: <25 or 5–10% weight loss
Exercise: cardiac rehabilitation; 30 min 5×/week
HbA1c: check if not done — post-MI T2DM risk elevated
DAPT Status and Duration
Continue ticagrelor + aspirin to 12 months

6 months post-PCI: drug-eluting stent

Ticagrelor 90mg BD + aspirin 75mg OD — continue to 12 months post-PCI. At 12 months: stop ticagrelor; aspirin 75mg lifelong. Never stop DAPT without cardiology agreement before 12 months — in-stent thrombosis risk.

LFTs and Statin Safety
Continue atorvastatin 80mg

ALT 52 U/L (1.15× ULN)

<3× ULN: continue atorvastatin 80mg. Exclude alcohol and NAFLD (BMI 29). Recheck LFTs in 3 months. If ALT persistently >3× ULN: reduce dose or switch statin.

📊 Post-MI medication targets — SMART monitoring
DrugTargetCurrent statusNext action
Atorvastatin 80mg (S — Statin)LDL-C <1.8 mmol/L or >50% reductionLDL-C 2.1 mmol/L — above targetConfirm adherence; add ezetimibe 10mg; recheck LDL-C in 3 months
Ramipril 5mg (M — Medicine for BP/heart)BP <130/80 mmHg; ACEi cardioprotectionBP 142/86 — above target; eGFR 78Titrate ramipril to 10mg OD; recheck BP and U&E in 2 weeks
Aspirin 75mg + Ticagrelor 90mg BD (A — Antiplatelet)DAPT for 12 months post-PCI; aspirin lifelong after6 weeks post-PCI; both being takenContinue to 12 months; transition to aspirin monotherapy at 12 months; never stop early without cardiology
Cardiac rehab (R — Rehabilitation)Reduce mortality 20–25%; exercise; education; psychologicalNot attendedExplore barriers; re-refer; offer remote/online alternative; follow up at 3 months
Risk factor targets (T — Targets)BP; LDL-C; smoking; BMI; HbA1c; PAMultiple targets above goalPrioritise smoking cessation (greatest benefit); BP titration; ezetimibe addition; dietary advice
🎓 SCA Checkpoint — Step 5TasksRelating to Others
Plain-language target review
"The stent has done a fantastic job — the artery is open and working. But the disease that caused the blockage in the first place — the furring of the blood vessels — is still there in the background. What the tablets are doing is slowing that process down. Your cholesterol is a bit above where I’d like it, and your blood pressure is too. Both of those are things we can work on today."
Deductions
  • Using clinical jargon without plain-language explanation: “your LDL-C is 2.1 and the target is 1.8” without explaining what this means and what we are going to do about it; this scores a Global Skills deduction for inadequate communication of clinical information
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Step 6
Referral — Cardiac Rehab · Cardiology · Stop Smoking · Occupational Health · Lipid Clinic
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Post-MI referrals are as important as prescriptions: cardiac rehabilitation reduces mortality equivalently to adding a drug; smoking cessation services achieve higher quit rates than brief advice alone; occupational health is essential for Mr. Henderson’s work return.
ReferralUrgencyWhat GP doesWhat NOT to do
Cardiac Rehabilitation (Phase II)Re-refer: routine (already offered)Mr. Henderson has not attended — explore barriers actively: timing? Transport? Feeling “too well”? Re-refer with a direct explanation of the benefit: “Cardiac rehab reduces your risk of another heart attack by 20–25% — that is equivalent to taking another medication.” Offer remote/online alternative if practical barriers. Enquire whether the wife could attend a family session — her anxiety is a barrier to both of them. Follow up at 3-month review.Do not accept non-attendance without exploring why and offering alternatives. A patient who does not attend cardiac rehabilitation is missing one of the highest-impact interventions in secondary prevention. Passive acceptance of non-attendance is a missed clinical opportunity.
NHS Stop Smoking ServiceRoutine — but urgent in terms of cardiovascular benefitBrief advice at every contact (3–5 minutes increases quit rates by 1–3%). Offer referral to NHS Stop Smoking Service (self-referral also available). Prescribe cessation aid today: varenicline (most effective; 22% 12-month abstinence; CI in severe renal impairment; monitor mood); or combination NRT (patch + gum/lozenge; 14% abstinence); or bupropion (12% abstinence). Set a quit date. Follow up at 4 weeks. CO testing at each review. Discuss e-cigarettes as harm reduction if patient resistant to other approaches (NICE supports this for reduction if not full cessation).Do not shame a smoking relapse. Do not give up on cessation because of previous relapse. Do not give brief advice and move on without offering a cessation aid — combined cessation support (advice + medication) achieves significantly higher quit rates than either alone.
Occupational Health / DVLADVLA notification: immediate (patient obligation)Advise Mr. Henderson to notify DVLA today that he has had an MI and PCI — this is his legal obligation, not the GP’s. Document that he has been advised. After 6 weeks post-PCI: he may be able to return to Group 2 driving if DVLA assesses and approves (requires satisfactory exercise tolerance; no symptoms; no other disqualifying conditions). GP can write a supporting medical letter when appropriate. Occupational health referral: employer may have alternative sedentary roles while DVLA assessment is pending.Do not notify DVLA on the patient’s behalf — this is the patient’s legal obligation. Do not advise the patient it is OK to drive before DVLA clearance has been obtained for Group 2. Do not assume that the 6-week timeframe automatically means he can drive — Group 2 requires DVLA approval, not just time elapsed.
Cardiology follow-upRoutine — standard 3–6 month post-MI cardiology reviewMost patients post-ACS/PCI have a cardiology outpatient appointment at 3–6 months (arranged at discharge). Ensure Mr. Henderson has this appointment and knows to attend. If echo has not been arranged: request or chase. If LDL-C remains above target on maximum statin + ezetimibe at the 3-month review: refer to lipid clinic or cardiology for PCSK9 inhibitor consideration (evolocumab; inclisiran — NICE-approved for high-risk patients not reaching targets).Do not assume the hospital is managing the lipid target — after discharge, LDL-C management is shared between cardiology and GP; the GP must know the target and act on it. Do not assume a 6-month cardiology review means the patient does not need GP secondary prevention monitoring in the interim.
Lipid clinic / PCSK9 inhibitor pathwayRefer if LDL-C >2.6 on maximum tolerated statin + ezetimibeFirst step: confirm maximum tolerated statin + ezetimibe. LDL-C still above target: refer to specialist lipid clinic or via cardiology for PCSK9 inhibitor initiation (evolocumab 140mg SC fortnightly; or inclisiran 284mg SC 6-monthly — the latter is given at the clinic and has a convenient twice-yearly dosing schedule). Both are NICE-approved for primary hypercholesterolaemia with established cardiovascular disease and persistently elevated LDL-C. Significant cost to NHS — NICE specifies the relevant criteria (TA394; TA507 for evolocumab; TA614 for inclisiran).Do not leave a post-MI patient with persistently elevated LDL-C without a treatment escalation plan. Uncontrolled LDL-C is a major ongoing risk for recurrent MI — not an acceptable status quo.
🎓 SCA Checkpoint — Step 6Tasks
Cardiac rehab re-referral phrase
"I want to come back to cardiac rehabilitation — because you haven’t been yet, and I want to understand why. The evidence for it is really strong — it reduces your risk of another heart attack by about 20%. That is the same as taking another medication. I do not want you to miss out on that. What has been getting in the way?"
Deductions
  • Accepting cardiac rehabilitation non-attendance without active follow-up — failing to explore barriers and re-refer is a significant missed opportunity; the cardiac rehabilitation referral (and active follow-up on non-attendance) is a Tasks mark in this SCA case
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Step 7
Management — Medications · Lifestyle · DVLA · Sexual Health · Cardiac Rehab · Safety-Netting
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7A — Address Mr. Henderson’s expectations first
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Mr. Henderson wants to be told he is fine and can go back to normal — he needs to understand that secondary prevention is what makes “normal” possible
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Validate the progress — the stent worked

Always begin with what has gone well. The PCI was successful; the stent is open; he has been taking his medications. This is genuine good news and should be said first — before any discussion of what is still above target.

"First — the stent is doing its job. You feel better, which is exactly what we would hope. That is genuinely good news. The treatment you had was very effective at fixing the immediate problem."
2
Explain why the work is ongoing

The illness model shift: from “I had a heart attack and now I’m better” to “I have an ongoing condition that is now well-managed” is the central educational task of secondary prevention. Without this shift, Mr. Henderson will stop medications, restart fully smoking, and avoid cardiac rehab.

"The thing is — the stent fixed the pipe. But the process that caused it to get blocked in the first place is still there. The tablets are managing that process. The lifestyle changes — particularly the smoking — are making that process worse every day."
3
Offer concrete good news where it is warranted

Mr. Henderson has specific concerns: sex; driving; having another heart attack. Each of these has a real, evidence-based answer that can be given with confidence. Giving these specific reassurances is motivating and builds trust.

"Here is what I can tell you today: sex is safe at this stage — the risk is very small. Exercise is not only safe — it is part of your treatment. And driving: I want to explain exactly what the timeline looks like."
7B — Treatment goals
SMART secondary prevention targets
LDL-C <1.8 mmol/L (or >50% reduction from baseline) — add ezetimibeBP <130/80 mmHg — titrate ramipril to 10mg Smoking cessation — varenicline + Stop Smoking Service referralDAPT to 12 months — aspirin lifelong after Cardiac rehabilitation — re-refer with active follow-upBMI <25 or 5–10% weight reduction — Mediterranean diet; PA prescription DVLA notification today — Group 2 clearance processPHQ-9 at 6 weeks and 3 months — sertraline if ≥10
Motivational language
"Stopping smoking is the single most effective thing you can do to reduce your risk of another heart attack — more than any single tablet. The medicines are excellent, but they work best alongside a smoke-free life. I want to help you get there."
"I want you to get back to driving your lorry. To do that, we need the DVLA to be happy with your heart health — and the way to make that happen as fast as possible is to get your blood pressure down and complete the cardiac rehab. It is all connected."
7C — Lifestyle: smoking · diet · exercise · alcohol
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Smoking Cessation
Complete cessation; reduces recurrent MI risk by 36%
Evidence

Smoking cessation post-MI reduces relative risk of further MI or death by 36% — equivalent to adding aspirin, a statin, and an ACE inhibitor combined. Every cigarette smoked damages the endothelium and accelerates exactly the atherosclerotic process the medications are trying to slow. The most effective intervention for secondary cardiovascular prevention available to a GP.

Approach

Non-judgemental re-engagement with cessation: normalise relapse; explore what triggered it (post-MI stress); discuss options: varenicline (most effective; 22% 12-month abstinence; start 1–2 weeks before quit date); combination NRT (patch + short-acting gum or lozenge); e-cigarettes (harm reduction if other methods failed). Set a quit date. NHS Stop Smoking Service referral (self-referral available). Follow up at 4 weeks.

Smoking cessation = 36% risk reduction — the highest-impact lifestyle intervention
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Mediterranean Diet
Reduces recurrent MI risk 30–50% (PREDIMED; Lyon Heart Study)
Evidence

Mediterranean diet is the best-evidenced dietary pattern for secondary cardiovascular prevention. Evidence: Lyon Diet Heart Study (1996) showed 56% reduction in recurrent MI; PREDIMED trial (2013) confirmed cardiovascular benefit. Components: olive oil as primary fat; oily fish 2×/week; high vegetable and fruit intake; legumes and wholegrain; limited red and processed meat; moderate red wine (optional). Not low-fat — the quality of fat matters, not the quantity.

Practical

Omega-3 supplements: NOT routinely recommended post-MI (NICE 2020; ASCEND and ORIGIN trials). Oily fish 2 portions/week (mackerel; salmon; sardines; trout). Salt restriction if hypertensive (<6g/day). Alcohol: maximum 14 units/week; no binge drinking (raises BP; arrhythmia risk after large intakes). Mr. Henderson: weight loss 5–10% from 94kg target — reduces BP; LDL-C.

Mediterranean diet: 30–50% reduction in recurrent MI; also reduces BP and LDL-C
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Exercise and Cardiac Rehab
30 min moderate aerobic activity 5 days/week; cardiac rehab completion
Mechanism

Regular moderate aerobic exercise reduces recurrent MI risk by 20–25% (Cochrane meta-analysis); reduces BP; improves LDL-C; reduces thrombotic risk; improves LV function and cardiac output; reduces depression and anxiety; improves quality of life. Exercise is not a risk factor for recurrence in stable post-MI patients — it is a treatment. Cardiac rehabilitation provides supervised, graduated exercise with monitoring and education.

Practical prescription

Cardiac rehab: Phase II — re-refer Mr. Henderson; remote / online option if practical barriers. At home: walking programme building to 30 minutes/day at moderate pace (able to hold a conversation) 5×/week. Avoid heavy lifting for 6 weeks post-PCI; no heavy manual labour for 4–6 weeks. Reassure: exercise does not increase recurrence risk. Heart rate target: 40–70% of maximum predicted HR (220 − age) during exercise.

Cardiac rehab: 20–25% mortality reduction; equivalent to adding another medication
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Sexual Activity
Safe 4–6 weeks post-MI; PDE5 inhibitors safe if NOT on nitrates
Evidence

Sexual activity in a stable partner is equivalent to climbing two flights of stairs in terms of cardiac demand: MET 2–3. Risk of triggering an MI during sexual activity is extremely low in treated, stable post-MI patients (2.5 per million person-hours). Fear of sex causing recurrence is much more prevalent than the actual risk — and leads to unnecessary sexual dysfunction and relationship strain. GP should proactively raise this.

PDE5 inhibitors

Sildenafil; tadalafil; vardenafil: safe to use post-MI once cardiovascular status is stable (typically 4–6 weeks). ABSOLUTE CONTRAINDICATION: concurrent use with any nitrate (GTN spray; isosorbide mononitrate; isosorbide dinitrate) — severe, potentially fatal hypotension. Mr. Henderson: not currently on nitrates — PDE5 inhibitors are safe. If bisoprolol is causing erectile dysfunction (common; 10% of patients): switch to nebivolol (vasodilatory beta-blocker; less ED risk).

Proactively raising sexual health distinguishes a strong pass from a pass in SCA
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DVLA and Return to Work
Group 1: 1 week (PCI); Group 2: 6 weeks + DVLA clearance
DVLA obligations

Mr. Henderson drives an HGV (Group 2 DVLA licence). Post-NSTEMI/PCI: Group 2 minimum 6 weeks; must notify DVLA (patient’s legal obligation — not the GP’s); must meet DVLA Group 2 medical standards before return. DVLA assessment may require: exercise tolerance test; resting 12-lead ECG; no symptoms; no residual ischaemia. GP documents that the patient has been counselled. Do not advise he can return to driving after 6 weeks without DVLA confirmation.

Practical support

Occupational health referral (ask if the employer has an OHA service). Explore alternative sedentary roles during the assessment period. Explain DVLA process timeline: notification now; DVLA assessment; medical standards satisfied; then return. DVLA phone: 0300 790 6806. Fitness to work letter for employer if needed (covering the cardiac event and expected return timeline).

DVLA Group 2: notify DVLA immediately; GP documents advice; cannot return to HGV without DVLA clearance
🤖
Psychological Wellbeing
PHQ-9 at 6 weeks and 3 months; sertraline if ≥10; no tricyclics
Why it matters

Post-MI depression occurs in 20–30% of patients and independently increases mortality risk (HR 1.8). Cardiac rehabilitation includes psychological support. PHQ-9 is part of the standard post-MI review template. Administer at 6 weeks (today) and again at 3 months. If PHQ-9 ≥10: treat (sertraline has best cardiac safety data — SADHART trial; avoid tricyclics: QTc effects). Depression may present as physical symptoms (fatigue; low energy; poor motivation) that can be attributed to cardiac disease rather than mood — always screen actively.

Safety

SSRIs in post-MI depression: sertraline 50mg OD (titrate to 100–200mg); citalopram: avoid if QTc concern (>40ms prolongation at doses >20mg). Tricyclics (amitriptyline): absolutely avoid post-MI — QTc prolongation; anticholinergic effects; arrhythmia risk. If SSRI not tolerated: mirtazapine; bupropion (also smoking cessation tool — dual benefit if both depression and smoking present). Psychological therapies: CBT is NICE first-line for depression; referral to NHS Talking Therapies or psychological therapies service.

PHQ-9 at every post-MI review; sertraline (not TCAs) if score ≥10; cardiac rehab has psychological benefit
7D — Prescribing guide
Post-MI prescribing is protocol-driven: all patients need the “DAABS” combination. DAPT (aspirin + P2Y12 inhibitor for 12 months); Atorvastatin 80mg (high-intensity; LDL-C <1.8); ACE inhibitor (ramipril; cardioprotective; BP); Beta-blocker (bisoprolol; LV remodelling; rate control); +/− eplerenone (if EF <35% + HF). Ezetimibe if LDL-C above target on maximum statin. PPI (omeprazole 20mg) with aspirin. Never stop DAPT without cardiology agreement before 12 months.
Step 1 — DAPT for 12 months (all post-ACS)
  • Aspirin 75mg OD + ticagrelor 90mg BD: continue for 12 months post-ACS (PLATO trial; superior to clopidogrel)
  • At 12 months: transition aspirin 75mg lifelong monotherapy; stop ticagrelor (or clopidogrel if used instead)
  • PPI (omeprazole 20mg OD) with DAPT: reduces GI bleeding risk by 50–60%
  • Never stop DAPT early: discuss with cardiology; in-stent thrombosis risk
TRANSITION AT 12 MONTHS: stop ticagrelor; aspirin 75mg lifelong. Never abrupt cessation of both.
Step 2 — Statin + LDL-C escalation
  • Atorvastatin 80mg OD: high-intensity; maximum dose; LDL-C target <1.8 mmol/L
  • If LDL-C above target despite atorvastatin 80mg + confirmed adherence: add ezetimibe 10mg OD
  • Ezetimibe reduces LDL-C by an additional 15–20% via cholesterol absorption inhibition
  • If LDL-C still above target on atorvastatin 80mg + ezetimibe: PCSK9 inhibitor via lipid clinic or cardiology
Mr. Henderson: LDL-C 2.1; add ezetimibe 10mg OD; recheck in 3 months
Step 3 — ACEi + BB titration
  • Ramipril: titrate to maximum tolerated dose (target 10mg OD); BP target <130/80 mmHg
  • If ACEi cough (10–15%): switch to candesartan 32mg OD (ARB)
  • Bisoprolol: titrate to HR 50–60 bpm (target for LV protection); review continuation beyond 12 months if EF preserved
  • If bisoprolol causes ED: switch to nebivolol (vasodilatory; less ED risk)
Mr. Henderson: titrate ramipril 5mg → 10mg OD; recheck BP and renal function in 2 weeks
Step 4 — Eplerenone: only if EF <35% + HF signs
  • Eplerenone 25mg OD (titrate to 50mg OD): indicated post-MI if echocardiogram shows EF <35% AND signs of heart failure (EPHESUS trial)
  • NOT indicated if EF preserved (no HF post-MI — which is Mr. Henderson’s current picture)
  • Monitor: K+ and creatinine at 1 week, 1 month, then 3-monthly (hyperkalaemia risk with ACEi + eplerenone)
  • If K+ >5.5: reduce dose; if >6.0: stop
LDL-C escalation pathway
  • Atorvastatin 80mg OD ⇒ maximum tolerated statin dose first
  • Add ezetimibe 10mg OD if LDL-C above target
  • If still above target on atorvastatin 80mg + ezetimibe: PCSK9 inhibitor
  • Evolocumab 140mg SC fortnightly (FOURIER trial; 59% additional LDL-C reduction)
  • Inclisiran 284mg SC 6-monthly (ORION trial; convenient twice-yearly dosing; NICE TA614)
  • Both available via lipid clinic or cardiology — not GP-initiated
7E — Medication selector

Select patient characteristics — post-MI medication guidance

Post-MI medication guidance
Post-MI standard regimen: aspirin 75mg + ticagrelor 90mg BD (DAPT for 12 months); atorvastatin 80mg OD; ramipril (titrate to 10mg OD); bisoprolol (titrate to HR 50–60 bpm); omeprazole 20mg OD (GI protection). LDL-C above target on atorvastatin 80mg: add ezetimibe 10mg OD; recheck in 3 months; if still above target: PCSK9 inhibitor via lipid clinic. ACEi cough: switch to candesartan 32mg OD (ARB). Bisoprolol ED: switch to nebivolol (vasodilatory BB; less ED risk). EF <35% + HF: add eplerenone 25mg OD (EPHESUS); titrate to 50mg; monitor K+ 1 week and 1 month; ICD assessment at 40 days. DAPT approaching 12 months: transition aspirin 75mg lifelong at 12 months; stop ticagrelor (with cardiology agreement); never stop both simultaneously. GI protection: omeprazole 20mg or lansoprazole 15mg with all DAPT and aspirin.
7F — Drug reference cards
Atorvastatin 80mg — High-Intensity Statin
80mg OD · NICE first-line post-MI · LDL target <1.8 mmol/L or >50% reduction · HMG-CoA reductase inhibitor
✓ First-line high-intensity statin for all post-MI patients — 80mg OD; LDL-C target <1.8 mmol/L
All post-MI patients — lifelongAtorvastatin 80mg OD evening; max dose; add ezetimibe 10mg if LDL-C above target
✓ Who and when
All post-MI patients regardless of baseline cholesterol: atorvastatin 80mg is prescribed universally post-ACS (PROVE IT–TIMI 22 trial; evidence for intensive therapy over moderate therapy). Mechanism: inhibits HMG-CoA reductase — rate-limiting enzyme in hepatic cholesterol synthesis; reduces LDL-C by 45–55%; also reduces CRP (anti-inflammatory pleiotropic effects independent of LDL-C reduction). LDL-C target: <1.8 mmol/L or >50% reduction from pre-treatment baseline (NICE NG185 2023 update). Recheck LDL-C at 3 months. If above target: confirm adherence first; then add ezetimibe 10mg OD. Evening dosing traditionally recommended (cholesterol synthesis peaks at night) but not strictly necessary with atorvastatin (long half-life).
✗ When to stop / reduce
ALT >5× ULN: stop immediately; investigate; rechallenge with lower dose or alternative statin when normalised. CK >10× ULN: stop immediately; hospital admission; IV fluids (rhabdomyolysis). Drug interactions that increase myopathy risk: ciclosporin; fibrates (gemfibrozil especially); clarithromycin; itraconazole — review all medications. Pregnancy: absolute CI (foetal harm).
Mild transaminase elevation (ALT <3× ULN): continue; recheck at 3 months; explore other causes (alcohol; NAFLD). Myalgia with normal CK: continue; review dose; switch to rosuvastatin or pravastatin (lower myopathy risk). Never stop statin after MI without trying lower dose or alternative statin first.
⚠ Side effects
Myalgia (common; 5–10%; often CK normal — symptomatic myopathy without objective CK rise). Myositis (CK 4–10× ULN; reduce dose or switch). Rhabdomyolysis (rare; CK >10× ULN; dark urine — stop immediately). Transaminase elevation (usually mild; self-limiting; <3× ULN: continue). Headache. GI (nausea; dyspepsia; constipation). New-onset diabetes: atorvastatin increases T2DM risk by 10–12% at 80mg (absolute risk small; risk–benefit strongly favours statins post-MI; do not stop statin for this reason).
🔬 Monitor
LFTs: baseline; at 3 months; annually when stable. LDL-C: at 3 months; annually. CK: only if myopathy symptoms (do NOT routinely check CK). New muscle symptoms: check CK; decide based on level. Drug interactions: check for ciclosporin; clarithromycin; azithromycin; HIV antiretrovirals; fibrates — all increase statin level and myopathy risk.
💬 Counselling

"This is your cholesterol tablet — it is one of the most important things you can take after a heart attack. It actively works to slow down the process that caused the blockage. You should take it every day, for life — even when your cholesterol looks good, because the tablet is what is making it good. If you get any muscle aches — particularly if they are severe or if you notice dark urine — please stop it and contact me."

Atorvastatin 80mg: high-intensity statin; all post-MI regardless of baseline cholesterol. LDL-C target <1.8 mmol/L (or >50% reduction). LFTs at 3 months. Myopathy: CK only if symptomatic. ALT <3× ULN: continue. ALT >5× ULN: stop. Mild myalgia (normal CK): continue; consider switching statin. Rhabdomyolysis (CK >10×): stop; hospital. Add ezetimibe 10mg OD if LDL-C above target. Drug interactions: clarithromycin; ciclosporin; fibrates — all increase statin levels and myopathy risk.

Ticagrelor 90mg BD — Preferred P2Y12 Inhibitor
90mg twice daily · 12 months DAPT · PLATO trial · superior to clopidogrel in ACS · P2Y12 ADP receptor antagonist
✓ Preferred P2Y12 inhibitor post-ACS: DAPT for 12 months; NEVER stop without cardiology advice
ACS (STEMI or NSTEMI): 12 months DAPT — then stop; aspirin continues lifelong90mg BD with aspirin 75mg OD; review antiplatelet plan with cardiology at 12 months
✓ Evidence and indication
PLATO trial (2009): ticagrelor superior to clopidogrel in ACS — 16% relative risk reduction in cardiovascular death, MI, or stroke at 12 months; no significant increase in major bleeding. Mechanism: reversible P2Y12 ADP receptor antagonist (unlike clopidogrel which is irreversible prodrug); faster onset and offset. Clinical advantage: faster platelet inhibition; more predictable; fewer non-responders. Use in ACS (STEMI and NSTEMI) for 12 months with aspirin. Preferred over clopidogrel unless: prior TIA/stroke; haemorrhagic history; very high bleeding risk; or clopidogrel specifically recommended (e.g. AF management context). Prasugrel 10mg OD: alternative if PCI performed; stronger antiplatelet but more bleeding; CI in >75 years; <60 kg; prior TIA/stroke.
✗ Critical: never stop early without cardiology
In-stent thrombosis (IST) is the most serious complication of early DAPT cessation. Risk is highest in the first 3–6 months. IST mortality is ~30%. Never stop ticagrelor without explicit cardiology guidance — even for elective surgery (discuss surgical timing with cardiologist; many procedures can be deferred; where urgent: aspirin may be continued; bridging with GP IIb/IIIa inhibitors in hospital if DAPT must stop). Contraindications: history of haemorrhagic stroke or intracranial haemorrhage; severe hepatic impairment. Ticagrelor is a CYP3A4 substrate — avoid grapefruit juice; check for drug interactions (simvastatin; digoxin).
⚠ Side effects
Dyspnoea (10–15%): mechanism unclear; likely prostaglandin-mediated; NOT bronchoconstriction — safe to continue in asthma/COPD; usually improves with time; switch to clopidogrel if intolerable. Bleeding (more than aspirin alone; GI bleeding; bruising — PPI essential). Bradycardia (may be asymptomatic; check if on bisoprolol together). Elevated creatinine and uric acid (mild; usually clinically insignificant).
🔬 Monitor
Adherence: check at every review. Bleeding: any GI symptoms; bruising; bleeding pattern change. Dyspnoea: if troublesome, switch to clopidogrel. 12-month review: plan transition to aspirin monotherapy (with explicit cardiology agreement at 12-month cardiology review). Signs of in-stent thrombosis: new chest pain, especially 6–48 hours after stopping DAPT — treat as ACS; 999.
💬 Counselling

"This tablet — ticagrelor — works with the aspirin to stop the blood from clotting in the stent. It is critical that you take both of these every day for the next 12 months. I want to be very direct: if you stop this tablet without speaking to me or the cardiologist first, you are at risk of the stent blocking again — and that is very serious. If you need an operation or procedure: do not let anyone stop this tablet without ringing us first."

Ticagrelor 90mg BD: preferred P2Y12 inhibitor in ACS (PLATO trial; superior to clopidogrel). 12 months DAPT with aspirin 75mg. NEVER stop without cardiology advice — in-stent thrombosis risk is fatal in 30%. Dyspnoea (10–15%): continue — prostaglandin-mediated; not bronchospasm. If intolerable: switch to clopidogrel 75mg (not stop). 12-month transition: stop ticagrelor; aspirin 75mg lifelong. If surgery needed while on DAPT: cardiology discussion mandatory before stopping.

Ramipril — ACE Inhibitor (Cardioprotective)
Starting 2.5mg OD; titrate to 10mg OD · post-MI cardioprotection · HOPE trial · AIRE trial · BP target <130/80
✓ First-line ACEi post-MI: titrate to 10mg OD; BP target <130/80; monitor renal function
All post-MI patients — lifelong; titrate to maximum tolerated doseStart 2.5mg OD; titrate 2.5→5→10mg over 2–4 weeks; monitor renal function and K+ at each titration step
✓ Cardioprotective evidence post-MI
AIRE trial: ramipril vs placebo in post-MI HF — 27% reduction in mortality. HOPE trial: ramipril in high-risk cardiovascular patients without HF — 22% reduction in MI; 26% reduction in cardiovascular death. NICE NG185: ACE inhibitor for all post-MI patients regardless of LV function (not just HF). Mechanism beyond BP: reduces LV remodelling; reduces ventricular dilatation post-MI; anti-atherosclerotic; reduces proteinuria. Titrate to maximum tolerated dose: Mr. Henderson currently on 5mg — titrate to 10mg OD; recheck BP and U&E in 2 weeks after dose change. BP target: <130/80 mmHg.
✗ Contraindications and cautions
Bilateral renal artery stenosis: can cause acute renal failure — absolutely contraindicated. Pregnancy: teratogenic (CI in all trimesters). History of ACEi-associated angioedema: absolute contraindication to all ACEi (switch to ARB). Hyperkalaemia (K+ >5.5 mmol/L): stop or reduce dose. Significant renal impairment (eGFR <30): use with extreme caution; specialist advice; dose reduction needed.
Cough (10–15%): bradykinin-mediated; switch to candesartan 32mg (ARB) — equal cardioprotection. Hypotension: particularly with first dose; take at night initially in high-risk (elderly; dehydrated). Monitor: eGFR rise <25% acceptable; K+ rise acceptable if <5.5 mmol/L.
⚠ Side effects and monitoring
Cough (most common; 10–15%): persistent dry cough from bradykinin accumulation; switch to candesartan if intolerable (not stop ACEi-class). First-dose hypotension: risk in volume-depleted, elderly, or high diuretic dose — start at night; low first dose. Renal impairment: expected mild rise in creatinine (<20–25% from baseline = acceptable; >30%: investigate; stop if severe). Hyperkalaemia: especially with eplerenone or CKD; check K+ at baseline, 1–2 weeks after each dose change, annually.
🔬 Monitor
U&E and creatinine: at initiation; 1–2 weeks after each dose change; annually when stable. BP: at each review (target <130/80). Serum potassium: particularly if on eplerenone; if K+ >5.5 = reduce dose; >6.0 = stop. Annual renal function check when on maximum dose. Pregnancy test in women of childbearing age (teratogenic).
💬 Counselling

"This tablet — ramipril — helps protect your heart after the heart attack in two ways. It lowers your blood pressure, which reduces the strain on the heart. It also directly helps the heart recover by reducing the stiffening and changes that can happen after a heart attack. You may develop a cough — a dry tickly cough — from this tablet. If that happens, please tell me; I can switch you to a different type that works the same way but without the cough."

Ramipril post-MI: all patients; titrate to 10mg OD; BP target <130/80 mmHg. AIRE trial; HOPE trial evidence. Monitor U&E 1–2 weeks after each dose change. Cough: switch to candesartan 32mg (not stop ACEi class). Hyperkalaemia: stop or reduce if K+ >5.5. Bilateral RAS: absolute CI. Never combine ACEi + ARB (dual RAAS blockade): increased hyperkalaemia and renal failure risk. Mr. Henderson: currently 5mg; titrate to 10mg; recheck U&E in 2 weeks.

Bisoprolol — Beta-Blocker (LV Protection)
Starting 2.5mg OD; titrate to 10mg OD · LV remodelling prevention · HR target 50–60 bpm · review continuation at 12 months
✓ Post-MI beta-blocker: titrate to HR 50–60 bpm; review continuation at 12 months if EF preserved
All post-MI patients up to 12 months; continue indefinitely if reduced EF or HFStart 2.5mg OD; titrate 2.5→5→10mg; target HR 50–60 bpm at rest
✓ Role post-MI
Beta-blockers post-MI: reduce LV remodelling (ventricular dilatation and dysfunction that occurs after MI); reduce sudden cardiac death (anti-arrhythmic); reduce heart rate (reduces myocardial oxygen demand). Evidence base: MERIT-HF; CIBIS-II (primarily HF trials; extrapolated to post-MI). NICE NG185: offer beta-blocker to all post-MI patients. Duration: current NICE guidance “up to 12 months in patients with preserved LV function” — European guidelines suggest indefinite. Titrate to resting HR 50–60 bpm (optimal for anti-remodelling effect). Bisoprolol: highly selective beta-1 antagonist; once daily; good tolerability. If bisoprolol causes troublesome ED: switch to nebivolol (vasodilatory mechanism; less ED risk at equivalent doses).
✗ When to caution
Acute decompensated heart failure (not long-term established HF with BB): do NOT start in acute HF; wait until euvolaemia. Significant bradycardia (<50 bpm at rest): reduce dose; check for conduction disease (AV block on ECG). Severe asthma: avoid (even ‘cardioselective’ beta-blockers can precipitate bronchoconstriction in severe asthma; COPD: use with caution, not contraindicated).
Erectile dysfunction (10%): switch to nebivolol. Fatigue and exercise intolerance (titrate slowly; may improve over weeks). Peripheral vasoconstriction and cold extremities (Raynaud’s may worsen).
⚠ Side effects
Fatigue (common, especially on initiation; usually improves). Bradycardia (reduce dose if HR <50; check ECG for heart block). Hypotension. Erectile dysfunction (10%: switch to nebivolol). Masking of hypoglycaemic symptoms in T2DM (sweating remains; tachycardia masked — counsel diabetic patients). Cold extremities / Raynaud’s exacerbation. Exercise intolerance (may limit cardiac rehabilitation participation — monitor and titrate).
🔬 Monitor
Heart rate at every review (target 50–60 bpm). BP monitoring. 12-month review: discuss with cardiologist whether to continue indefinitely (especially if EF preserved). ECG: if palpitations, bradycardia, or suspected conduction disease. Side effects: ED; fatigue; cold peripheries — switch to nebivolol if ED troublesome.
💬 Counselling

"This tablet — bisoprolol — slows the heart down slightly, which helps it recover from the heart attack. It also helps prevent dangerous heart rhythm problems. You might find you feel more tired than usual at first — this usually settles. One thing I want to mention: this tablet can affect sexual function in some men. If that becomes an issue, please tell me — there is a different version I can switch you to that has less effect on that."

Bisoprolol post-MI: all patients; titrate to resting HR 50–60 bpm; review continuation at 12 months (continue indefinitely if reduced EF or HF). ED side effect: switch to nebivolol (not stop beta-blocker class). Never stop abruptly (rebound hypertension; angina; arrhythmia). COPD: use with caution (not absolute CI; cardioselective). Asthma (severe): avoid. Bradycardia (<50 bpm): reduce dose; check ECG.

Aspirin 75mg — Lifelong Antiplatelet (Post-DAPT)
75mg OD lifelong · with omeprazole 20mg OD · COX-1 inhibitor · ISIS-2 evidence · DO NOT use NSAIDs concurrently
✓ Lifelong aspirin 75mg after DAPT completes at 12 months — with PPI gastroprotection
Post-DAPT: lifelong aspirin 75mg + omeprazole 20mg OD (GI protection)75mg OD with food; with omeprazole 20mg OD (or lansoprazole 15mg); NEVER use NSAIDs without cardiology advice
✓ DAPT period and transition to monotherapy
Aspirin + ticagrelor (DAPT) for 12 months post-ACS. At 12 months: stop ticagrelor; continue aspirin 75mg lifelong. Aspirin irreversibly inhibits platelet COX-1 — prevents thromboxane A2 synthesis — reduces platelet aggregation. ISIS-2 trial: aspirin alone reduces cardiovascular mortality by 23% post-MI. Lifelong aspirin reduces annual major cardiovascular event risk by 25% in secondary prevention. PPI prescription: omeprazole 20mg OD (or lansoprazole 15mg) is mandatory with DAPT and strongly recommended with lifelong aspirin (reduces GI bleeding risk by 50–60%; PLATO-TIMI 38 data). Never give NSAIDs (ibuprofen; naproxen; diclofenac) with aspirin — increased GI bleeding risk and possible attenuation of cardioprotection.
✗ Cautions and interactions
NSAIDs (ibuprofen; naproxen; diclofenac): concurrent use with aspirin increases GI bleeding risk significantly and may interfere with aspirin’s platelet inhibition (ibuprofen competes for COX-1 binding). Avoid if possible; if NSAID needed for musculoskeletal pain: use paracetamol first; if NSAID essential, use lowest dose for shortest time with PPI; inform cardiologist. Active GI bleed: stop aspirin; reinstate as soon as haemostatically safe (with cardiology input — risk of IST from stopping).
Warfarin: triple therapy (aspirin + ticagrelor + warfarin) in AF patients; use DOAC instead of warfarin in AF post-MI if possible; triple therapy duration should be minimised. Methotrexate: aspirin reduces methotrexate clearance; toxicity risk; specialist advice.
⚠ Side effects
GI (dyspepsia; gastric irritation; GI bleed — especially without PPI). Easy bruising and prolonged bleeding times. Aspirin hypersensitivity (rare; Samter’s triad — aspirin-exacerbated respiratory disease with nasal polyps and asthma; cross-reacts with NSAIDs; clopidogrel substitution). Avoid high doses in renal impairment. Tinnitus (rare; at high doses not therapeutic 75mg).
🔬 Monitor
Annual review: is patient still taking it? Any GI symptoms? FBC annually (anaemia from chronic GI blood loss). Renal function: aspirin can worsen renal function in CKD — monitor. Ensure PPI is co-prescribed at every repeat. Flag if any new NSAID prescriptions (interaction; alternative analgesia recommended).
💬 Counselling

"The aspirin you are on — 75mg — is not the same as the aspirin you might take for a headache. This is a low dose that works specifically to stop blood clots forming in the arteries. You will need to take it every day for life — not just when you feel you need it. Always take it with food. And please avoid ibuprofen and similar anti-inflammatory painkillers without speaking to me first — they can interfere with how the aspirin works."

Aspirin 75mg lifelong post-DAPT. PPI (omeprazole 20mg) mandatory — reduces GI bleeding by 50–60%. NSAIDs: avoid (GI bleeding risk + potential interference with aspirin’s COX-1 mechanism). Aspirin during DAPT: always combined with ticagrelor or clopidogrel for 12 months. At 12 months: stop ticagrelor; continue aspirin. Never stop aspirin post-MI without cardiologist input — even for dental procedures (usually safe to continue; inform dentist).

Eplerenone — Aldosterone Antagonist (If EF <35% + HF)
25mg OD titrated to 50mg OD · post-MI + EF <35% + HF signs · EPHESUS trial · monitor K+ and creatinine
✓ Post-MI if EF <35% + HF signs: eplerenone 25mg OD titrated to 50mg (NOT for preserved EF)
Post-MI only if EF <35% AND clinical signs of HF; not for preserved EF post-MI25mg OD for 4 weeks then titrate to 50mg OD; monitor K+ and eGFR at 1 week, 1 month, 3-monthly
✓ EPHESUS criteria (Eplerenone Post-AMI HF Efficacy and Survival Study)
EPHESUS trial: eplerenone added to standard post-MI therapy in patients with EF <40% + HF signs — 15% reduction in all-cause mortality. Indication: EF <35% + clinical heart failure (fluid overload; breathlessness; ankle oedema) post-AMI. Not indicated if EF preserved (no HF — Mr. Henderson’s current picture). Start within 3–14 days of AMI (once haemodynamically stable). Mechanism: selective aldosterone antagonist (blocks aldosterone’s cardiac fibrosis and sodium-retaining effects); reduces LV remodelling; reduces cardiac fibrosis; reduces arrhythmia risk. More selective than spironolactone — fewer sex hormone side effects (gynaecomastia). ICD consideration: if EF remains <35% at 40 days post-MI: assess for ICD implantation (MADIT-II criteria; NICE guidance).
✗ Contraindications — hyperkalaemia is the critical risk
eGFR <30 mL/min/1.73m²: absolute CI (hyperkalaemia risk unacceptable). Serum potassium >5.0 mmol/L at baseline: do not start. Concomitant potassium-sparing diuretics (amiloride; triamterene): severe hyperkalaemia risk. Strong CYP3A4 inhibitors (itraconazole; ketoconazole; clarithromycin): increase eplerenone levels — avoid or use with extreme caution. ACEi + eplerenone combination: hyperkalaemia risk; requires intensive monitoring.
eGFR 30–50: use with caution; start 25mg OD; avoid titration to 50mg if renal function borderline. Diabetes + CKD: highest hyperkalaemia risk; more frequent monitoring needed.
⚠ Hyperkalaemia monitoring is the most critical safety issue
Hyperkalaemia (most important side effect): check K+ at 1 week after starting and after each dose change; then monthly for 3 months; then 3-monthly. Action thresholds: K+ 5.0–5.5 = monitor more frequently; K+ 5.5–6.0 = reduce dose to 25mg; K+ >6.0 = stop immediately; medical review. Also monitor: creatinine and eGFR (renal impairment worsens hyperkalaemia risk). Report of gynaecomastia: much less than spironolactone due to receptor selectivity. Headache; dizziness; GI symptoms.
🔬 Monitor
K+ and creatinine: 1 week; 1 month; then 3-monthly (more frequently if CKD, DM, or ACEi co-prescription). BP (antihypertensive effect). Symptoms of HF: improvement in breathlessness; ankle oedema; exercise tolerance. Echo at 3 months: has EF recovered? ICD decision at 40 days: document and refer if still <35% EF.
💬 Counselling

"This tablet helps protect your heart by blocking a hormone that can cause the heart to stiffen and become weaker after a heart attack. It is particularly important for you because the scan of your heart showed that the pumping function is slightly reduced. We will need to check your kidney function and the potassium level in your blood regularly — particularly in the first few months — as this tablet can sometimes cause those levels to change."

Eplerenone: post-MI only if EF <35% AND HF signs (EPHESUS criteria). NOT for preserved EF. Start 25mg OD; titrate to 50mg. Critical monitoring: K+ at 1 week, 1 month, 3-monthly. K+ >5.5: reduce dose. K+ >6.0: stop immediately. CI: eGFR <30; K+ >5.0 at baseline; concomitant potassium-sparing diuretics. ACEi + eplerenone = high hyperkalaemia risk; monitor closely. ICD referral if EF <35% persists at 40 days post-MI. Spironolactone: cheaper alternative; more gynaecomastia risk than eplerenone.

7G — Psychosocial impact of post-MI recovery
♥️
A heart attack at 58 is an identity-threatening event that challenges every dimension of Mr. Henderson’s life
MI recovery is not just physical restoration — it is a psychological renegotiation of identity, mortality, and future. Mr. Henderson faces occupational uncertainty (HGV licence; livelihood); sexual anxiety; fear of recurrence; a smoking relapse he feels guilty about; a worried wife; and a body that has let him down. The GP who addresses these dimensions is providing genuinely comprehensive post-MI care; the GP who does not will find that risk factor targets are not met because the patient cannot engage with them.
🚘
Work and Identity (DVLA)

HGV driving is not just Mr. Henderson’s job — it is his identity, his income, and his independence. The DVLA obligation is a direct threat to all three. Compassionate delivery: “I know this is the news you didn’t want. The rule exists to protect you and others on the road — not to punish you.” Practical support: occupational health referral; employer discussion; alternative roles during DVLA assessment.

"I want to help you get back to driving as quickly as we safely can — and I can tell you what the process looks like and what we need to do to make it happen."
💑
Sexual Health and Fear

Mr. Henderson wanted to raise sex but didn’t. The GP must raise it. The risk of MI from sexual activity in a stable treated post-MI patient is extremely small. Reassurance: “If you can climb two flights of stairs comfortably, you are physically ready to have sex.” Bisoprolol may be contributing to ED — switch to nebivolol if this is the case. PDE5 inhibitors safe if no nitrates.

"The risk of sex triggering another heart attack is extremely small for someone at your stage of recovery. I would expect you to be able to manage this without any problem at 6 weeks."
Fear of Recurrence

Fear of another MI is universal post-MI; it drives excessive caution, avoidance of exercise and sex, and hypervigilance about symptoms. Counter-evidence: “The treatment you have had — the stent, the medications — significantly reduces your risk. You are doing far better than if you hadn’t had the stent.” Specific exercises and activities confirmed safe. PHQ-9 to detect anxiety converting to clinical depression.

"I want to be clear about the risk: the stent has dramatically reduced your risk of another event. The tablets are doing more of the same work. Exercise is not a risk — it is actively protective."
🚪
Smoking Relapse Without Shame

Mr. Henderson is smoking again. He may be expecting criticism. A shame-based approach reduces engagement. Normalise: “Restarting after a heart attack is more common than people think — the post-MI period is one of the most stressful of someone’s life.” Re-engage: explore what triggered the relapse (stress; anxiety; habit); offer a better-supported cessation attempt this time (varenicline rather than willpower alone).

"I am not here to judge you for starting again — I just want to help you stop in a way that actually works this time. Can we try something different?"
7H — Follow-up
T
Today — 6-week review actions

All 5 medications reviewed; ezetimibe 10mg OD added (LDL-C 2.1); ramipril titrated to 10mg OD; varenicline 0.5mg OD started (quit date in 2 weeks); cardiac rehab re-referred (remote option offered); DVLA Group 2 advised and documented; PHQ-9 administered; sexual health addressed; wife invited to next review; smoking cessation service referred; PPI confirmed prescribed.

Recheck U&E in 2 weeks (ramipril titration)
2
2 Weeks — U&E after ramipril titration + quit date check

Renal function and electrolytes (2 weeks after ramipril 10mg OD started). Smoking: quit date review; CO test; varenicline tolerability. BP recheck. Any new symptoms? Side effects? DVLA: has he notified? Occupational health: has he made contact?

U&E recheck; BP; smoking CO; quit date; DVLA confirmation
3
4 Weeks — Smoking cessation review

4-week CO test (NRT or varenicline); smoking cessation service check-in. PHQ-9 recheck if scores were 5–9 at 6 weeks. Side effects of new medications (ezetimibe; ramipril 10mg). Has wife attended? Cardiac rehab: has he started?

4-week smoking CO; PHQ-9; cardiac rehab attendance confirmed
4
3 Months — LDL-C target recheck; full review

LDL-C recheck (3 months on atorvastatin 80mg + ezetimibe 10mg). LFTs. Renal function. BP. PHQ-9. Cardiac rehab completion (or explore barriers). HbA1c if not done. Cardiology review: has he attended? DVLA: has he been cleared to drive? Smoking: CO test; sustained quit?

LDL-C; LFTs; BP; PHQ-9; DVLA status; cardiac rehab; 3-month cardiology review
5
12 Months — DAPT transition; annual review

Stop ticagrelor (with cardiologist agreement at 12-month cardiology review); continue aspirin 75mg lifelong. Annual secondary prevention review: LDL-C; BP; BMI; smoking; HbA1c; PHQ-9; ECOG; renal function; LFTs. Review beta-blocker continuation (cardiologist guidance). DVLA annual report if required for Group 2 licence. 12-month cardiac rehab completion.

Stop ticagrelor at 12 months; aspirin lifelong; annual secondary prevention review
7I — Monitoring — SMART

SMART secondary prevention monitoring mnemonic

Statin: LFTs at 3 months; LDL-C at 3 months (target <1.8 mmol/L); CK only if myopathy symptoms. Medicines (ACEi + BB): U&E after each ramipril titration; BP at every review; HR (target 50–60 bpm on bisoprolol). Antiplatelet: DAPT adherence; bleeding symptoms; 12-month DAPT transition; aspirin lifelong. Rehab: cardiac rehab attendance; exercise tolerance at each review; PHQ-9 at 6 weeks and 3 months. Targets: LDL-C; BP <130/80; BMI; smoking status; HbA1c (if diabetic); PA level (150 min moderate/week).

DrugParameterTimingAction threshold
Atorvastatin 80mgLDL-C; LFTsLDL-C at 3 months; LFTs at 3 months then annuallyLDL-C >1.8: add ezetimibe. ALT >3× ULN: reduce dose; investigate alcohol/NAFLD. ALT >5× ULN: stop.
Ticagrelor 90mg BDDAPT adherence; bleeding; dyspnoeaEvery review; 12-month DAPT transitionDyspnoea: continue (prostaglandin; not bronchospasm). Intolerable: switch to clopidogrel. At 12 months: transition to aspirin monotherapy.
Ramipril (ACEi)U&E; creatinine; BP1–2 weeks after dose change; then annuallyeGFR fall >25%: investigate; withhold. K+ >5.5: reduce dose. BP target <130/80: titrate.
BisoprololHR; BP; side effects (ED; fatigue)Every reviewHR <50: reduce dose. ED: switch to nebivolol. Review continuation at 12 months.
Risk factorTargetAssessment
LDL-C<1.8 mmol/L or >50% reduction3-monthly until target; then annually
Blood pressure<130/80 mmHgEvery review until target; then 3–6 monthly
SmokingComplete cessation (CO <10 ppm)CO measurement at every review for 1 year
BMI<25 or 5–10% weight lossAnnual; weight management referral if BMI >30
PHQ-9<10 (no significant depression)6 weeks and 3 months post-MI; then annually or if concern
HbA1c<53 mmol/mol (if T2DM)6-monthly if T2DM; check for new-onset T2DM annually (statin risk)
7J — Safety-netting

⚠ Three critical safety-net conversations

🔴 Emergency — chest pain on DAPT
"If you develop any chest pain, tightness, or pressure — call 999 immediately. Do not wait; do not drive yourself; do not take paracetamol and see if it settles. In your situation, chest pain needs to be assessed as an emergency. If anyone tries to tell you it is indigestion — get an ECG first."
In-stent thrombosis presents as STEMI: the window for treatment is minutes. A post-MI patient on DAPT who develops chest pain has a high pre-test probability of a cardiac cause. The explicit instruction to call 999 — not to wait — is medico-legally important and clinically critical.
💉 Medication — never stop ticagrelor without calling us
"I need to be very direct about one thing: the ticagrelor tablet — the one you take twice a day — must not be stopped without speaking to me or the cardiologist first. If you run out; if a dentist or a hospital doctor tells you to stop it; if it is causing a side effect — please ring us before stopping. Stopping it suddenly can cause the stent to block, and that is very dangerous."
This is the most important medication safety-net in post-MI secondary prevention. The 30% mortality rate from in-stent thrombosis makes this a life-saving conversation. Pre-warning the patient about surgical/dental requests to stop DAPT — and giving them explicit instruction to ring the GP — prevents the most common cause of IST.
🟠 DVLA — do not drive your HGV until DVLA clears you
"The law says you need to tell the DVLA about your heart attack and that you drive a lorry. Until they have assessed you and confirmed you are safe to return, you cannot drive commercially. I know that is very difficult. I want to help you through the process as quickly as possible — and I will support you with letters if needed. But the law on this is clear, and I have to be honest with you about it."
The GP has a legal and ethical duty to advise Group 2 drivers of their DVLA notification obligation and to document that this advice has been given. A patient who continues to drive an HGV without DVLA clearance is committing a criminal offence. The GP who does not give this advice may face GMC consequences if harm results.
2 weeksU&E after ramipril titration; BP recheck; smoking CO; DVLA confirmation
4 weeks4-week smoking CO; PHQ-9; cardiac rehab attendance; ezetimibe tolerability
3 monthsLDL-C; LFTs; BP; HbA1c; cardiac rehab; DVLA; cardiology review
🎓 SCA Checkpoint — Step 7 (Final)TasksRelating to OthersGlobal Skills
Closing the consultation
"Let me bring together what we have agreed today. Medications: everything you are on is right — I am adding a tablet called ezetimibe to bring your cholesterol to target; and I am increasing your ramipril from 5mg to 10mg. Both of these will be on your prescription today."
"Smoking: I am not going to tell you off for starting again. What I am going to do is give you something that makes stopping a lot easier — a tablet called varenicline. Let’s set a quit date together. Two weeks from today?"
"Driving: I need to be clear — you need to ring the DVLA and tell them about the heart attack and that you drive a lorry. They decide when you can go back. I am writing that in your notes today. If your employer needs a letter from me, I can write one."
"Sex: it is safe at this stage. The risk is very small. If the bisoprolol is causing any difficulty, I can switch you to a slightly different version."
"Before you go — is there anything I have not addressed that you were hoping we would cover today?"
Deductions
  • Not raising sexual health — patient said he “didn’t want to bring it up”; this is the signal for the GP to raise it, not a reason to leave it
  • Not addressing DVLA Group 2 — this is both a Tasks mark and a legal obligation; omitting it is a significant consultation failure
  • Shaming the smoking relapse — reduces engagement with cessation; Relating to Others deduction
  • Not explaining what will happen at 12 months with DAPT — patient must know ticagrelor is time-limited and aspirin continues
Tasks — full criteria
  • All 5 medications reviewed; ezetimibe added (LDL-C above target)
  • Ramipril titrated to 10mg; U&E booked for 2 weeks
  • Smoking cessation re-engaged; varenicline prescribed; SSS referred
  • DVLA Group 2 obligation explained and documented
  • Sexual health raised; PDE5/nitrate rule explained
  • Cardiac rehab barriers explored; re-referred
  • PHQ-9 administered
  • Safety-net: chest pain = 999; never stop ticagrelor
Relating to Others — criteria
  • Emotional opener; acknowledged the post-MI journey
  • ICE all three explored; hidden concerns named
  • Smoking relapse normalised without judgement
  • Sexual health raised proactively; embarrassment acknowledged
  • DVLA delivered with compassion; practical support offered
  • Ticagrelor importance emphasised without alarming
  • Wife invited; closing question with genuine pause
🔴 Red
Drug checklist only; no emotional opener; DVLA not mentioned; sex not raised; smoking shamed; cardiac rehab not followed up; DAPT transition not explained
🟠 Amber
Empathetic opener; medications reviewed; smoking re-engaged; DVLA mentioned; sex mentioned briefly without specific reassurance; PHQ-9 done; ezetimibe added; cardiac rehab not explored
🟩 Green
Emotional opener; ICE all three; all 5 medications + ezetimibe added + ramipril titrated; smoking cessation re-engaged warmly with varenicline; DVLA Group 2 documented; sexual health raised proactively with PDE5/nitrate rule; cardiac rehab barriers explored + re-referred; PHQ-9; wife invited; 12-month DAPT transition explained; closing question
MI Secondary Prevention — SCA Consultation Scorecard
NICE NG185 · DAPT 12 months · Atorvastatin 80mg · LDL-C <1.8 · DVLA Group 2 · Smoking cessation · Sexual health · Cardiac rehab
0/ 33 pts
🌐
Global Skills
Structure, language, person-centred approach
0/7
Tasks
Clinical reasoning, prescribing, co-ordination
0/15
🤝
Relating to Others
Empathy, communication, patient-centred care
0/11
RAG Self-Assessment
🔴 Red
Drug checklist only; no emotional opener; DVLA not mentioned; sex not raised; smoking shamed; cardiac rehab passively accepted; DAPT transition not explained; no PHQ-9; ezetimibe not added
🟠 Amber
Empathetic opener; medications reviewed; smoking re-engaged; DVLA mentioned; sex mentioned briefly without specific reassurance or nitrate rule; PHQ-9 done; ezetimibe added; cardiac rehab not actively re-referred
🟩 Green
Emotional opener; ICE all three; all 5 medications + ezetimibe + ramipril titrated; smoking warmly re-engaged with varenicline; DVLA Group 2 documented; sex raised proactively with nitrate rule; cardiac rehab re-referred; PHQ-9; wife invited; DAPT transition explained; closing question
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"Good morning doc. Honestly, I feel pretty decent now. I’ve been wondering whether I really need all these tablets any more — I feel back to normal."
Who you are

James Henderson, 58, HGV lorry driver for a national haulage company. Married to Sandra (55). Two grown-up children. NSTEMI 6 weeks ago; treated with PCI (drug-eluting stent to LAD). Post-hospital period has been difficult: bored at home; anxious; started smoking 15/day again about 2 weeks after discharge. You haven’t attended cardiac rehab — first appointment clashed with a family commitment. Sandra is very anxious and does not want you doing anything strenuous. Your boss has said he can hold your job for another 6 weeks. You want your life back.

Hidden concerns — disclose if directly asked

Sex (disclose if GP raises it): “I’ve been wanting to ask about that. Sandra and I haven’t … since the heart attack. She’s scared, and honestly I am too. What’s the risk?” Responds very well to reassurance: “Two flights of stairs equivalent — that’s honestly all? OK, that’s a relief.”

Financial concern (disclose if DVLA conversation happens compassionately): “If I can’t drive the lorry, I lose my job. The company can only hold it so long. What am I supposed to do about money?” — this reveals the real stakes of the DVLA conversation; GP should acknowledge this with empathy and occupational health referral.

Smoking guilt: “I know I shouldn’t have started again. I just … the first two weeks at home were terrible. I was bored and anxious and it was just there.” — respond well if GP is non-judgemental: “Actually it would really help to have something proper to try this time.”

Responses to key conversations
  • On medications: “do I need all these?”: "The stent fixed it, didn't it?" — respond to plain-language explanation of atherosclerosis as an ongoing condition: "OK — I hadn't thought of it that way. Like the stent fixed the pipe but not the furring."
  • On DVLA (compassionate delivery): initially crestfallen then: "What's the actual process? Is there anything I can do to speed it up?" — practical information is reassuring
  • On ticagrelor stopping warning: visibly surprised: "I didn't know you couldn't just stop it. My mate had a stent and he stopped his tablets after a year and nothing happened." — respond to clear explanation: "OK, I'll be careful."
  • On cardiac rehab: initially dismissive ("I feel fine, I don't need it") — respond to evidence: "20 to 25% risk reduction — that much? OK. Maybe I should give it a go."
Clinical details
  • Age 58; NSTEMI 6 weeks ago; PCI to LAD (drug-eluting stent)
  • Current medications: aspirin 75mg OD; ticagrelor 90mg BD; atorvastatin 80mg OD; ramipril 5mg OD; bisoprolol 2.5mg OD
  • Today: BP 142/86; HR 72 bpm; weight 94 kg; BMI 29
  • Bloods: LDL-C 2.1 mmol/L; total cholesterol 4.6; eGFR 78; Na+ 139; K+ 4.2; ALT 52 (ULN 45 — mildly elevated)
  • Smoking: 15/day since 2 weeks post-discharge
  • PHQ-9: ask in-consultation — likely score 7–9 (subthreshold depression; occupational stress; anxiety about recurrence)
"When can I go back to my lorry? That’s what I really need to know. My boss says he can only hold the job for another 6 weeks. If I can’t go back after that, I’m out of a job. What am I supposed to do?"

Resolution: Mr. Henderson accepts the DVLA news if delivered with compassion and practical support (occupational health referral; realistic timeline; GP supporting letter offered). He agrees to try varenicline if the GP is non-judgemental about the relapse. He is visibly relieved when sex is raised proactively and reassured. He agrees to cardiac rehab re-referral when evidence is given specifically (“20–25% risk reduction”). He leaves having agreed to ezetimibe, ramipril 10mg, varenicline, cardiac rehab, DVLA notification, and a 2-week review. He says: “I didn’t expect this appointment to go like that. I thought you’d just be checking boxes.”

🏥
Clinic Quick Reference
MI Secondary Prevention Framework
NICE NG185 · DAPT 12 months · Atorvastatin 80mg · ACEi · BB · Cardiac rehab · DVLA
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💊 1 — SMART Secondary Prevention
Post-MI discharge → DAPT confirmed → Statin (high-intensity) → ACEi (titrate) → BB (titrate) → Risk factor targets → Cardiac rehab → DVLA
DAPT: aspirin 75mg + ticagrelor 90mg BD for 12 months post-ACS; then aspirin 75mg lifelong. Never stop ticagrelor without cardiology — in-stent thrombosis (30% mortality). PPI (omeprazole 20mg) essential with DAPT
Statin: atorvastatin 80mg OD regardless of baseline cholesterol. LDL-C target <1.8 mmol/L (or >50% reduction). LFTs at 3 months. CK only if myopathy symptoms. If above target: add ezetimibe 10mg OD
ACEi: ramipril; titrate to maximum tolerated dose (10mg OD); BP target <130/80. U&E 1–2 weeks after each dose change. Cough: switch to candesartan (not stop ACEi class)
BB: bisoprolol; titrate to HR 50–60 bpm; review continuation at 12 months (continue indefinitely if reduced EF or HF). ED from bisoprolol: switch to nebivolol
Eplerenone: ONLY if EF <35% + HF signs post-MI (EPHESUS); 25mg OD titrated to 50mg; K+ at 1 week, 1 month, 3-monthly; stop if K+ >6.0
Cardiac rehab (all patients) · Smoking cessation · Mediterranean diet · BP <130/80 · LDL-C <1.8 · DVLA Group 2 notification · PHQ-9 at 6 weeks + 3 months
📋 2 — Key Numbers and Targets
DAPT 12M
Dual antiplatelet duration post-ACS; aspirin lifelong after
LDL-C <1.8
LDL-C target (mmol/L) post-MI; or >50% reduction
BP <130/80
Blood pressure target post-MI (mmHg)
HR 50–60
Resting HR target on bisoprolol (bpm)
Cardiac rehab
Reduces mortality 20–25%; offer to all; re-refer if non-attender
Smoking → 36%
Risk reduction from smoking cessation — greatest single modifiable factor
Group 2 = 6wk
DVLA Group 2 (HGV/bus): 6 weeks minimum + notify DVLA + clearance
PHQ-9 at 6w + 3M
Depression screen post-MI; sertraline if ≥10 (not TCAs)
Ezetimibe +15–20%
Additional LDL-C reduction from ezetimibe 10mg added to statin
EF <35%
Add eplerenone (+ HF signs); ICD assessment at 40 days (MADIT-II)
PDE5 + Nitrate = CI
Sildenafil absolutely contraindicated with nitrates — severe hypotension
K+ >6.0 = STOP
Stop eplerenone immediately if K+ >6.0 mmol/L (hyperkalaemia)
⚠ 3 — Key Clinical Rules
NEVER stop ticagrelor without cardiology advice — in-stent thrombosis (30% mortality) PDE5 inhibitors + nitrates = absolute CI — severe hypotension; potentially fatal DVLA Group 2 — patient’s legal obligation to notify; GP must document advice given LDL-C above target on atorvastatin 80mg: add ezetimibe 10mg OD; PCSK9 inhibitor via lipid clinic if still above target Statin myopathy: CK only if symptomatic; ALT <3× ULN continue; ALT >5× ULN stop Smoking cessation: warmth not shame; varenicline first-line (22% 12-month abstinence); avoid shame-based approach Depression post-MI: sertraline (best cardiac safety); NOT tricyclics (QTc risk); cardiac rehab has psychological component Sexual activity: safe after cardiovascular stabilisation; equivalent to 2 flights of stairs; raise proactively at every post-MI review
🔬 4 — SMART Monitoring
SMARTParameterTimingAction
S — StatinLDL-C; LFTs; CK if symptomaticLDL-C + LFTs at 3 months; annuallyLDL-C >1.8: add ezetimibe. ALT >5× ULN: stop. CK >10×: stop; hospital
M — Medicines (ACEi + BB)U&E; BP; HR; side effectsU&E 1–2 weeks post titration; BP at every reviewBP above target: titrate ramipril; add amlodipine. K+ >5.5: reduce ACEi. HR >70 on bisoprolol: titrate
A — AntiplateletDAPT adherence; bleeding; dyspnoeaEvery review; 12-month transitionTicagrelor dyspnoea: continue (prostaglandin-mediated). At 12M: stop ticagrelor; aspirin lifelong
R — RehabCardiac rehab attendance; PHQ-9; exercise tolerancePHQ-9 at 6W + 3M; cardiac rehab review at 3MNon-attender: explore barriers; re-refer; remote option. PHQ-9 ≥10: sertraline
T — TargetsLDL-C; BP; smoking; BMI; HbA1c3M until target; then annuallySmoking: re-engage with cessation support; varenicline. BMI >30: weight management referral
🎓
SCA Exam Quick Reference
MI Secondary Prevention SCA — DAPT · Targets · DVLA · Sexual Health
NICE NG185 · Never stop ticagrelor · Atorvastatin 80mg · Group 2 DVLA · Sex safe; PDE5 + nitrate CI
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💬 Opening & ICE
Opener: “Six weeks since your heart attack — that is a big deal. Before we go through everything, how have you been getting on in yourself?” — 30 seconds; patient leads; hidden agenda emerges
ICE — Ideas: “What do you think caused your heart attack?” — illness model determines engagement with secondary prevention; “the stent fixed it” mindset needs gentle challenging
ICE — Concerns: “What worries you most about the future? Is there anything you’ve been concerned about but haven’t mentioned yet?” — the second question invites the hidden agenda (driving; sex; financial impact)
ICE — Expectations: “What did you hope today’s appointment would tell you?” — validate what is genuinely going well first; then address targets above goal
Sex (raise proactively): “I want to ask about something most people find hard to bring up — have you thought about, or tried, getting back to sexual activity? The risk is very small — similar to climbing two flights of stairs.” Patient said he “didn’t want to bring it up” — the GP must raise it
Smoking relapse (warmth): “Restarting smoking after a heart attack is more common than people think — the first few weeks at home are one of the hardest periods. I’m not here to tell you off; I want to help you try again with something that actually works.”
Challenge: “When can I go back to my lorry?” — “Because you drive an HGV, you are in a different category. The DVLA need to know and need to clear you before you go back. I know that is hard to hear. Let me tell you what the process looks like and how we can make it happen as fast as possible.”
✅ Key SCA Tasks (15pt)
All 5 medications reviewed (2pt): aspirin; ticagrelor; atorvastatin; ramipril; bisoprolol — adherence confirmed; side effects asked; indications explained; PPI co-prescribed
Smoking cessation (2pt): relapse normalised; varenicline prescribed (1st line; 22% 12M abstinence); SSS referral; quit date set 2 weeks; 4-week CO follow-up
DVLA Group 2 documented (2pt): Group 2 minimum 6 weeks + notify DVLA + DVLA clearance required; patient’s legal obligation; GP documents advice given; occupational health referral
LDL-C above target (2pt): LDL-C 2.1 (target <1.8); confirm adherence; add ezetimibe 10mg OD; 3-month recheck; LFTs: ALT 52 (1.15×ULN — continue; recheck 3M)
Sexual health raised (2pt): GP raises proactively; risk very low; PDE5 inhibitors safe if NOT on nitrates; ABSOLUTE CI with nitrates (GTN spray; ISMN); bisoprolol-related ED: switch to nebivolol
Cardiac rehab re-referred (1pt): barriers explored; re-referred; remote/online option; “20–25% mortality reduction — same as adding another tablet”; wife’s involvement in information session
PHQ-9 (1pt): at 6 weeks; if ≥10: sertraline 50mg (SADHART trial; best cardiac safety); NOT tricyclics (QTc risk)
BP titration (1pt): BP 142/86 (target <130/80); ramipril 5mg → 10mg; U&E 2 weeks; recheck BP 4 weeks
DAPT transition explained (1pt): ticagrelor for 12 months; then stop (with cardiology); aspirin 75mg lifelong
Safety-net (1pt): chest pain = 999; never stop ticagrelor without cardiology advice — in-stent thrombosis risk (30% mortality)
🔴 Never ask sex question and then immediately move on — give it space; embarrassment acknowledged; PDE5/nitrate rule must be explained
🔴 DVLA not mentioned — automatic deduction; group 2 drivers are a specific examinable category in SCA
👥 Relating to Others (11pt)
Emotional opener (1pt): the post-MI period is profoundly stressful; acknowledge before any clinical content
Illness model explored (1pt): “the stent fixed it” mindset; gently challenge: “the stent fixed the pipe but not the process that caused it”
Hidden concerns invited (1pt): “anything you’ve been worried about but haven’t mentioned yet?” — the specific second question gives permission; candidates who don’t ask it miss the hidden agenda
Valid reassurance given (1pt): validate what’s going well first; give specific evidence-based reassurance where warranted — “2 flights of stairs” for sex; “stent is working well” for cardiac status
Smoking: warmth not shame (1pt): normalise relapse; acknowledge the stressor; focus on what will work better this time; the patient who feels judged disengages
Sex raised proactively (1pt): don’t wait for patient; name the embarrassment first; then give specific information
DVLA: compassion + practical (1pt): empathise with the livelihood threat; then immediately give practical support: process; timeline; occupational health; GP letter
Ticagrelor without catastrophising (1pt): clear about the why; specific about the action (ring us before stopping); not alarmist
Wife invited (1pt): Sandra’s anxiety is causing overprotection and deconditioning; invite her to hear the information from the GP
Cardiac rehab evidence given (1pt): specific evidence motivates; “20–25% risk reduction — same as another tablet”
Closing question with pause (1pt): genuine 3–5 second pause after “anything else you wanted to cover today?”
🟩 Realistic outcome: Mr. Henderson accepts ezetimibe + ramipril titration; agrees to varenicline + quit date; accepts DVLA timeline; visibly relieved about sex; agrees to re-do cardiac rehab
💊 Drug Quick-Pick
Reviewed: July 2026 · citations verified against current NICE / UK guidance