Intended for healthcare professionals

Rapid response to:

Practice A Patient’s Journey

Left atrial myxoma

BMJ 2013; 347 doi: (Published 26 July 2013) Cite this as: BMJ 2013;347:f4430

Rapid Response:

Re: Left atrial myxoma

Open heart surgery is a frightening experience for most people as described by Susie Layton (in her journey to have an atrial myxoma removed).[1] After cardiac surgery the patient is "keen to get back to 'normal' as soon as possible",[1] she and her husband missed the support and after care that can be offered by a comprehensive cardiac rehabilitation programme. This omission was highlighted by David Ripley in his clinical commentary.[1]

Participation rates in cardiac rehabilitation in the UK are suboptimal and even globally the rates vary widely but are estimated at around 30%.[2] We need to develop a culture where rehabilitation for all post cardiac patients is the rule and not the exception. Endorsement of cardiac rehabilitation programmes by cardiac surgeons and cardiologists has been shown to positively influence participation rates.[3] Clinicians should emulate David Ripley by emphasising the importance of rehabilitation to all post cardiac surgery patients.[1] This would not only improve the post discharge care of patients such as Susie Layton but could also reduce hospital readmissions.


1. Layton, S., D. P. Ripley, and N. G. Bellenger. "Left atrial myxoma." BMJ 347 (2013): f4430..

2. Briffa, T. G. and A. Tonkin. "Put disease prevention first." Circulation 128.6 (2013): 573-75.

3. Park QR,Goel K, Lahr BD et al. Paricipation in cardiac rehabilitation and survival after coronary artery bypass graft surgery: a community based study. Circulation.(2013);128:590-597.

Competing interests: No competing interests

28 September 2013
Hasnain M Dalal
General Practitioner and Senior Lecturer
Morgan O'Flaherty[ 4th year medical student,Peninsula Medical School), Frances Clarke ( 4th year student,Peninsula Medical School) and Jenny Wingham (Senior Clinical Researcher, Royal Cornwall Hospitals Trust, Truro)
Department of Primary Care,University of Exeter Medical School
Royal Cornwall Hospitals Trust,Truro TR1 3HD