…disease or hypoxia, chronic thromboembolic obstruction, or a range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the…

…7.35 with raised pCO₂ Acute or acute on chronic hypercapnic respiratory failure Rapidly falling pH An urgent ventilatory problem Focal chest pain or unilaterally…

…7.35 and a PaCO₂ above 6.0 kPa despite optimal medical treatment with bronchodilators, steroids and controlled oxygen. Acute on chronic hypercapnic failure in…

…acute or chronic heart failure are often better categorised as myocardial injury. Clinical Presentation and Symptoms Patients with Type 2 MI frequently present with acute…

… 2. Is the hyponatraemia acute or chronic? Severe symptoms require immediate treatment with hypertonic sodium chloride, whether the hyponatraemia is acute or chronic. The aim…

…cardiac arrests caused by chronic or acute ischemic heart disease, it is often not true in other circumstances (e.g. pulmonary embolism, trauma, respiratory causes…

…bradycardia may present with chronic or acute symptoms, ranging from chronic fatigue and exercise intolerance to sudden cardiac arrest. The most common acute symptoms are…

…Examples Acute coronary atherothrombosis Plaque disruption or erosion with thrombosis Reduced myocardial perfusion Coronary spasm, microvascular dysfunction, coronary embolism, coronary dissection, hypotension, shock, respiratory failure…

…acute pancreatitis, alkalosis due to hyperventilation, rhabdomyolysis (particularly the initial phase), sepsis, malignancies with osteoblastic metastases, diminished calcium absorption and/or enhanced calcium excretion, chronic…

…Contraindications Ongoing respiratory depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given…

…airway obstruction results in PEA and cardiac arrest within 8 minutes. Cardiac arrest as a result of asphyxia or hypoxia is managed according to the…

…NSTEMI is confirmed by a typical rise and/or fall of high sensitivity cardiac troponin (hs cTn), with at least one value above the 99th…

…or chronic, when troponin elevation persists without such a change. Myocarditis, sepsis, takotsubo cardiomyopathy, valvular disease, arrhythmias, and heart failure are among the conditions associated…

…chronic obstructive pulmonary disease, renal insufficiency, systemic hypertension, and concomitant abdominal aortic aneurysm. Clinical Presentation and Symptoms Acute chest and/or back pain is the…

…and heart failure of ischaemic or cardiometabolic origin. Major clinical presentations The principal outpatient presentations include: Reproducible stress induced angina or ischaemia associated with obstructive…

…anticoagulation (OAC). Clinical context and treatment objectives DAPT is used in two principal settings: After ACS , whether managed medically or with revascularization. After elective PCI…

…the occurrence of contrast induced AKI is negligible or very low. Risk rises substantially with chronic kidney disease, particularly diabetic kidney disease and advanced CKD…

…also consider acute severe mitral regurgitation, mechanical complications, and ischaemia related ventricular failure as potential causes of shock. Patients with moderate to severe chronic kidney…

…recovering from myocardial infarction or acute coronary syndrome. Patients with stable or chronic atherosclerotic coronary disease, many of whom have a previous acute coronary syndrome…

…LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical signs, and an LVEF below 40%…

…in patients with heart failure with reduced ejection fraction (HFrEF) and coronary artery disease (CAD), and after acute coronary syndromes in patients with reduced left…

…is a chronic, progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental pathophysiological substrate for acute coronary…

…reduces preload and afterload, further reducing myocardial workload. Levosimendan is used in severe acute or chronic heart failure. Consider urgent angiography in patients with unknown…

…Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related…

…arrest and asystole represent severe manifestations of impulse generation or conduction failure. The pathophysiology of these events may stem from reversible causes, including hypovolemia, hypoxia…

…atrial fibrillation. Acute and paroxysmal cases are common in clinical practice. Chronic flutter is, however, very rare. Thus, as compared with atrial fibrillation, atrial flutter…

…cerebral and mesenteric vessels. Few Dopamine medium dose Cardiogenic shock Vasodilatory shock Heart failure (HF), acute Heart failure (HF), chronic Bradycardia (second line alternative) Medium…

…coronary compromise or malperfusion. Important presentations include: Hypotension or shock Acute severe aortic regurgitation with heart failure Cardiac tamponade from haemopericardium Myocardial ischaemia from coronary…

…of the ischaemic process: acute, evolving or chronic The severity of ischaemia and whether infarction has occurred The extent and degree of myocardial involvement The…

…cerebral and mesenteric vessels. Few Dopamine medium dose Cardiogenic shock Vasodilatory shock Heart failure (HF), acute Heart failure (HF), chronic Bradycardia (second line alternative) Medium…

…reliably exclude clinically important differences in ischemic events or stent thrombosis. Stable coronary disease and elective PCI For chronic coronary syndromes treated with elective PCI…

…segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS), acute coronary syndrome (ACS), myocardial infarction, and repeat target lesion revascularization…

…abrupt or progressive, and cardiogenic shock may develop rapidly. Ventricular septal rupture VSR typically causes: Recurrent chest pain. Dyspnoea. Hypotension. Rapid development of biventricular failure…

…heart failure, and chronic kidney disease (CKD). These agents interfere with the renin angiotensin aldosterone system (RAAS) by inhibiting the enzyme responsible for the conversion…

…the massive transfusion protocol. Plasma and platelets: in ongoing bleeding with coagulopathy, or as part of balanced transfusion in massive haemorrhage. Transfusion thresholds in the…

…support during hospitalization. Depression and adverse environmental exposures are associated with continued or resumed smoking after the acute event and warrant particular attention. Cardiovascular benefits…

…and procedural risk factors The risk of adverse events is increased by: advanced age; diabetes mellitus; chronic kidney disease or renal failure; congestive heart failure…

…haemorrhage, acute coronary syndrome, acute left ventricular failure with pulmonary oedema, acute aortic syndrome, acute kidney injury, microangiopathic haemolysis, and severe pre eclampsia or eclampsia…

…Heart failure, acute or chronic. Bradycardia (second line option). 3.0–10.0 μg/kg/min + ++++ + +++++ Intermediate dose dopamine activates β1, releases noradrenaline and…

…Established ASCVD includes previous acute coronary syndrome, chronic coronary syndromes, coronary revascularization, stroke, transient ischaemic attack, and peripheral arterial disease. Heart failure is also considered…

…of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease, and other very high risk settings described…

…cardiac. In acute coronary syndrome (ACS), the angiographic culprit lesion may appear as an eccentric stenosis with scalloped or overhanging margins and a narrow neck…

…deaths annually worldwide. The most common cause of sudden cardiac death is acute or chronic coronary artery disease (ischemic heart disease). Cardiomyopathies (dilated or hypertr

…in patients with CVD. The clinical consequences of diabetes may present through any major cardiovascular phenotype: CAD, including chronic coronary syndromes and acute coronary syndromes…

…and if so at what pressure. Palpable foot pulses are not an acceptable substitute, and in patients with diabetes or renal failure the index may…

…is consistent with chronic myocardial injury. Non ischaemic conditions, including myocarditis, rapid ventricular rate atrial fibrillation, marked anaemia, hypertensive emergency, heart failure, and end stage…

…uncertain. Acute HF generally produces higher BNP and NT proBNP concentrations than chronic, stable disease, and greater volume overload is usually associated with higher levels…

…single) T wave inversion in lead V1 is common and normal. It is generally concordant with the QRS complex (which is negative in lead V1…

…of stroke by 70%, as compared with placebo. Besides anticoagulation, atrial fibrillation is treated with rate and/or rhythm control . Rate control implies the use…

…clinical setting, time from MI or percutaneous coronary intervention (PCI), ischaemic risk, bleeding risk, need for anticoagulation, and whether coronary stents are present. Clinical objectives…

…failure, particularly when left ventricular function is impaired Haemodynamic or electrical instability in advanced or acute presentations Left main disease may be clinically silent, and…

…multivessel CAD varies from stable angina or exertional limitation to acute coronary syndrome (ACS), ventricular arrhythmia, heart failure or cardiogenic shock. In chronic coronary disease…

…exercise or other situations with increased myocardial load. Symptoms are exacerbated by increasing the level of exertion ( i.e increasing the myocardial load), and vice…

…exercise or other situations with increased myocardial load. Symptoms are exacerbated by increasing the level of exertion ( i.e increasing the myocardial load), and vice…

…of an acute myocardial infarction during long term follow up. Moreover, several potentially high risk plaques may coexist within one coronary tree, and inflammatory activity…

…Clinical presentation and symptoms SCAD generally presents as ACS. Symptoms may therefore include acute chest pain or chest discomfort, with associated manifestations of myocardial ischaemia…

…cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS), peripheral artery disease (PAD), and acute coronary syndromes (ACS). Its…

…heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive…

…and cardiac arrest Cardiac arrest associated with tamponade has an exceptionally poor prognosis. In the vast majority of these cases, the tamponade develops acutely or…

…Post cardiac surgery (hemorrhagic pericarditis). Symptoms of acute pericarditis/myocarditis There are two forms of pericarditis: acute and chronic. This article will focus on the…