…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…

…severe airflow obstruction pH below 7.35 with raised pCO₂ Acute or acute on chronic hypercapnic respiratory failure Rapidly falling pH An urgent ventilatory problem…

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

…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…

…example a Glasgow Coma Scale below 8 Vomiting together with clear neurological impairment Respiratory failure or respiratory arrest Clinical signs of raised intracranial pressure or…

…overdoses, etc.). Among victims in whom the cardiac arrest was caused by VT or VF (e.g acute or chronic myocardial ischemia, heart failure, etc.)…

…arrest. The most common acute symptoms are dizziness (pre syncope), hypotension (chock), syncope, chest pain, heart failure and cardiac arrest. In cases with intermittent symptoms…

…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…

…morphine Morphine has an active renally excreted metabolite that causes late sedation and respiratory depression Marked liver failure A reduced dose of all of them…

…arrest : Trauma and injuries : Direct trauma can cause airway injuries, resulting in obstruction. Central nervous system (CNS) injuries might cause apnea or hypoventilation. Respiratory conditions…

…Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial accumulation of…

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

…with advanced age, smoking, coronary artery disease, chronic obstructive pulmonary disease, renal insufficiency, systemic hypertension, and concomitant abdominal aortic aneurysm. Clinical Presentation and Symptoms Acute…

…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…

…The clinical rationale for DAPT is particularly strong after ACS and coronary stent implantation. ACS is associated with a high risk of platelet driven atherothrombosis…

…AKI is negligible or very low. Risk rises substantially with chronic kidney disease, particularly diabetic kidney disease and advanced CKD. The clinical course is often…

…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…

…heart failure requiring hospitalization. Progressive sodium and fluid retention is described as a frequent mechanism of clinical deterioration and acute decompensation despite apparently effective chronic…

…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…

…early hours following infarction may be associated with hemodynamic compromise. More broadly, bradyarrhythmic arrest and asystole represent severe manifestations of impulse generation or conduction failure…

…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…

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

…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…

…dosing Definition and pathophysiological rationale Dual antiplatelet therapy (DAPT) denotes treatment with aspirin plus a P2Y12 receptor inhibitor. In the setting of acute coronary syndrome…

…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…

…catastrophic or subacute. In the catastrophic form, an acute tear causes haemopericardium, tamponade, and sudden: Loss of pulse. Loss of blood pressure. Loss of consciousness…

…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…

…Ongoing bleeding with haemodynamic compromise, whatever the current haemoglobin — haemoglobin falls late in acute haemorrhage and a normal value does not exclude significant blood loss…

…acute coronary syndrome, tobacco abstinence has been associated with reductions in reinfarction of approximately 30–40% and in death of approximately 35–45%. In chronic…

…access. In patients with acute coronary syndrome, randomized evidence has demonstrated lower rates of access site bleeding, surgical repair, and blood transfusion with radial access…

…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…

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

…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…

…Measure and trace the ulcer; photograph it with a ruler in the image. A reduction in size of 40% within four weeks predicts healing — failure…

…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…

…AVNRT and AVRT (pre excitation, WPW syndrome) being the most common. Atrial fibrillation with onset during hyperthyroidism (thyrotoxicosis), alcohol overdose, thoracic surgery, acute myocardial infarction…

…chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term antiplatelet therapy after STEMI is associated with…

…or electrical instability in advanced or acute presentations Left main disease may be clinically silent, and revascularisation recommendations are not restricted to patients with symptoms…

…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…

…Virtually all patients with STE ACS exhibit elevated troponin levels, and are thereby diagnosed as ST elevation myocardial infarction (STEMI) . Chronic Coronary Syndromes (CCS) Coronary…

…Virtually all patients with STE ACS exhibit elevated troponin levels, and are thereby diagnosed as ST elevation myocardial infarction (STEMI) . Chronic Coronary Syndromes (CCS) Coronary…

…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…

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

…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…