…mass. Waist circumference and the waist to hip ratio provide additional information about visceral adiposity and may correlate more closely with outcomes than BMI, particularly…

…combined dyslipidaemia, non HDL C is particularly relevant because it captures triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk…

…the deep forearm veins accessible to those who are experienced. Size Colour Approximate flow Typical use : : : : 14 G Orange 250–300 mL/min Massive haemorrhage…

…from adding PCSK9 inhibition to statin therapy when LDL C is ≥1.8 mmol/L. In peripheral arterial disease, addition to statins further reduces major…

…atherosclerotic vascular disease or familial hypercholesterolaemia, addition of bempedoic acid to statin therapy reduced LDL C by approximately 16.5%; the reduction in a subgroup…

…8 mmol/L). Reasonable addition of a non statin agent when LDL C is 55–69 mg/dL (≥1.4 to <1.8 mmol/L)…

…undertaken to maintain or improve physical fitness. Regular physical activity is a central component of cardiovascular prevention and treatment. It is associated with lower cardiovascular…

…a lesion proximal to the first septal perforator of the left anterior descending artery was associated with lower five year survival than a more distal…

…lower C reactive protein, and impair neutrophil chemotaxis toward inflammatory sites. Its cardiovascular effects therefore appear to reflect modulation of vascular inflammation rather than lipid…

…needed to treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy of these interventions is much lower or…

…raise strong suspicion of another or an additional cause [1]. Delirium tremens most often begins after one to three days but can start earlier in…

…cardiovascular risk. Dyslipidaemia may be difficult to interpret during active disease: inflammatory cytokines can lower LDL and HDL concentrations while increasing the atherogenic index, a…

…histology IVUS can provide additional information regarding calcific, fibrotic, fibro fatty, and necrotic components. Virtual histology IVUS has also been used to identify thin cap…

…used as an adjunct to dietary measures and maximally tolerated statin therapy, with or without other LDL C lowering drugs, when additional LDL C reduction…

…under acute coronary syndromes (ACS). Aortic dissection Pneumothorax Pulmonary embolism Mediastinitis (rare condition) In addition to these five conditions, there are numerous other causes of…

…exercise capacity (and VO2 max , see below). In addition to exercise capacity, stress testing also provides information on electrocardiographic (ECG) reaction, the occurrence of arrhythmias…

…gel is recommended. In addition to the gel, it is important to apply some pressure when holding the transducer against the skin. Patients with extensive…

…contractility. Analogous electrophysiological changes occur within the sinus and atrioventricular (AV) nodes. In addition to these direct effects, adenosine antagonizes catecholamine stimulated adenylate cyclase. This…

…ventricular function is therefore an important therapeutic objective. Exercise intolerance Exercise limitation is multifactorial. In addition to elevated exercise induced filling pressures, patients may have:

…refined. Similarly, the development of transesophageal echocardiography (TEE) has been extremely valuable. Echocardiography is used to assess the morphology of valves, the presence of vegetations…

…pacing. 25 mm/s. In addition to stimulation artifacts, ventricular pacing yields wide QRS complexes with LBBB morphology (i.e left bundle branch block appearance)…

…Effusion: fluid in the pericardial space Normally, the pericardial sac contains 25 to 50 ml of liquid. This volume is so small that the pericardial…

…EMS) is trained in BLS. It is increasingly common to dispatch first responders to OHCA, in addition to ambulances. Chest compressions are prioritized above ventilations…

…valvular regurgitation and defects in the atria or ventricles (Figure 2). In addition, color Doppler can be used to align the continuous Doppler. Figure 2…

…myocardial territory through the left anterior descending (LAD) and left circumflex (LCx) arteries (Figure 1). Acute obstruction can lead to rapid hemodynamic deterioration, cardiogenic shock…

…high value As required, in addition to the mealtime dose Never stop basal insulin in a person with type 1 diabetes , not even before fasting…

…Additional pharmacological options include quinidine, ranolazine, and procainamide [4]. Catheter Ablation : Catheter ablation may be employed as an interventional alternative to suppress the arrhythmia [4…

…The diagnosis requires elevated levels of cardiac troponins. In addition to elevated troponins, the patient must display either symptoms or ECG changes consistent with myocardial…

…duration of 120 ms (0.12 s) or more is required to diagnose a complete left bundle branch block . In addition to prolonged QRS duration…

…to these superficial injections. Preparation and equipment Chlorhexidine in alcohol, an iodine solution or isopropyl alcohol. A depot glucocorticoid: triamcinolone hexacetonide (Lederspan 20 mg/mL…

…heart disease and GUCH Complex malformations often require intervention (surgical or catheter based intervention). In addition to the malformation, these subjects frequently develop associated complications…

…after hospitalization for heart failure is 60%, which is comparable to common cancers ( Stewart et al ). In addition, heart failure is a disabling condition with…

…after hospitalization for heart failure is 60%, which is comparable to common cancers ( Stewart et al ). In addition, heart failure is a disabling condition with…

…inventions of the 20th century. Cardiac pacing has evolved from a hazardous experiment in the 1930s, to a routine, safe, and sophisticated treatment used worldwide…

…without any recurring costs. Purchasing this membership grants you permanent access to the website and there are no additional costs and no recurring costs. Ever.

…in the precordial (chest) leads. Pointed T waves are tall and narrow at the top. Refer to Figure 1 . Patients with left ventricular hypertrophy may…

…earlier identification and treatment of high risk ACS patients. Future randomized trials are needed to validate this paradigm and support its broader adoption. Figure 1…

…L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization, sarcoidosis, thyrotoxicosis, familial hypocalciuric hypercalcemia, Addison…

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

…be universal adoption of the Cabrera format. This recommendation, 1 was issued 16 years ago and fortunately all modern ECG machines can switch to the…

…0.25 mg/mL, one ampoule. A peripheral venous cannula and a saline flush. A tube for serum or plasma cortisol according to local instructions…

…weight, smoking, diet, physical inactivity, and alcohol consumption. Additional considerations include psychosocial stress, obstructive sleep apnoea, social determinants of health, air pollution, family history, ethnicity…

ECG Myocardial ischemia and infarction Using the ECG to localize myocardial infarction and the coronary occlusion Determining the localization of myocardial infarction and ischemia, as…

…exclusively at the infarct related artery (IRA), or it may extend to additional non infarct related lesions. Culprit only revascularization treats the artery responsible for…

…additional mechanisms include vascular stiffness and accelerated medial calcification related to disturbed calcium–phosphate metabolism. Patients with advanced CKD are particularly vulnerable to structural cardiac…

…more patients survive with severe, diffuse CAD that is no longer amenable to additional mechanical revascularization. Despite treatment with antianginal drugs and PCI or CABG…

…where it is stated that it is extremely uncommon to have a non ischemic ECG (absence of ST T changes) during chest pain caused by…

…RVD 2), cm 2.7–3.3 3.4–3.7 3.8–4.1 4.2 Base to apex length (RVD 3), cm 7…

…Brinavess) is administered as an infusion. The infusion is diluted to 4 mg/ml and administered over 10 minutes. A maximum of two infusions can…

…confirmed hypertension generally require BP lowering treatment without additional risk stratification for that treatment decision. Population to which SCORE2 and SCORE2 OP apply SCORE2 and…

…with an eGFR of 30–44 mL/min/1.73 m2 and up to 17% when eGFR is below 30 mL/min/1.73 m2…

…ACS Approximately 20–25% additional reduction compared with simvastatin monotherapy Bempedoic acid plus ezetimibe Approximately 38% reduction PCSK9 inhibitor added to statin therapy Approximately 60…

…CTOs are common among patients undergoing coronary angiography, with reported prevalence ranging from 18% to 52%. They frequently occur in patients with severe coronary artery…

Myocardial ischemia and infarction Definition and pathophysiology Periprocedural myocardial infarction (MI) is myocardial necrosis temporally related to coronary revascularization. It may follow percutaneous coronary intervention…

…and infarction Definition and clinical rationale Stable angina, or chronic chest pain attributable to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of…

…and an additional trigger is required. Potential triggers include thrombus formation and sympathetic activation. Rho kinase may increase vascular smooth muscle sensitivity to calcium by…

…sudden cardiac arrest is common. The following cardiomyopathies lead to dilation of the ventricle: Dilated cardiomyopathy (DCM) Idiopathic or genetic . Ischemic cardiomyopathy Alcoholic cardiomyopathy Diabetic…

…These additional leads are V3R, V4R and V7. V3R and V4R are used in children under the age of 5 years due to the fact…

…possess an additional pathway between the atria and the ventricles. Such pathways may be conductive, such that they can transmit the atrial impulse to the…

…tends to underestimate GFR in individuals with near normal or mildly reduced kidney function (eGFR 60 mL/min/1.73 m²), potentially leading to misclassification…