…fitness or individual health status. In particular, it cannot distinguish adipose tissue from lean mass. Waist circumference and the waist to hip ratio provide additional…

…may be clinically important in individuals at high or very high risk. Prolonged exposure to lower LDL C concentrations is associated with lower ASCVD risk…

…the fine needle is in addition the only one that will go in. The rule that saves time is simple: two attempts or 90 seconds —…

…Clinical Indications PCSK9 inhibitors are used as additional lipid lowering therapy in patients whose LDL C remains above the recommended goal despite maximally tolerated statin…

…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…

…directed therapies. Anti inflammatory treatment seeks to reduce this residual risk without necessarily altering lipid concentrations, blood pressure or other conventional risk factors. Colchicine is…

…17%–25% In patients with atherosclerotic vascular disease or familial hypercholesterolaemia, addition of bempedoic acid to statin therapy reduced LDL C by approximately 16.5…

…much lower or uncertain. Indeed, the greatest opportunities for survival exist during the first few minutes from collapse. Table 1 shows the number needed to…

…products and sweets. An umbrella review incorporating observational studies and randomized trials reported associations between greater adherence to a Mediterranean diet and lower risks of

…with ACS to reduce major adverse cardiovascular events. Therapy should preferably begin before planned percutaneous coronary intervention when feasible. Patients already taking low or moderate…

…focal seizures or status epilepticus should raise strong suspicion of another or an additional cause [1]. Delirium tremens most often begins after one to three…

…scale IVUS include lower spatial resolution than OCT and imperfect discrimination between plaque components. Radiofrequency or virtual histology IVUS can provide additional information regarding calcific…

…lowers non HDL C by up to approximately 50% and apolipoprotein B by approximately 20–40%. Effects on triglycerides and lipoprotein(a) are variable or…

…condition) In addition to these five conditions, there are numerous other causes of chest pain, but the other causes are either subacute or non acute…

…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…

…the contact surface between the transducer and the skin. Generous use of gel is recommended. In addition to the gel, it is important to apply…

…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:

…drug users (intravenous addiction), elderly patients with altered valves, patients with valve prostheses or other cardiac devices (pacemaker, CRT, ICD). In addition to staphylococcus aureus …

…be visible in one or a few leads. Figure 1. Stimulation artifact (red arrows) in ventricular pacing. 25 mm/s. In addition to stimulation artifacts…

…In addition to echocardiography, ECG and clinical examination, blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or…

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

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

…therefore critical. The 12 lead electrocardiogram (ECG) is an immediately available diagnostic tool that can provide essential clues to LMCA occlusion or critical stenosis. This…

…required, in addition to the mealtime dose Never stop basal insulin in a person with type 1 diabetes , not even before fasting or an investigation…

…multiple QT prolonging medications, and drug accumulation secondary to renal or hepatic impairment or the inhibition of cytochrome P450 metabolism [1]. Nonmodifiable risk factors encompass…

…levels of cardiac troponins. In addition to elevated troponins, the patient must display either symptoms or ECG changes consistent with myocardial infarction/ischemia. Most patients…

…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…

…hypersensitivity to the preparations. Relative: Poorly controlled diabetes — expect a raised blood glucose for 2–5 days. Suspected or known tendon rupture. No response to…

…catheterization. Principles of management of congenital heart disease and GUCH Complex malformations often require intervention (surgical or catheter based intervention). In addition to the malformation…

…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.

…duration of exposure to cardiovascular risk factors. Primary prevention Primary prevention targets people without clinical CVD who nevertheless have established risk factors or an elevated…

…For instance, administering nitroglycerin to alleviate ischemic chest pain may lead to hemodynamic collapse in patients with right ventricular ischemia or infarction. Recognizing ECG signs…

…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…

…cardiovascular effects. Diabetes may also contribute to arrhythmogenesis through diabetic neuropathy and adverse metabolic effects, independently of coexisting CAD, previous myocardial infarction or HF. Nevertheless…

…Response to current antianginal therapy. Adverse effects that restrict further drug escalation. Previous PCI, CABG, or attempted chronic total occlusion recanalization. Patient preferences concerning additional…

…refer to ECG leads or Additional leads in acute myocardial infarction). Importance of performing ECG during ongoing chest pain It is of paramount importance to…

…Base to apex length (RVD 3), cm 7.1–7.9 8.0–8.5 8.6–9.1 9.2 RVOT DIAMETER Above aortic…

…should be completed, even if the patient reverts to sinus rhythm. Th e infusion must be aborted if hypotension or bradycardia occurs. A defibrillator should…

…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…

…injury is an acute deterioration in renal function occurring after exposure to iodinated contrast media, particularly during cardiovascular angiography, computed tomography, or percutaneous coronary intervention…

…those with statin intolerance or persistent failure to reach goal. For statin intolerant patients, ezetimibe may be used initially. If LDL C remains above target…

Myocardial ischemia and infarction Definition and pathophysiology A chronic total occlusion (CTO) is a complete or nearly complete coronary arterial obstruction that has persisted for…

…concentration is above the 99th percentile upper reference limit, it must be stable or falling before a subsequent rise can reliably be attributed to acute…

…CCTA) is generally preferred to exclude obstructive CAD. Intermediate or high probability: above 15% in the chest pain pathway. Either CCTA or functional imaging is…

…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…

…DCM) Idiopathic or genetic . Ischemic cardiomyopathy Alcoholic cardiomyopathy Diabetic cardiomyopathy Takotsubo cardiomyopathy Tachycardia induced cardiomyopathy Non compaction cardiomyopathy Peripartum cardiomyopathy Cardiomyopathy secondary to valvular heart…

…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…

…variable dense Size left atrium normal normal or enlarged enlarged Size left ventricle normal normal or enlarged enlarged Additional PISA parameters Mild regurgitation Moderate regurgitation…

…variable dense Size left atrium normal normal or enlarged enlarged Size left ventricle normal normal or enlarged enlarged Additional PISA parameters Mild regurgitation Moderate regurgitation…

…almost not compressible Additional qualitative parameters Mild regurgiation Moderate regurgitation Severe regurgitation Coaptation defect mild moderate severe Size right ventricle normal normal or enlarged enlarged…

…and miscellaneous conditions A novel potentially life threatening cardiac arrhythmia syndrome identified with ECG The ECG may be used to diagnose several cardiac genetic disorders…

…been shown to improve long term cardiovascular outcomes in CCS. General strategy For most patients, initial therapy consists of a beta blocker and/or a…

…with apolipoprotein(a) structure and kringle IV repeat number. Assays show substantial variability, partly because apolipoprotein(a) isoform size can lead to underestimation or ov

…with myocardial infarction. Cardiac troponin identifies injury to myocardial cells, but infarction requires additional clinical evidence that the injury resulted from acute myocardial ischaemia. Thus…