…which is a potentially life threatening condition. Note, however, that any arrhythmia arising in the atria may have wide QRS complexes if the ventricles cannot…

…hypotension and abdominal tenderness. Leakage or rupture is life threatening and requires emergency operation or endovascular repair. AAA may also be associated with mesenteric ischemia…

…than a single apparently reassuring measurement. Finding Moderate attack Acute severe attack Life threatening attack : : : : Speech Full sentences Cannot complete a sentence in one breath…

…itself. It may cause symptoms and impaired quality of life, contribute to heart failure, and increase the risk of stroke and other thromboembolic events. Subclinical…

…arteries. Early lesions may undergo positive or compensatory remodelling, in which the vessel enlarges outward before a major reduction in the lumen becomes apparent. Consequently…

…limited life expectancy. Available randomized evidence has not demonstrated that frailty weakens the cardiovascular benefits of blood pressure lowering among the frailer participants enrolled in…

…diastolic dysfunction) or electrical changes (ST T changes on ECG) become apparent. In contrast, modalities like echocardiography and ECG typically identify ischemia at later stages…

…Conversely, apparently mild lesions may rupture and precipitate myocardial infarction or sudden death. Coronary anatomy must therefore be interpreted within the broader clinical and physiological…

…during vigorous exercise. In AAOCA, high risk anatomical features include an interarterial course between the aorta and pulmonary artery, a slit like orifice, a high…

…remain central. Diagnostic Strategy Initial 12 lead ECG The resting 12 lead ECG is the first line diagnostic test in suspected acute coronary syndrome. It…

…approximately 1 in 100 cases of preeclampsia may progress to eclampsia. Clinical presentation and symptoms The clinical spectrum ranges from hypertension without apparent organ injury…

… and A thiazide or thiazide like diuretic, with all agents prescribed at maximum or maximally tolerated doses. The apparently uncontrolled office blood pressure must be…

…Pharmacology & dosing Definition and pathophysiology Heart failure is a clinical syndrome in which the heart cannot provide blood flow commensurate with the body’s requirements…

…and becomes less steep in later life, although diagnoses may still occur after the age of 65 years. Overall penetrance in cardiomyopathy families may reach…

…ECG interpretation will frequently be a matter of life and death. ECG interpretation is a sophisticated art, even in the current era of artificial intelligence …

…heart disease (CHD) is the most common class of major congenital malformations. CHD occurs in approximately 1% of live births, and 10% of aborted fetuses…

…determined solely by the apparent frequency or duration of documented episodes. The central therapeutic objective is prevention of thromboembolic complications, particularly stroke. In untreated AF…

…cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac amyloidosis, BNP or NT proBNP may be markedly elevated even when overt congestion is not apparent…

…persistent obstruction of the treated epicardial segment. The phenomenon occurs in approximately 2%–3% of PCI procedures overall. It is particularly associated with intervention on…

…MI: MI associated with in stent restenosis. Type 5 MI: MI related to CABG. Type 4b and type 4c events fulfil the criteria for type…

…particularly in patients with resistant hypertension. Dietary sodium and potassium abnormalities and commonly used over the counter medicines may also contribute to apparent treatment resistance…

Conduction defects ECG Myocardial ischemia and infarction Left bundle branch block (LBBB) in acute myocardial infarction (AMI): clinical implications & Sgarbossa criteria Contrary to right bundle…

…outcomes Among participants with diabetes, bempedoic acid produced significant relative and absolute reductions in four component major adverse cardiovascular events. The reported hazard ratio was…

…Cardiovascular events occur earlier, and approximately half of premature deaths in RA may be directly attributable to CVD. Excess mortality becomes apparent approximately 7–10…

…concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of acute coronary syndrome (ACS)…

…or are associated with high event risk. The apparent differences between thresholds reflect different guideline frameworks and clinical pathways rather than a single universal classification…

…the investigation, not the end. In a frail older patient an apparently small insult — sleep deprivation, urinary retention or a new sedative drug, for example…

…Epidemiological studies have often described a J shaped association between consumption and cardiovascular outcomes, with apparently lower overall cardiovascular risk around one drink daily. However…

…acute coronary events during infections: An acute coronary event may be triggered by increased myocardial demand during the infection. Systemic inflammation results in increased levels…

…arterial disease. Heart failure is also considered established clinical CVD in the risk based approach to elevated BP. Risk categories In apparently healthy individuals, SCORE2…

…ventricle may have apparently preserved global systolic emptying while exhibiting impaired relaxation, increased passive stiffness, or both. Consequently, relatively small increases in venous return can…

…substantial mortality, even though incidence and prognosis vary widely between patient groups and care settings [2]. Practical first actions Do the following in parallel, not…

…some lesions with apparently lesser narrowing are physiologically important. Lesion location also matters: stenoses in the left main stem or proximal left anterior descending artery…

…Thus, even a modest absolute reduction may be clinically important in individuals at high or very high risk. Prolonged exposure to lower LDL C concentrations…

…adverse events in virtually all patient populations, including apparently healthy individuals. Exercise stress testing in the age of non invasive cardiovascular imaging Advances in computerized…