…typical” and “atypical” angina have limited value, particularly in patients with microvascular dysfunction or vasospasm. Angina associated with microvascular disease or vasomotor abnormalities may not…

…Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced…

…in chronic lung disease amoxicillin 750 mg × 3 PO 5–7 days or benzylpenicillin 3 g × 4 IV Pneumonia, suspected atypical pathogen erythromycin 500 mg…

…Chronic limb threatening ischaemia CLTI occurs when resting perfusion is insufficient to meet the basal nutritional requirements of tissue. Typical symptoms include: Ischaemic rest pain…

…when marked hormonal changes occur. Hypertension and oestrogen exposure. Emotional or chronic mental stress. Fibromuscular dysplasia (FMD), which may produce arterial wall abnormalities and intramural…

…morning within several hours of awakening has been described. Atypical and painless presentations Pain is not universal. Painless STEMI is more frequent in people with…

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…

…fatigue and oedema. This definition does not depend on left ventricular ejection fraction (LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the…

…either via the subxiphoid or apical window, is generally considered less effective than thoracotomy. This is because it does not ensure complete drainage of the…

…release that does not fulfil the criteria for ischaemic myocardial infarction. It may be acute, when serial troponin values show a dynamic change, or chronic…

…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…

…collateral circulation. A first or anterior infarction. Single vessel disease without collateral support. Chronic kidney disease, particularly in relation to VSR. Large infarction, especially for…

…is not an absolute rule. While it often holds true for cardiac arrests caused by chronic or acute ischemic heart disease, it is often not…

…practice. Chronic flutter is, however, very rare. Thus, as compared with atrial fibrillation, atrial flutter is not capable of persisting for longer periods of time…

…its etiology, severity (Table 2), and temporal onset. Distinguishing between acute and chronic hyponatremia, based on the rapidity of onset, is of paramount importance. The…

…arch or descending aorta. Stanford type B: does not involve the ascending aorta and includes dissections involving the arch or descending aorta. In the DeBakey…

…part of shared clinical decision making. Pathophysiological and Diagnostic Considerations Angiographic severity and physiological severity do not always correspond. Visual estimation of luminal narrowing may…

…40% that has subsequently improved to 40% under guideline directed medical therapy (GDMT). These patients must be managed as having HFrEF, as their underlying pathophysiology…

…a negative T wave. Lead III may occasionally display an isolated T wave inversion. This is considered normal if the neighboring lead (aVF) does not…

…In such clinical scenarios, an atypical ECG presentation does not definitively exclude a typical flutter circuit utilizing the CTI. Atrial flutter is broadly categorized into…

…and anxiety related disorders. The immediate objective is not simply to establish whether the patient has ACS. It is to determine whether the patient is…

…sudden cardiac death (15%), atypical chest pain (30%) and dyspnea (10%). The major ECG findings in ARVC are T wave inversion in V1–V3 (in…

…To conclude, concave ST segment elevation is atypical of ischemia, but they do not rule out ischemia. Other features of ischemic ST segment elevations In…

…activity (PEA). Evaluation and Physical Examination The source material does not provide specific details regarding the physical examination maneuvers for patients with bradycardia. Diagnostics Electrocardiography…

ECG Genetic and miscellaneous conditions Takotsubo cardiomyopathy (broken heart syndrome, apical ballooning syndrome, stress induced cardiomyopathy) Takotsubo cardiomyopathy (broken heart syndrome) is a rather peculiar…

CPR Hyperthermia and malignant hyperthermia Hyperthermia is characterized by a body temperature exceeding the typical range of 36.5 37.6°C (97.7 99.7°F)…

…is an emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint or absent. Take cultures immediately, but never let…

…does not provide a detailed catalogue of specific embolic syndromes. Clinical suspicion should be heightened after: Anterior STEMI. A large or transmural infarction. Persistent apical…

…routine neurological examination is therefore not sufficient to exclude stroke [3]. Step 1: classify by time course and triggers Syndrome Typical course Common or important…

…Skin symptoms may be absent, and circulatory shock does not have to be present for the condition to be serious [1]. Intramuscular adrenaline (epinephrine) is…

…and bicarbonate ≥ 15 mmol/L Hyperosmolality Not required Effective osmolality 300 mosm/kg or total osmolality 320 mosm/kg Typical patient Often type 1 diabetes…

…as SIRVA. Both are avoided with the right landmark and the right needle length. Indications Route Typical drugs Absorption : : : Intramuscular (IM) Vaccines, depot antipsychotics, hydroxocobalamin…

…by rest or nitroglycerin [4], [6]. Presentation Nuances: While typical angina is defined by these characteristics, the presentation can be highly variable, particularly in females…

…not exclude the diagnosis. Findings suggesting pericardial effusion A large effusion may cause: Diminished heart sounds Disappearance of the friction rub Loss of the apical…

…Typical findings include: Jugular venous distension Kussmaul’s sign Hepatomegaly Hypotension, which may or may not be present Markedly reduced cardiac output in severe cases…

…vulnerable plaque” describes an atherosclerotic lesion thought to be susceptible to disruption and thrombosis. Typical features include a lipid rich core, a thin fibrous cap…

…ratio: Blood flow across the mitral valve Flow velocity across the mitral valve is examined in the apical four chamber view (A4C) using pulsed Doppler…

…principles and differences of dilatation and hypertrophy, as well as typical ECG changes seen in atrial and ventricular enlargement. Dilatation is caused by volume (diastolic…

…may be used to diagnose myocardial ischemia and infarction. Symptoms – Patients with acute myocardial infarction may present with typical ischemic chest pain, or with dyspnea…

…types of cardiomyopathies Cardiomyopathy implies that the myocardium is structurally and functionally altered, and the pathological changes are not explained by coronary heart disease, hypertension…

…the left ventricle named basal , mid cavity , and apical . These three parts are divided into a total of 17 segments (Figure 1). Six basal segments…

…for pathological R wave progression is considerably lower than pathological Q waves and guidelines do not state any ECG criteria specific to R wave progression…

…even positioned vertically, which is important to obtain images from apical windows. The patient's left arm should be placed under the patient's head…

…Figure 1. Premature ventricular contraction (complex/beat). Typical appearance. Note the paper speed 50 mm/s (1 large box equals 100 ms). The impulse discharged…

…shaped appendage of the left ventricle. On longitudinal sections (A4C, apical four chamber view), the right ventricle is a triangular structure ( Figure 1 ). Figure 1…

…of objectively demonstrating peripheral arterial disease, and it is needed more often than it is used — not only in claudication, but before every compression treatment…

…is not a diagnostic requirement. Hallucinations, usually visual, disturbed sleep rhythm, anxiety, fear and delusions are common but not obligatory. Psychomotor subtypes Subtype Typical picture…

Procedurer In acute circulatory failure it is not the number of cannulae that matters but the flow per unit time . A large bore, short cannula…

…and constitutes a medical emergency. Rupture may occur without preceding symptoms. Typical acute manifestations include severe pain, hypotension and abdominal tenderness. Leakage or rupture is…

…and long term management. Clinical presentation and symptoms The source material does not describe the typical symptoms or symptom burden of uncomplicated hypertension. It does…

…during acute decompensated heart failure, but worsening renal function does not necessarily indicate reduced cardiac output or impaired renal perfusion. Many patients have preserved cardiac…

…does not show that the P wave in lead II might actually be slightly asymmetric by having two humps. This is often (but not always…

…excitation', and QRS duration ≥140 ms is considered 'Profound nonspecific intra ventricular conduction delay', both of which are not typical normal findings. 5. Which of…

…Gemfibrozil should not be combined with statins because it alters statin absorption, hepatic uptake and disposition. Clinical presentation and symptoms Typical SAMS consists of: Symmetric…

…11 mm Sokolow Lyon's index is the most used index, despite having the lowest sensitivity (20%) of all indexes. The specificity is high ( 85%)…

…5) LAD = left anterior descending artery: proximal segment (6) medial segment (7) apical segment (8) first diagonal branch (D1) (9) second diagonal branch (D2…

…Infections are difficult to heal because the heart valves are not vascularized and therefore it is difficult for the immune system to reach the bacteria…

…ventricular hypertrophy under normal loading conditions. Hypertrophic cardiomyopathy should not be confused with hypertrophy caused by increased loading conditions. Increased ventricular load is mostly caused…

…If stress imaging results are entirely normal, further imaging may not be necessary. Rest Imaging : Conducted after a predefined interval to allow for radiotracer clearance…

…is virtually always 50 beats/min, meaning that any heart rate below 50 beats/min is most likely not paced. An intrinsic heart rate faster…