…state. Patients may remain stable for prolonged periods, but chronic coronary disease can progress or destabilize abruptly, leading to an acute coronary syndrome (ACS). Clinical…

…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…

…process: acute, evolving or chronic The severity of ischaemia and whether infarction has occurred The extent and degree of myocardial involvement The anatomical territory, including…

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…

…of life. The underlying aetiology is heterogeneous. Chronic heart failure evaluation should therefore seek reversible or treatable causes. The source material identifies coronary disease, hypertension…

…It is uncommon for chronic pericardial effusions to cause sudden cardiac arrest since these cases tend to be recognized and managed before circulatory collapse occurs…

…infarction. It may be acute, when serial troponin values show a dynamic change, or chronic, when troponin elevation persists without such a change. Myocarditis, sepsis…

…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…

…occur in one patient. The typical depiction of sudden cardiac death as a gradual transition from sinus rhythm to ventricular tachycardia (VT), to ventricular fibrillation…

…diagnosed cases). Paroxysmal atrial flutter. Chronic atrial flutter. The observant will notice that the classification differs slightly from that of atrial fibrillation. Acute and paroxysmal…

…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…

…Acute: 1–14 days. Subacute: 15–90 days. Chronic: more than 90 days. The central clinical danger is progressive aortic wall disruption, rupture and compromise…

…culprit lesion is present. Clinical Indications Suspected Chronic Coronary Syndrome The decision to perform ICA is based on the clinical likelihood of obstructive CAD, symptoms…

…the escalating prevalence of cardiometabolic comorbidities. The demographic profile of the typical HFpEF patient differs markedly from that of HFrEF. Patients are predominantly older (frequently…

…and V6 should display positive T waves in adults. Lead aVR normally displays a negative T wave. Lead III may occasionally display an isolated T…

…the CTI has been definitively ruled out. Typical flutter is closely related to atrial fibrillation (AF) in clinical practice. Both arrhythmias are associated with similar…

…or non cardiac . The term “atypical” is discouraged because it may understate the possibility of ischaemia. A focused history should establish: Quality of the discomfort…

…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…

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

…is often required to capture symptomatic events. A typical 24 to 48 hour Holter monitor is frequently insufficient. Monitors that offer real time data transmission…

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…

…segment after myocardial infarction (MI). It is particularly associated with extensive anterior or transmural infarction, apical dysfunction, LV aneurysm formation, and reduced LV systolic function…

…3]. Step 1: classify by time course and triggers Syndrome Typical course Common or important causes Targeted examination : : : : Acute vestibular syndrome Acute or subacute onset…

…a known or probable allergen , even if skin symptoms are absent [1,4]. Typical warning symptoms are: hoarseness, stridor, swelling of the tongue or throat…

…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…

…predominantly after larger infarctions and/or delayed reperfusion. Its typical onset is 1–2 weeks after AMI, although descriptions of the syndrome include a broader…

…by manifestations of severe right ventricular failure. Typical findings include: Jugular venous distension Kussmaul’s sign Hepatomegaly Hypotension, which may or may not be present…

…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…

…cardiomyopathy (Dilated Cardiomyopathy, DCM) . Arrhythmogenic Right Ventricular Cardiomyopathy / Dysplasia (ARVC/ARVD) Restrictive Cardiomyopathy (RCM ) Takotsubo cardiomyopathy (broken heart syndrome, apical ballooning syndrome). Non compaction cardiomyopathy

…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…

…increased in order to suggest ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always accompany…

…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…

…Severe ischaemia Urgent vascular surgical assessment Exercise ABI. With a normal or borderline resting ABI but typical claudication, the ankle pressure is measured immediately after…

…sleep rhythm, anxiety, fear and delusions are common but not obligatory. Psychomotor subtypes Subtype Typical picture Clinical significance : : : Hyperactive Agitation, motor restlessness, picking, calling out…

…to those who are experienced. Size Colour Approximate flow Typical use : : : : 14 G Orange 250–300 mL/min Massive haemorrhage, rapid volume replacement 16 G…

…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…

…congestion may be important mechanisms. Diuretics relieve the hemodynamic consequences of congestion by producing a negative sodium and water balance. They can reduce jugular venous…

…will be enhanced. Enlargement of the left and right atria causes typical P wave changes in lead II and lead V1 ( Figure 3 ). Enlargement of…

…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…

…This discrepancy reflects, at least in part, the nocebo effect : negative expectations, contextual cues and attribution of pre existing symptoms to the medication. No single…

…in the left sided leads. It is typical that the ST segment bulges upwards (Figure 1 and 2) in these leads. These ECG changes were…

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

…the presence of vegetations, hemodynamic status, and the extent of endocarditis. Endocarditis gives three typical findings on echocardiography: Vegetations. Abscesses. Prosthetic detachment. These three findings…

…ventricular myocardium varies. Septal hypertrophy, apical hypertrophy and hypertrophy of the left ventricular free wall are common. General hypertrophy is less common. Hypertrophic cardiomyopathy causes…

…in rest images compared to stress images. This pattern contrasts with the typical expectation in myocardial perfusion imaging, where defects are more pronounced during stress…

…activation may proceed in the opposite direction, which results in negative (retrograde) P waves in lead II. QRS Complex QRS morphology also depends on where…