…as limb complications. Atherosclerotic lesions generally affect large and medium sized arteries. Pathological features include plaque formation with calcium deposition, medial thinning, destruction of muscular…

…ischemia: ischemic ST segment & T wave changes This chapter discusses typical and atypical changes in the ST segment and the T wave during myocardial ischemia…

…g × 4 IV Pneumonia, suspected atypical pathogen erythromycin 500 mg × 4 PO 5–7 days or doxycycline 200 mg × 1 (day 1), then 100 mg…

…renal function Formula Used for : : CKD EPI 2021 (creatinine) The first choice for eGFR in adults Cystatin C based eGFR With an atypical muscle mass…

…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…

…older adults with markedly limited physical activity. Traditional labels such as “typical” and “atypical” angina have limited value, particularly in patients with microvascular dysfunction or…

…ACS is generally similar to that in non pregnant patients, although symptoms may be atypical. Pregnant patients with SCAD may have a more severe presentation…

…to infarct volume than to transmurality. Clinical Presentation and Symptoms Typical presentation Pain is the most frequent presenting symptom. It is generally deep and visceral…

…the same symptoms and events. Perhaps the most distinguishing feature was the characteristic ST segment elevations in leads V1–V3. Prevalence and genetics of Brugada…

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

…presence of myocardial necrosis. NSTEMI is confirmed by a typical rise and/or fall of high sensitivity cardiac troponin (hs cTn), with at least one…

…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…

…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…

…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…

…wards a substantial proportion of older patients are affected, and the incidence is particularly high after hip fracture, major surgery and intensive care [1,2…

…Intraosseous access (absolute, for the bone in question): A fracture of the bone to be punctured, or a major injury proximal to the puncture site…

…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…

…or cardiogenic shock. Features that favour ACS rather than chronic stable angina include sudden symptom onset at rest or with minimal exertion, symptoms lasting at…

…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…

…disease modifying strategy applies to symptomatic HFrEF. Clinical presentation and symptoms Typical manifestations reflect pulmonary and systemic congestion, reduced forward cardiac output and limited exercise…

… and additional nephrotoxic exposures. The typical biochemical pattern is a rise in serum creatinine beginning 24–48 hours after exposure, with a peak at approximately…

…considerably. Symptoms of systemic venous congestion include: Peripheral edema Rapid weight gain Increasing abdominal girth Early satiety Bendopnea Abdominal ascites Older patients may present atypically…

…an uncommon cause of acute chest pain but carries a particularly high mortality when diagnosis is delayed. The typical presentation is sudden onset, severe chest…

…Intravascular imaging can identify plaque disruption, thrombus and other structural features that may not be evident on angiography alone. It is particularly useful when ACS…

ECG Introduction to ECG interpretation Physiology and ECG features of the P wave, PR interval and PR segment The P wave ECG interpretation usually starts…

…haemodynamic deterioration. Inferior infarction is associated with basal septal perforation and a worse prognosis than the typically apical defect associated with anterior infarction. Ventricular free…

…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…

…hepatic uptake and disposition. Clinical presentation and symptoms Typical SAMS consists of: Symmetric muscle pain Muscle aching or soreness Weakness, often perceived or functional Predominant…

…Figure 1. Typical atrial flutter. The atrial rate (i.e the rate measured between flutter waves) typically ranges between 250 and 350 beats per minute…

…thiazide administration, and over supplementation of calcium and vitamin D. ECG in hypercalcemia Typical ECG changes: Shortened QT interval. Attenuated T wave amplitude. Prolonged QRS…

…of collapse. Pericardiocentesis , performed using a large needle introduced either via the subxiphoid or apical window, is generally considered less effective than thoracotomy. This is…

…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…

…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…

…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…

…system (His Purkinje network), which results in rapid impulse transmission and thus shorter QRS duration (as compared with apical pacing). Because ventricular pacing results in…