…anorexia nervosa, or more than 5 days without nutrition. Check the phosphate, potassium and magnesium before and daily during the build up, give thiamine before…

…and thyroid surgeries, as well as medications and agents such as bisphosphonates, calcitonin, citrate (from transfusions), phenytoin, phosphate, and foscarnet, among others. ECG in hypoc

…In CKD, additional mechanisms include vascular stiffness and accelerated medial calcification related to disturbed calcium–phosphate metabolism. Patients with advanced CKD are particularly vulnerable to…

…up At an eGFR below 60, or in the presence of albuminuria: check the potassium, calcium, phosphate, PTH, haemoglobin and bicarbonate , review the medication list …

…Plasma glucose before insulin. Creatine kinase in suspected rhabdomyolysis. Phosphate, urate and lactate dehydrogenase in suspected tumour lysis syndrome. A digoxin level when toxicity i

…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…

…functional ventricular abnormalities and progressive neurohormonal activation. The therapeutic rationale for disease modifying treatment is to reduce mortality, prevent recurrent hospitalization for worsening heart failure…

Cardiology Nephrology Definition and pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months…

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…

Cardiology Coronary Atherosclerosis Coronary atherosclerosis is a chronic, progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

Cardiology Endocrinology & metabolism Definition and pathophysiology Obesity is a chronic, relapsing and biologically complex disease characterized by excessive accumulation of adipose tissue. It is an…

Cardiology Evaluation and management of stable coronary artery disease Chronic coronary syndromes (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris…

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…

ECG Evaluation and management of stable coronary artery disease Chronic coronary syndrome (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris…

Myocardial ischemia and infarction Pharmacology & dosing Definition and therapeutic objectives Antianginal therapy in chronic coronary syndrome (CCS) is directed primarily at reducing myocardial ischaemia and…

…be selected according to clinical judgement. Low to moderate probability: greater than 5% to 50% in the chronic coronary syndrome pathway. Coronary CT angiography (CCTA…

Cardiology Clinical medicine Definition and clinical classification Hypertensive disorders of pregnancy comprise chronic or pre existing hypertension, gestational hypertension, and preeclampsia. Collectively, they affect approximately…

Cardiology Myocardial ischemia and infarction Definition and Pathophysiology Refractory angina is a chronic syndrome of persistent ischaemic symptoms despite the exhaustion of conventional therapeutic options…

Echocardiography Constrictive pericarditis: the end stage of pericardial inflammation Constrictive pericarditis is the result of chronic inflammation of the pericardium. In principle, all causes of…

CPR It is commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being…

…how acute the condition is. A patient with a chronic plasma sodium of 112 mmol/L may be relatively unaffected, while a rapid fall from…

…therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial…

…heart failure, and chronic kidney disease (CKD). These agents interfere with the renin angiotensin aldosterone system (RAAS) by inhibiting the enzyme responsible for the conversion…

…extensive MI with necrosis and scar formation Diffuse myocardial fibrosis Reversible ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic stunning Adverse left ventricular (LV…

…chronic coronary syndrome (CCS), peripheral artery disease (PAD), and acute coronary syndromes (ACS). Its principal therapeutic objective is reduction of low density lipoprotein cholesterol (LDL…

…acute when serial measurements demonstrate a rise and/or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction…

…recommended criterion for precapillary PH, partly because this value has been used in therapeutic studies of pulmonary arterial hypertension (PAH). The threshold is not absolute…

…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…

…further reducing myocardial workload. Levosimendan is used in severe acute or chronic heart failure. Consider urgent angiography in patients with unknown etiology for acute severe…

…steroids and controlled oxygen. Acute on chronic hypercapnic failure in obesity hypoventilation and neuromuscular disease. Hypercapnic failure in cardiogenic pulmonary oedema that does not improve…

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

…ankle brachial index before the first bandage is applied . Indications Venous leg ulcer — about 70% of all leg ulcers. Chronic venous oedema, lipodermatosclerosis, stasis dermatitis…

…for pain). An opioid is rarely the right choice in nociplastic or neuropathic pain, in chronic non cancer pain, or in headache. A failure to…

…coach actively, and do not accept a trace you would not be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea, wheeze or…

…Indications Acute urinary retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of urine output in a…

…risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease, hay fever, or nasal polyps (increased risk of hypersensitivity…

…1.73 m². Advantages of MDRD eGFR Clinical utility: The MDRD equation has been instrumental in identifying and staging chronic kidney disease (CKD), facilitating early…

…HF), acute Heart failure (HF), chronic Bradycardia (second line alternative) Medium dose : 3.0 10.0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1…

…including the number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions (CTOs), calcification, and thrombus presence. These factors are weighted…

…Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive Pulmonary Disease (COPD) : Associated with higher perioperative risk. Clinical Applications Personalized Decision Making : SYNTAX Score II…

…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…

… prevent stent thrombosis after PCI; reduce recurrent atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant…

…circumstances where diabetes specific risk assessment or risk categorization is applicable Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or…

…with downstream effects involving interleukin 6 and C reactive protein, has been a major therapeutic target. This concept is clinically relevant because cardiovascular risk may…

…or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular dysfunction and/or MVD…

…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…

…major or life threatening bleeding. The clinical presentation, whether ACS or chronic coronary syndrome (CCS). Whether and how PCI was performed. The need for non…

…Place in lipid lowering therapy General treatment sequence High intensity statin therapy remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome…

…of ischaemia represents acute myocardial injury rather than MI. Persistent elevation without a significant dynamic change is consistent with chronic myocardial injury. Non ischaemic conditions…

…angina caused by disease in the treated segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS), acute coronary syndrome (ACS)…

…major adverse cardiovascular events (MACE), heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), and peripheral artery disease (PAD). Figure 1 (below) shows…

…activity therefore contributes to higher LDL C concentrations. The genetic evidence provides the rationale for therapeutic inhibition. Gain of function PCSK9 mutations are associated with…

…manifest as exertional symptoms, or progress to chronic limb threatening ischaemia (CLTI). Clinical presentation and symptoms Asymptomatic and atypical disease Fewer than half of patients…

…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…

…does not produce a proportional reduction in cardiovascular harm. Complete cessation is therefore the preferred therapeutic endpoint. The cardiovascular benefits of cessation extend across primary…

…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…

…including: Cardiac causes Systemic causes Heart failure Sepsis Myocarditis Chronic kidney disease Cardiomyopathy Stroke or subarachnoid haemorrhage Takotsubo syndrome Pulmonary embolism Recent coronary revascularization Infiltrative…

…regurgitation are aortic dissection , endocarditis and trauma . Chronic aortic regurgitation If aortic regurgitation develops gradually, then the ventricle will adapt to the volume overload. Unfortunately…