…Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather…

…with gastrointestinal and urogenital tumours Marked renal failure Low molecular weight heparin with dose adjustment, or warfarin Subsegmental pulmonary embolism without deep vein thrombosis An…

…disruption of an atherosclerotic plaque through rupture or erosion. The relative contributions of plaque disease and thrombus vary considerably. Thrombotic material may embolize distally and…

…a chronic and serious condition. Mortality in pulmonary embolism is up to 20%, and roughly 30% of patients with pulmonary embolism or deep vein thrombosis…

…smooth muscle cell dysfunction, and dysregulation of sympathetic innervation), coronary embolism, and spontaneous coronary artery dissection with or without intramural haematoma. Spontaneous coronary artery dissection…

…but also by the vulnerability of the myocardium and coronary microcirculation. Endothelial dysfunction promotes leukocyte and platelet activation and interaction. Thrombotic debris may worsen microvascular…

…supply and demand. The universal classification distinguishes infarction according to its mechanism: Type 1 myocardial infarction: acute atherosclerotic plaque disruption or erosion with coronary thrombosis…

…Thromboembolism is a leading cause of death worldwide (1). Emboli originating in the atria, left atrial appendage (LAA), ventricles, valves, and proximal aorta can cause…

…Pericardial disease, including constriction Right ventricular dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies, particularly cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac amyloidosis, BNP…

CPR Cardiac arrest is a result of tachyarrhythmia, bradyarrhythmia or asystole. The tachyarrhythmias include ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include…

…ventricular activity. Fortunately, the treatment of atrial fibrillation has come a long way. Treatment with anticoagulation is highly effective in reducing stroke risk. Wrfarin and…

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

…ventricular fibrillation), whose occurrence is highly stochastic. This is evident from the fact that the vast majority of all myocardial infarctions and episodes of myocardial…

…hypercapnic respiratory acidosis, if invasive ventilation is not immediately required. 8. Document the ceiling of care and the decision on intubation early. Initial assessment Confirm…

…RAD) and left axis deviation (LAD) Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale…

…RAD) and left axis deviation (LAD) Causes of right axis deviation Normal in newborns. Right ventricular hypertrophy. Acute cor pulmonale (pulmonary embolism). Chronic cor pulmonale…

Cardiology Myocardial ischemia and infarction Definition and Pathophysiology Chronic coronary syndromes (CCS) comprise the clinical manifestations of chronic structural and/or functional disease involving the…

…The resulting haemodynamic congestion produces a characteristic clinical phenotype of breathlessness, fatigue and oedema. This definition does not depend on left ventricular ejection fraction (LVEF)…

…cardiac and renal axes may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is particularly associated with elevated central venous pressure…

…left ventricular ejection fraction, procedural factors and anticipated outcomes. The supplied material does not describe specific physical signs of CTO or a dedicated physical examination…

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…

…is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction, immune cell recruitment, extracellular matrix remodelling, and thrombosis interact…

…Chronic, low grade systemic inflammation Insulin resistance Abnormal adipokine signalling Endothelial dysfunction Dyslipidaemia A prothrombotic state Albuminuria and declining estimated glomerular filtration rate Development of…

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…

…atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial accumulation of apolipoprotein B containing…

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…

…in patients with reduced left ventricular ejection fraction (LVEF). They are also recommended in patients within one year of MI and in those with LVEF…

…and infarction Definition and clinical rationale Stable angina, or chronic chest pain attributable to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of…

…and thrombocytopenia—is generally regarded as a severe preeclamptic phenotype or variant. Pathophysiology The precise mechanism of preeclampsia remains incompletely established. Proposed contributors include chronic…

…of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has identified the relevant endotype and…

…usually unaffected, but the shock volume and ejection fraction (EF) may be reduced because the end diastolic volume of the ventricle (EDV) is reduced. Constrictive…

…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…

…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…

…dosing Definition and Pathophysiology Angiotensin converting enzyme (ACE) inhibitors are foundational therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart…

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

…to chronic LV systolic dysfunction and HF Angina, although its absence does not exclude ischemic cardiomyopathy Symptoms related to recurrent ischemia Symptoms associated with ventricular…

…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…

…most common risk factor for PH. It produces postcapillary PH through elevation of left atrial and pulmonary venous pressure. In some patients, chronic postcapillary pr

…chronic pericardial effusions to cause sudden cardiac arrest since these cases tend to be recognized and managed before circulatory collapse occurs. The leading causes of…

…concurrent use of beta blockers. The vasodilating effect reduces preload and afterload, further reducing myocardial workload. Levosimendan is used in severe acute or chronic heart…

…for the device available on the unit. Preparation and equipment A device capable of both CPAP and bilevel ventilation, or alternatively flow generated CPAP with…

…10 days Clostridioides difficile, high risk of recurrence fidaxomicin 200 mg × 2 PO 10 days In appendicitis, cholecystitis, diverticulitis and pancreatitis, antibiotics are given only…

…kPa) and avoidance of hypoxia, since hypercapnia raises the intracranial pressure. Circulation Parameter Target Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or…

…of all leg ulcers. Chronic venous oedema, lipodermatosclerosis, stasis dermatitis. Prevention of recurrence after a healed venous ulcer. After deep vein thrombosis with post thrombotic…

…depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given for the pain…

…Instillation therapy and contrast studies of the urinary tract. Wound healing with a sacral pressure sore or extensive perineal wounds where urinary leakage prevents healing…

…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…

…surface area of 1.73 m². Advantages of MDRD eGFR Clinical utility: The MDRD equation has been instrumental in identifying and staging chronic kidney disease…

…electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors…

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

…both anatomical (from the original SYNTAX Score) and clinical variables (e.g., age, sex, renal function, left ventricular ejection fraction) to provide a more personalized…

…or chronic, when troponin elevation persists without such a change. Myocarditis, sepsis, takotsubo cardiomyopathy, valvular disease, arrhythmias, and heart failure are among the conditions associated…

…reduce ischaemic stroke and cardiovascular mortality; prevent stent thrombosis after PCI; reduce recurrent atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention…

…adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast…

…the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes. Mechanisms of action Colchicine Colchicine appears to exert several…

…and ischaemia related ventricular failure as potential causes of shock. Patients with moderate to severe chronic kidney disease have a higher burden of comorbidity and…

…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…

…whether ACS or chronic coronary syndrome (CCS). Whether and how PCI was performed. The need for non cardiac surgery. The presence of an indication for…

…remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease, and other very high…

…is consistent with chronic myocardial injury. Non ischaemic conditions, including myocarditis, rapid ventricular rate atrial fibrillation, marked anaemia, hypertensive emergency, heart failure, and end stage…