…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…

…to fluid retention and worsening congestion The clinical course may be chronic and relatively stable or punctuated by episodes of worsening heart failure requiring hospitalization…

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…

…Conversely, an angiographically identified CTO without demonstrable ischaemia or viable myocardium provides a less compelling basis for intervention. The source material does not provide a…

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…

…are lower or otherwise modified in some populations. Cardiometabolic mechanisms Visceral and ectopic fat are particularly relevant to cardiovascular risk. Excess adipose tissue promotes: Chronic…

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…

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

…to 50% in the chronic coronary syndrome pathway. Coronary CT angiography (CCTA) is generally preferred to exclude obstructive CAD. Intermediate or high probability: above 15…

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…

…attempted chronic total occlusion recanalization. Patient preferences concerning additional medication, invasive investigation, and device based treatment. Refractory angina should be distinguished from symptoms caused or…

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…

… 2. Is the hyponatraemia acute or chronic? Severe symptoms require immediate treatment with hypertonic sodium chloride, whether the hyponatraemia is acute or chronic. The aim…

…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 causing chronic refractory cough, akin to chronic neuropathic pain. This syndrome presents with a dry or minimally productive cough and a tickle or sensitivity…

…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…

…therefore heterogeneous. Irreversibly scarred regions may alternate with viable segments that are dysfunctional because of repeated ischemic episodes or chronic reductions in perfusion. The amount…

…component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS), peripheral artery disease (PAD), and acute coronary syndromes…

…reference limit. It is classified as acute when serial measurements demonstrate a rise and/or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury…

…disease, left sided cardiac disease, chronic lung disease or hypoxia, chronic thromboembolic obstruction, or a range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis…

…the tamponade develops acutely or subacutely. It is uncommon for chronic pericardial effusions to cause sudden cardiac arrest since these cases tend to be recognized…

…2021; 385:516 525 Indications Severe left ventricular failure, acute or chronic. Severe biventricular failure, acute or chronic. Severe left ventricular failure post myocardial infar

…the IPAP against hypercapnia SpO₂ 88–92% Hypoxaemic failure without hypercapnia CPAP or high flow nasal oxygen 5–10 cmH₂O According to oxygenation requirement SpO₂…

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

…Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h…

…infection — all chronic wounds are colonised, and a culture taken without clinical suspicion leads only to unnecessary antibiotics. 5. Biopsy any ulcer that has not…

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

…height without shoes, the weight, the age, the sex and the ancestry before the measurement; the reference values are based on them. In kyphosis, 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…

…kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease…

…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…

…Tissue ischemia (high doses or extravasation) Dopamine high dose Cardiogenic shock Vasodilatory shock Heart failure (HF), acute Heart failure (HF), chronic Bradycardia (second line alternative…

…disease or left main coronary artery disease . It integrates multiple variables, including the number of lesions, their location, and specific characteristics such as bifurcations, chronic…

…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…

…mg once daily after ACS or STEMI. Aspirin 75–162 mg once daily is described as an acceptable secondary prevention range in chronic coronary disease…

…or both. A person may also be considered at increased cardiovascular risk without a calculated SCORE2 or SCORE2 OP estimate when certain clinical conditions are…

…therapy alongside standard treatment. Interleukin 1β inhibition Canakinumab reduced inflammatory biomarkers without affecting lipids or other major coronary risk factors. In patients with previous…

…PCI of chronic total occlusion lesions may improve angina and quality of life, but randomized trials have not demonstrated reductions in mortality or myocardial infarction…

…with normal renal function, the occurrence of contrast induced AKI is negligible or very low. Risk rises substantially with chronic kidney disease, particularly diabetic kidney…

…including those with NSTE ACS. It applies whether ACS is managed with PCI or without revascularization, although the exact antithrombotic strategy may differ when long…

…Inclisiran, with or without statin therapy Approximately 50% reduction The absolute reduction depends on the pretreatment LDL C concentration and the accompanying lipid lowering regimen…

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

…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…

…FH are principal settings in which these drugs have received approval. In chronic coronary syndrome, the recommended LDL C objective is: LDL C <1.4…

…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…

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

…approximately 30–40% and in death of approximately 35–45%. In chronic coronary syndrome, cessation has been associated with a 36% reduction in premature mortality…

…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…

…with advancing age. Presentations without pain may include: Sudden breathlessness Syncope or sudden loss of consciousness Confusion Profound weakness An arrhythmia Peripheral embolism An ot

…is a rise and/or fall in cTn values. An elevated cTn alone does not establish MI, because myocardial injury may occur without myocardial ischaemia…

…and peripheral artery disease (PAD). Diabetes also substantially increases the risk of chronic kidney disease (CKD), which itself promotes cardiovascular disease and amplifies cardiovascular and…

…prevent, or alleviate, the pressure increase in the left ventricle and left atrium. Chronic aortic regurgitation leads to dilatation and hypertrophy of the left ventricle…

…2), obesity, smoking, obstructive sleep apnea and chronic obstructive pulmonary disease (COPD). Moreover, certain other tachyarrhythmias predispose to developing atrial fibrillation: atrial flutter, AVNRT and…

…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…