…clinically silent. The underlying coronary disease may be obstructive or non obstructive. Atherosclerotic plaque accumulation in the epicardial arteries is a major pathological substrate, but…

…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…

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…

…chronic and mostly progressive disease. NSTE ACS (Non ST Elevation Acute Coronary Syndrome) : NSTE ACS is an acute condition that occurs when an atherosclerotic plaque…

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…

…chronic and mostly progressive disease. NSTE ACS (Non ST Elevation Acute Coronary Syndrome) : NSTE ACS is an acute condition that occurs when an atherosclerotic plaque…

…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…

…coronary microvascular dysfunction or vasospasm. A normal or non obstructive coronary anatomy does not necessarily exclude an ischaemic mechanism. Clinical assessment and estimation of pre…

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…

…intervention (PCI), including attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has…

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…

…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…

…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…

…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…

…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…

…classification also recognizes vasoreactivity subgroups among patients with idiopathic PAH, including acute responders and non responders. Left heart disease is the most common risk factor…

…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…

…non severe (DS CRB65 0–1) phenoxymethylpenicillin 1 g × 3 PO 5–7 days or benzylpenicillin 3 g × 3 IV Pneumonia, in chronic lung disease…

…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…

…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…

…history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or…

…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…

…used in adults aged ≥70 years. SCORE2 OP accounts for the competing risk of death from non cardiovascular causes, an important consideration in older populations…

…recently recovering from myocardial infarction or acute coronary syndrome. Patients with stable or chronic atherosclerotic coronary disease, many of whom have a previous acute coronary…

…exclusively at the infarct related artery (IRA), or it may extend to additional non infarct related lesions. Culprit only revascularization treats the artery responsible for…

…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…

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

Cardiology Pharmacology & dosing Definition and pharmacological basis Ezetimibe is a non statin lipid lowering agent that inhibits the Niemann–Pick C1 like 1 (NPC1L1) transporter…

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

…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…

…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…

…large epidemiological analysis, mechanical complications occurred in approximately 0.27% of STEMI cases and 0.06% of non ST elevation myocardial infarction cases. Despite their…

…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…

…STEMI). Non ST elevation myocardial infarction (NSTEMI). Unstable myocardial ischaemia. Ventricular arrhythmia or sudden cardiac arrest. Chronic coronary dissection presenting as heart failure, although this…

…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…

…Non ischaemic myocardial injury may accompany numerous cardiac and systemic disorders, including: Cardiac causes Systemic causes Heart failure Sepsis Myocarditis Chronic kidney disease Cardiomyopathy Stroke…

…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…

…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…

…population is 1.0% to 1.5%. The crude prevalence is lower in non Western countries, primarily due to the younger age composition in those…

…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…