…be monitored according to clinical practice. Special attention should be given to patients ≥ 75 years, those with moderate/severe renal impairment, and those concurrently treated…

…remain stable for prolonged periods, but chronic coronary disease can progress or destabilize abruptly, leading to an acute coronary syndrome (ACS). Clinical manifestations may therefore…

…exercise tolerance Peripheral oedema Symptoms related to fluid retention and worsening congestion The clinical course may be chronic and relatively stable or punctuated by episodes…

…comparable renal impairment. The cardiovascular burden of CKD extends beyond CAD to peripheral arterial disease, cerebrovascular disease, valvular heart disease, heart failure, atrial fibrillation, and…

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…

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

…modified in some populations. Cardiometabolic mechanisms Visceral and ectopic fat are particularly relevant to cardiovascular risk. Excess adipose tissue promotes: Chronic, low grade systemic inflammation…

…artery disease Chronic coronary syndromes (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris , has traditionally been defined and managed as…

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…

…artery disease Chronic coronary syndrome (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris , has traditionally been defined and managed as…

…according to blood pressure, heart rate, left ventricular function, comorbidities, concomitant medications, potential drug interactions, the presumed mechanism of ischaemia, patient preferences, local availability, and…

Cardiology Myocardial ischemia and infarction Definition and clinical rationale Stable angina, or chronic chest pain attributable to suspected chronic coronary syndrome, is evaluated by estimating…

…Maternal and obstetric complications Immediate maternal complications include placental abruption, stroke, multiple organ failure, disseminated intravascular coagulation, pulmonary oedema, hepatic complications, renal impairment, and cerebrovascular…

…It is defined by symptoms lasting more than 3 months and attributable to established reversible myocardial ischaemia in either of two settings: Obstructive coronary artery…

…during inhalation, which lowers pressure in the pulmonary veins and left atrium; this facilitates blood flow from the pulmonary veins to the left atrium. In…

…The discrepancy between traditional figures and recent studies is due to the dramatic decrease in the incidence of acute coronary syndromes over the past decades…

…management: 1. Does the patient have severe neurological symptoms that may be due to the hyponatraemia? 2. Is the hyponatraemia acute or chronic? Severe symptoms…

…renal function. Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to…

…and upper airway. Due to the risk of airway compromise, it represents a medical emergency. Evaluation and Physical Examination The evaluation of chronic cough in…

…or electrophysiology in relation to ACE inhibitor therapy. Biomarkers and Laboratory Findings Monitoring renal function and potassium is a critical component of ACE inhibitor therapy…

…include: Symptoms attributable to chronic LV systolic dysfunction and HF Angina, although its absence does not exclude ischemic cardiomyopathy Symptoms related to recurrent ischemia Symptoms…

…the usually modest anatomical regression of coronary atherosclerosis. The magnitude of LDL C reduction varies according to the statin, dose, and individual response. In general…

…rise and/or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction. Cardiac troponin identifies injury to myocardial…

…to left heart disease Group 3: PH due to chronic lung disease, hypoxia, or sleep disordered breathing Group 4: Chronic thromboembolic pulmonary hypertension (CTEPH) and…

…is explained by the elevated intrapericardial pressure due to the tamponade. The increased pressure causes compression of the atria and the ventricles (particularly the former…

…and initiation of renal replacement therapy. The study found no significant differences between the two treatment groups with respect to either the primary or secondary…

…method and settings Condition Method Starting pressure Escalation Oxygen target : : : : : Cardiogenic pulmonary oedema CPAP 5–7.5 cmH₂O Increase in steps of 2.5 to…

…are pregnancy and the period before a urological procedure. A positive urine dipstick in an older patient is difficult to interpret. Skin and soft tissue…

…70 mmHg CPP = MAP − ICP RASS −2 to 0 Lightly sedated to awake and calm CAM ICU Negative Screen for delirium every shift BIS…

…to compression The ankle brachial index measured with Doppler determines whether compression may be applied at all, and if so at what pressure. Palpable foot…

…on the bowel must be taken into account). Known allergy to the preparation — rare; itching and urticaria are usually due to histamine release, not allergy…

…be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea, wheeze or reduced exercise capacity. Suspected asthma or COPD — diagnosis and follow up…

…resistance, and never catheterising urethrally when urethral injury is suspected. Indications Acute urinary retention. Chronic urinary retention with renal impairment or a large residual volume…

…acid inhibits renal excretion, increasing plasma levels. Monitor levels and adjust doses as needed. Valproic acid: Acetylsalicylic acid may reduce valproate binding to serum albumin…

…been instrumental in identifying and staging chronic kidney disease (CKD), facilitating early intervention and management. Standardization: Its widespread adoption has led to standardized reporting of…

…and additionally severe hypertension (caution if patient on nonselective beta blockers). Dobutamine Cardiogenic shock Bradycardia (second line therapy) Stress testing (due to induced increase in…

…to 0.76). Lack of Clinical Variables : The original SYNTAX Score focuses solely on anatomical factors, ignoring clinical variables such as age, diabetes, and renal…

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

…and heart failure are among the conditions associated with myocardial injury. Relationship to chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations…

…MI are to: prevent recurrent MI; reduce ischaemic stroke and cardiovascular mortality; prevent stent thrombosis after PCI; reduce recurrent atherothrombotic events in chronic coronary disease…

…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…

…inflammatory effects relevant to coronary disease: Reduction of inflammasome activation. Inhibition of interleukin 1β related inflammatory signalling. Reduction of interleukin 6 and C reactive…

…also influenced by anatomic complexity and comorbidity, which themselves may contribute to progression of native coronary artery disease. The chronic total occlusion is an important…

…min/1.73 m2 and up to 17% when eGFR is below 30 mL/min/1.73 m2. In patients with relatively normal renal function…

…undergoing PCI for ACS, prasugrel should be considered in preference to ticagrelor, although the comparative evidence between prasugrel and ticagrelor is conflicting. A 12 month…

…a patient is unable to tolerate any statin regimen. The treatment sequence for patients with chronic coronary syndrome is: Lifestyle intervention and a maximally tolerated…

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

…segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS), acute coronary syndrome (ACS), myocardial infarction, and repeat target lesion revascularization…

…heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), and peripheral artery disease (PAD). Figure 1 (below) shows weight loss effects of novel…

…C by approximately 50–60%, including in patients receiving background statin therapy and in those unable to tolerate statins, provided that hepatic LDL receptor expression…

…perfusion is insufficient to meet the basal nutritional requirements of tissue. Typical symptoms include: Ischaemic rest pain. Coldness or numbness of the foot and toes…

…lesions are: Ventricular septal rupture (VSR), producing an acute left to right shunt. Ventricular free wall rupture, producing haemopericardium and cardiac tamponade. Papillary muscle rupture…

…coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to chronic limb threat

…solely as an isolated coronary event. SCAD predominantly affects the left sided coronary circulation and may involve multiple vessels. Pregnancy associated SCAD can occur at…

…precipitating factor is identifiable in up to one half of cases. Reported precipitants include vigorous physical activity, emotional stress, and an intercurrent medical or surgical…

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

…including chronic coronary syndromes and acute coronary syndromes HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD…

…and trauma . Chronic aortic regurgitation If aortic regurgitation develops gradually, then the ventricle will adapt to the volume overload. Unfortunately, adaptation implies that the left…

…is too often discovered first at hospital admission due to its complications (stroke, thromboembolism, heart failure, dyspnea). Most individuals, however, do experience symptoms and th