…clinical classification Hypertensive disorders of pregnancy comprise chronic or pre existing hypertension, gestational hypertension, and preeclampsia. Collectively, they affect approximately 5–15% of pregnancies worldwide…

…Do not administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs)…

…with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational diabetes Small for gestational age delivery Placental…

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

…Other anti inflammatory strategies have produced less favourable results. Canakinumab, a monoclonal antibody directed against interleukin 1β, provided proof of concept but was not…

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…

…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…

…reduces thrombogenicity, and favourably modifies inflammatory and collagen related components of atherosclerotic plaque. These effects help explain why reductions in cardiovascular events are substantially greater…

…of the character of Angina Pectoris. Atherosclerosis: the cause of coronary artery disease The underlying cause is atherosclerosis, which is a chronic inflammatory disease of…

…implantation produce local vascular injury and initiate a sustained inflammatory and reparative response. Proliferation and accumulation of tissue within the stent progressively reduce the lumen…

…chronic kidney disease (CKD), and peripheral artery disease (PAD). Figure 1 (below) shows weight loss effects of novel multi agonists in recent clinical trials (Rawshani…

…Loeys–Dietz syndrome Ehlers–Danlos syndrome Inflammatory aortitis, including Takayasu arteritis and giant cell arteritis Bicuspid aortic valve Coarctation of the aorta Previous aortic trauma…

…5′ monophosphate activated protein kinase and inhibit mammalian target of rapamycin complex 1 signalling, thereby reducing inflammatory mediator expression and glycolytic activity in relevant renal…

…coronary cause of symptoms. CCS is a clinical syndrome rather than a permanently stable state. Patients may remain stable for prolonged periods, but chronic coronary…

…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…

…chronic angina, an anginal equivalent or exertional dyspnoea. Patients may continue to have lifestyle limiting symptoms despite guideline directed medical therapy (GDMT), prompting consideration of…

…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…

…guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment of chronic coronary syndromes (CCS). Ischemic heart disease…

…guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment of chronic coronary syndromes (CCS). Ischemic heart disease…

…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…

…or chronic chest pain attributable to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of obstructive coronary artery disease (CAD) before diagnostic testing…

…because quality of life is often poor, hospitalizations are frequent, and healthcare resource utilization is high. Clinical Presentation and Symptoms The dominant manifestation is chronic…

…parietal and visceral leaves of the pericardium are most often fused. The process most often affects the entire pericardium. Constrictive pericarditis is most often chronic…

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…

…rise can cause osmotic demyelination syndrome [1,2]. Hyponatraemia is primarily a disorder of water balance. The plasma sodium reflects the ratio between the body…

…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…

…ACE) inhibitors are foundational therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction …

…Definition and Pathophysiology Angiotensin converting enzyme inhibitors (ACE inhibitors) constitute a cornerstone in the management of cardiovascular disease, heart failure, and chronic kidney disease (CKD)…

…Reversible ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic stunning Adverse left ventricular (LV) remodeling Ischemic cardiomyopathy is the leading cause of heart failure…

…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…

…heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise from pulmonary vascular disease, left sided cardiac disease, chronic lung disease…

…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…

…NIV are two different treatments with different physiology, and the commonest source of error is confusing them. CPAP delivers a constant pressure that recruits alveoli…

…applies where you work. They assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick…

…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…

…4. Culture only in the presence of clinical signs of infection — all chronic wounds are colonised, and a culture taken without clinical suspicion leads only…

…is given. The serious incidents almost always arise when the principle of titration is abandoned — when a fixed dose is given without assessment, when a…

…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…

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

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

…with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual…

…disease . It integrates multiple variables, including the number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions (CTOs), calcification, and thrombus…

…II Anatomical SYNTAX Score : Derived from the original SYNTAX Score, which evaluates the complexity of coronary lesions. Clinical Variables : Age : Older patients have a higher…

…the time of assessment. Ongoing chest discomfort with electrical or haemodynamic instability. Cardiac arrest or cardiogenic shock. Features that favour ACS rather than chronic stable…

…after PCI; reduce recurrent atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term…

…abnormal single risk factors or genetic, rare lipid, or BP disorders Pregnancy Established ASCVD includes previous acute coronary syndrome, chronic coronary syndromes, coronary revascularization, stroke…

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

…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…

…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…

…in the chronic coronary syndrome lipid lowering recommendations. Acute coronary syndrome The period immediately following ACS is associated with particularly high risk of recurrent cardiovascular…

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

…In chronic coronary syndrome, the recommended LDL C objective is: LDL C <1.4 mmol/L (<55 mg/dL) , and A reduction of at least…

…or progress to chronic limb threatening ischaemia (CLTI). Clinical presentation and symptoms Asymptomatic and atypical disease Fewer than half of patients with PAD have typical…

…Hypertension. Absence of an adequate collateral circulation. A first or anterior infarction. Single vessel disease without collateral support. Chronic kidney disease, particularly in relation to…

…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

…dissection (SCAD) is an acute coronary disorder caused by separation within the coronary arterial wall, usually through formation of an intramural haematoma that compresses the…

…restoration of epicardial flow. The electrocardiographic appearance depends on several interacting factors: The stage of the ischaemic process: acute, evolving or chronic The severity of…

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