…The absence of chest pain does not exclude clinically important CCS. Silent or minimally symptomatic disease may occur in patients with diabetes and autonomic neuropathy…

…follow up and appropriate therapy. In this setting, the risk of sudden death and end stage heart failure is high, and assessment for advanced therapies…

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…

…of patency may be particularly relevant when the occluded artery supplies viable myocardium with demonstrable ischaemia. However, randomized evidence has not shown a reduction in…

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…

…and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction, immune cell recruitment…

…Dyslipidaemia A prothrombotic state Albuminuria and declining estimated glomerular filtration rate Development of type 2 diabetes mellitus Atherosclerotic cardiovascular events HF and atrial fibrillation Obesity…

…be in line with the European guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment of chronic…

…thrombogenic surface occurs via three primary mechanisms: Plaque Rupture: Accounting for 60 70% of ACS presentations, plaque rupture typically occurs in thin cap fibroatheromas (TCFAs)…

…be in line with the European guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment of chronic…

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

…because the clinical value of any diagnostic test depends not only on its sensitivity and specificity but also on disease prevalence in the population being…

…laboratory abnormalities indicate end organ injury. Eclampsia is the occurrence of new onset seizures or coma in a pregnant woman with preeclampsia. HELLP syndrome—haemolysis…

…24% of patients with CAD. The pathophysiology of refractory angina is heterogeneous. In obstructive CAD, symptoms may result from extensive or diffuse epicardial disease, chronic…

…leaves of the pericardium are most often fused. The process most often affects the entire pericardium. Constrictive pericarditis is most often chronic, but in some…

…of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being the most common. The figure 80% occurs in…

…in extracellular tonicity. This explains why acute hyponatraemia chiefly carries a risk of cerebral oedema, while rapid correction of chronic hyponatraemia carries a risk of…

…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…

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

…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)…

…In the absence of infarction, contractile recovery can occur rapidly after reperfusion, with recovery generally occurring within one week. By contrast, chronic hypoperfusion may result…

…and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS)…

…in the presence of symptoms suggestive of ischaemia and presumed new ischaemic ECG changes. The distinction between myocardial injury and type 2 infarction is particularly…

…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

…In the vast majority of these cases, the tamponade develops acutely or subacutely. It is uncommon for chronic pericardial effusions to cause sudden cardiac arrest…

…Compared with Dobutamine in the Treatment of Cardiogenic Shock. N Engl J Med 2021; 385:516 525 Indications Severe left ventricular failure, acute or chronic…

…IPAP 12–15 and EPAP 4–5 cmH₂O Increase the IPAP in steps of 2–3 cmH₂O every 5–10 min towards 20–25 cmH₂O…

…3 IV Pneumonia, in chronic lung disease amoxicillin 750 mg × 3 PO 5–7 days or benzylpenicillin 3 g × 4 IV Pneumonia, suspected atypical pathogen…

…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…

…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…

…when the principle of titration is abandoned — when a fixed dose is given without assessment, when a modified release preparation is started in an opioid…

…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…

…Prophylaxis against recurrence of cerebrovascular disease: 75–80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant…

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

…vasodilation in coronary, renal, cerebral and mesenteric vessels. Few Dopamine medium dose Cardiogenic shock Vasodilatory shock Heart failure (HF), acute Heart failure (HF), chronic Bradycardia…

…could enhance the score's predictive accuracy. The SYNTAX Score remains a cornerstone in the management of complex CAD, providing a structured approach to revascularization…

…risk assessment. Key Variables in SYNTAX Score II Anatomical SYNTAX Score : Derived from the original SYNTAX Score, which evaluates the complexity of coronary lesions. Clinical…

…cardiomyocyte necrosis occurring in the clinical setting of acute myocardial ischaemia and is diagnosed according to the fourth universal definition of MI. Type 1 MI…

…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…

…chronic coronary syndromes, coronary revascularization, stroke, transient ischaemic attack, and peripheral arterial disease. Heart failure is also considered established clinical CVD in the risk based…

…treatment in coronary disease has principally involved two populations: Patients recently recovering from myocardial infarction or acute coronary syndrome. Patients with stable or chronic atherosclerotic…

…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…

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

…months , irrespective of stent type. The preferred regimen is aspirin plus a potent P2Y12 inhibitor, usually prasugrel or ticagrelor. In patients undergoing PCI for ACS…

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

…be considered. The immediate clinical categories include: Non cardiac diagnosis Chronic stable angina Possible ACS Definite ACS In patients with ST segment elevation, immediate reperfusion…

…Definition and Clinical Significance In stent restenosis (ISR) is recurrent narrowing within a previously implanted coronary stent. It represents a form of arterial hyperplastic disease…

…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…

…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…

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

…syndrome, tobacco abstinence has been associated with reductions in reinfarction of approximately 30–40% and in death of approximately 35–45%. In chronic coronary syndrome…

…to demonstrate an intramural haematoma or double lumen Type 1 is reported in fewer than one third of cases in the pregnancy related source material…

…produce extravascular compression. In the most severe form, termed no reflow, structural and functional microvascular impairment persists despite restoration of epicardial flow. The electrocardiographic appearance…

…cTn concentration in the absence of evidence of ischaemia. Classification of myocardial infarction The Fourth Universal Definition separates MI into five principal types. Type Mechanism…

…is therefore recommended in patients with CVD. The clinical consequences of diabetes may present through any major cardiovascular phenotype: CAD, including chronic coronary syndromes and…

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

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

…observant will notice that the classification differs slightly from that of atrial fibrillation. Acute and paroxysmal cases are common in clinical practice. Chronic flutter is…