…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…

…often chronic, but in some cases, the condition may be transient. Pericardiotomy can be curative, which is why it is important to detect the disease…

…palliative phase (at lower doses than for pain). An opioid is rarely the right choice in nociplastic or neuropathic pain, in chronic non cancer pain…

…predictors of adverse outcomes. Non acute or asymptomatic bradycardia Non acute bradycardia is a common finding in both healthy and diseased individuals. Asymptomatic bradycardia may…

…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…

…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…

…hyperplastic disease arising after percutaneous coronary intervention (PCI). In contemporary practice, ISR remains the most frequent cause of PCI failure, despite its substantially lower incidence…

…if tolerated 70–79 Diabetes 120–130 70–79 Chronic kidney disease 130–139 70–79 Avoid a systolic pressure < 120 mmHg and a…

…start cardiac monitoring at a plasma potassium above 6.0 mmol/L, and at lower values if the rise is rapid, the patient has symptoms…

…LVEF) : Lower LVEF is associated with worse outcomes. Unprotected Left Main Disease : Increases complexity and risk. Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive…

…which further enhances the effects of angiotensin suppression. In the context of chronic kidney disease, ACE inhibitors slow the rate of decline of kidney function…

…when serial troponin values show a dynamic change, or chronic, when troponin elevation persists without such a change. Myocarditis, sepsis, takotsubo cardiomyopathy, valvular disease, arrhythmias…

…associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy. The cardiovascular implications of lower alcohol intake remain controversial. Epidemiological studies have…

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

…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…

…altitude or wind. A gradual progression is particularly important in previously sedentary individuals and those with chronic disease. Increasing frequency and duration before substantially increasing…

…heart failure, congenital heart disease, diabetes mellitus (both type 1 and type 2), obesity, smoking, obstructive sleep apnea and chronic obstructive pulmonary disease (COPD). Moreover…

…no absolute threshold defines the condition. A rapid rise in blood pressure can cause serious organ damage even at lower levels, particularly in pregnancy [1…

…and autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis, are important risk enhancing conditions and are more prevalent in women. Chronic kidney disease and…

…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…

…status or the documented ischaemic burden. In chronic coronary syndrome, revascularisation is particularly indicated when functionally significant disease produces persistent, lifestyle limiting symptoms despite guideline…

…where appropriate. Established clinical atherosclerotic cardiovascular disease (ASCVD) and FH are principal settings in which these drugs have received approval. In chronic coronary syndrome, the…

…in several overlapping populations: T2DM with established cardiovascular disease or high cardiovascular risk T2DM with chronic kidney disease Heart failure with reduced ejection fraction (HFrEF…

…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

…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…

…a more symmetrical T wave, a more distinct transition from ST segment to T wave and lower T wave amplitude. The T wave should be…

…the lower the level of myocardial workload required to elicit ischemia and symptoms. Angina pectoris: the hallmark of coronary artery disease Angina pectoris is the…

…4%. Risk is substantially higher in older patients, emergency or urgent procedures, chronic kidney disease, ST segment elevation myocardial infarction, and cardiogenic shock. Patient related…

…Chronic: more than 90 days. The central clinical danger is progressive aortic wall disruption, rupture and compromise of branch vessels. Type A disease may cause…

…HF but the diagnosis remains uncertain. Acute HF generally produces higher BNP and NT proBNP concentrations than chronic, stable disease, and greater volume overload is…

…heart failure or cardiogenic shock. In chronic coronary disease, the principal symptomatic indication for revascularization is angina that remains refractory despite medical therapy when significant…

…increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is not affected by the concurrent use…

…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…

…sinus rate. Its principal therapeutic distinction from beta blockers is that it lowers heart rate without directly reducing myocardial contractility or altering vascular tone. Accordingly…

…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…

…is heterogeneous. Chronic heart failure evaluation should therefore seek reversible or treatable causes. The source material identifies coronary disease, hypertension, diabetes, obesity, valvular disease, cardiomyopathies…

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…

…and vice versa . Stable angina pectoris is a chronic and mostly progressive disease. NSTE ACS (Non ST Elevation Acute Coronary Syndrome) : NSTE ACS is an…

…Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial accumulation of…

…and vice versa . Stable angina pectoris is a chronic and mostly progressive disease. NSTE ACS (Non ST Elevation Acute Coronary Syndrome) : NSTE ACS is an…

…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…

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…

…refractory angina is heterogeneous. In obstructive CAD, symptoms may result from extensive or diffuse epicardial disease, chronic total occlusion, incomplete revascularization, or coronary anatomy unsuitable…

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…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Ischemic cardiomyopathy is severe myocardial dysfunction caused by coronary artery disease (CAD). The clinical syndrome may resemble…

…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…

…pulmonary arterial pressure. It may arise from pulmonary vascular disease, left sided cardiac disease, chronic lung disease or hypoxia, chronic thromboembolic obstruction, or a range…

…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…

…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…

…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…

…respiratory symptoms, and occupational exposure to dust, gas or fumes. Preoperative assessment before thoracic or upper abdominal surgery in a patient with known lung disease…

…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…