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…

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…

Cardiology Endocrinology & metabolism Definition and Pathophysiology Type 2 diabetes mellitus (T2DM) is a major cardiovascular risk condition. It is associated with a two to four…

Cardiology Continous medical discussion: the ECG blog Endocrinology & metabolism Cardiovascular medicine is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes…

…18F FDG uptake represent a perfusion–metabolism mismatch and may indicate viable, hibernating myocardium. Clinical Indications Suspected or Known Chronic Coronary Syndrome Stress SPECT or…

Cardiology Endocrinology & metabolism Pharmacology & dosing Definition and pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose…

…capacity, expressed by exercise duration, workload or metabolic equivalents, is among the strongest predictors of mortality in patients with cardiovascular disease after accounting for age…

…Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes…

…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…

…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…

…women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism. Alcohol dehydrogenase converts ethanol to acetaldehyde…

…3 weeks or occasionally longer; loading doses mitigate this delay. During chronic therapy, plasma concentrations correlate well with oral doses, averaging approximately 0.5 mg…

…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)…

…have a rate reducing effect in selected circumstances. Ivabradine undergoes extensive first pass hepatic metabolism through CYP3A4. Dose adjustment is required in severe hepatic or…

…abnormalities. Assessment of wall motion abnormalities is particularly important in the setting of chronic or acute coronary artery disease. All types of ischemia– chronic, acute…

…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…

…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…

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 Evaluation and management of stable coronary artery disease Chronic coronary syndromes (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris…

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…

ECG Evaluation and management of stable coronary artery disease Chronic coronary syndrome (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris…

…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…

…be selected according to clinical judgement. Low to moderate probability: greater than 5% to 50% in the chronic coronary syndrome pathway. Coronary CT angiography (CCTA…

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…

Cardiology Myocardial ischemia and infarction Definition and Pathophysiology Refractory angina is a chronic syndrome of persistent ischaemic symptoms despite the exhaustion of conventional therapeutic options…

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…

…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

…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…

…failure where high flow nasal oxygen is insufficient and the carbon dioxide is normal. Bilevel NIV: Acute exacerbation of COPD with respiratory acidosis , that is…

…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…

…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…

…risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease, hay fever, or nasal polyps (increased risk of hypersensitivity…

…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…

…circumstances where diabetes specific risk assessment or risk categorization is applicable Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or…

…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…

…of shock. Patients with moderate to severe chronic kidney disease have a higher burden of comorbidity and an increased risk of in hospital complications, including…

…the occurrence of contrast induced AKI is negligible or very low. Risk rises substantially with chronic kidney disease, particularly diabetic kidney disease and advanced CKD…

…major or life threatening bleeding. The clinical presentation, whether ACS or chronic coronary syndrome (CCS). Whether and how PCI was performed. The need for non…

…Place in lipid lowering therapy General treatment sequence High intensity statin therapy remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome…

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

…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…

…manifest as exertional symptoms, or progress to chronic limb threatening ischaemia (CLTI). Clinical presentation and symptoms Asymptomatic and atypical disease Fewer than half of patients…