…atherosclerotic lesion with atherotrombosis. Over decades, the lesion progresses from a simple fatty streak to a complex fibroatheroma. Smooth muscle cells (SMCs) migrate from the…

…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…

…induced angina or ischaemia associated with obstructive epicardial coronary disease. Angina or ischaemia caused by epicardial vasomotor dysfunction or microvascular abnormalities without obstructive epicardial disease…

…or without physical signs, and an LVEF below 40%. Signs may be absent in early disease or after effective treatment. HFrEF is commonly associated with…

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…

…angiography performed for another indication. When clinically significant, it may present with chronic angina, an anginal equivalent or exertional dyspnoea. Patients may continue to have…

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 Endocrinology & metabolism Definition and pathophysiology Obesity is a chronic, relapsing and biologically complex disease characterized by excessive accumulation of adipose tissue. It is an…

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

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…

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

…guideline discussion. By contrast, the benefit of beta blockers in patients with CAD without previous MI and with normal LVEF is uncertain. Similarly, evidence for…

…an ischaemic mechanism. Clinical assessment and estimation of pre test probability Symptoms and clinical context The assessment begins with the clinical presentation, including the character…

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…

…intervention (PCI), including attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has…

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…

…commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being the most common…

…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…

…people with a low muscle mass — the elderly, the undernourished, amputees, patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic…

…medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial infarction (MI) care…

…and chronic kidney disease (CKD). These agents interfere with the renin angiotensin aldosterone system (RAAS) by inhibiting the enzyme responsible for the conversion of angiotensin…

…of repeated ischemic episodes or chronic reductions in perfusion. The amount and distribution of both viable and nonviable myocardium, together with coronary anatomy and the…

…therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS), peripheral artery disease (PAD)…

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

…chronic thromboembolic obstruction, or a range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the patient’s clinical…

…with tamponade has an exceptionally poor prognosis. In the vast majority of these cases, the tamponade develops acutely or subacutely. It is uncommon for chronic…

…workload. Levosimendan is used in severe acute or chronic heart failure. Consider urgent angiography in patients with unknown etiology for acute severe heart failure. A…

…oxygen. Acute on chronic hypercapnic failure in obesity hypoventilation and neuromuscular disease. Hypercapnic failure in cardiogenic pulmonary oedema that does not improve with CPAP alone…

…or with a history of gastrointestinal bleeding Refeeding syndrome There is a risk in starvation, alcoholism, anorexia nervosa, or more than 5 days without nutrition…

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

…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…

…chronic cough, dyspnoea, wheeze or reduced exercise capacity. Suspected asthma or COPD — diagnosis and follow up. Risk groups: current or former smokers over 40 with…

…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…

…with bronchial asthma, chronic obstructive pulmonary disease, hay fever, or nasal polyps (increased risk of hypersensitivity reactions, such as asthma attacks, angioedema, or urticaria with…

…critical, especially in individuals with near normal kidney function, alternative equations like the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) equation may offer improved accuracy…

…ICU (intensive care unit) or ER (emergency room). Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is…

…standardized method to evaluate the anatomical complexity of CAD, particularly in patients with multivessel disease or left main coronary artery disease . It integrates multiple variables…

…with worse outcomes. Unprotected Left Main Disease : Increases complexity and risk. Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive Pulmonary Disease (COPD) : Associated with…

…chronic, when troponin elevation persists without such a change. Myocarditis, sepsis, takotsubo cardiomyopathy, valvular disease, arrhythmias, and heart failure are among the conditions associated with…

…chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term antiplatelet therapy after STEMI is associated with…

…In contrast, patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification for that treatment decision. Population to which SCORE2 and SCORE2…

…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…

…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…

…regimen remains the default for most patients with ACS, including those with NSTE ACS. It applies whether ACS is managed with PCI or without revascularization…

…is not achieved with the maximum tolerated statin dose. This recommendation carries Class I status with Level B evidence in the chronic coronary syndrome lipid…

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

…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)…

…offering profound benefits in major adverse cardiovascular events (MACE), heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), and peripheral artery disease (PAD)…

…generally with ezetimibe where appropriate. Established clinical atherosclerotic cardiovascular disease (ASCVD) and FH are principal settings in which these drugs have received approval. In chronic…

…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…

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

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

…may present with: ST elevation myocardial infarction (STEMI). Non ST elevation myocardial infarction (NSTEMI). Unstable myocardial ischaemia. Ventricular arrhythmia or sudden cardiac arrest. Chronic coronary…

…Painless STEMI is more frequent in people with diabetes and becomes more common with advancing age. Presentations without pain may include: Sudden breathlessness Syncope or…

…occur without myocardial ischaemia. Non ischaemic myocardial injury may accompany numerous cardiac and systemic disorders, including: Cardiac causes Systemic causes Heart failure Sepsis Myocarditis Chronic…

…as in patients without diabetes. Clinical Presentation and Symptoms T2DM may be clinically silent while vascular disease progresses. Many patients presenting with CVD have previously…

…parallel with increasing myocardial load (and hence oxygen demand). The most common causes of acute aortic regurgitation are aortic dissection , endocarditis and trauma . Chronic aortic…

…confounders) individuals with atrial fibrillation are at five times increased risk of stroke and two times increased mortality, as compared with individuals without atrial fibrillation…

…paroxysmal cases are common in clinical practice. Chronic flutter is, however, very rare. Thus, as compared with atrial fibrillation, atrial flutter is not capable of…