…may produce a transient mismatch between myocardial oxygen demand and coronary blood supply, resulting in myocardial hypoperfusion or ischaemia. Ischaemia is commonly precipitated by exertion…

…Pharmacology & dosing Definition and pathophysiology Heart failure is a clinical syndrome in which the heart cannot provide blood flow commensurate with the body’s requirements…

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…

…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…

…Chronic Coronary Syndromes (CCS) Coronary artery disease is a progressive but dynamic disease. The majority of individuals in high income countries have some degree of…

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…

…Chronic Coronary Syndromes (CCS) Coronary artery disease is a progressive but dynamic disease. The majority of individuals in high income countries have some degree of…

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…

…50% in the chronic coronary syndrome pathway. Coronary CT angiography (CCTA) is generally preferred to exclude obstructive CAD. Intermediate or high probability: above 15% in…

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…

…In obstructive CAD, symptoms may result from extensive or diffuse epicardial disease, chronic total occlusion, incomplete revascularization, or coronary anatomy unsuitable for further intervention. In…

…fused. The process most often affects the entire pericardium. Constrictive pericarditis is most often chronic, but in some cases, the condition may be transient. Pericardiotomy…

…caused by acute or chronic coronary artery disease, with the latter being the most common. The figure 80% occurs in most textbooks in the field…

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

…halve before the creatinine leaves the reference range, because the relationship is hyperbolic. In people with a low muscle mass — the elderly, the undernourished, amputees…

…Evaluation and Physical Examination The evaluation of chronic cough in a patient taking an ACE inhibitor should begin with a comprehensive history and physical examination…

…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)…

…therefore heterogeneous. Irreversibly scarred regions may alternate with viable segments that are dysfunctional because of repeated ischemic episodes or chronic reductions in perfusion. The amount…

…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)…

…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

…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…

…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…

…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…

…Target Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg…

…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…

…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…

…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…

…80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin…

…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…

[calc_syntax] SYNTAX Score: A Tool for Revascularization Strategy in Complex Coronary Artery Disease The SYNTAX Score is a semi quantitative scoring system designed to…

…a more personalized risk assessment. Key Variables in SYNTAX Score II Anatomical SYNTAX Score : Derived from the original SYNTAX Score, which evaluates the complexity of…

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

… 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…

…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…

…treatment. The presence of ST segment changes or a positive troponin assay identifies patients in whom an invasive strategy is generally preferred over selective angiography…

…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…

…events (MACE) and stent thrombosis. Premature DAPT interruption is described as the strongest predictor of stent thrombosis in this setting. The duration of therapy requires…

…maximum tolerated statin dose. This recommendation carries Class I status with Level B evidence in the chronic coronary syndrome lipid lowering recommendations. Acute coronary syndrome…

…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…

…restenosis refers to recurrent angina caused by disease in the treated segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS)…

…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…

…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…

…caused by stenosis or occlusion of the aorta or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause…

…A first or anterior infarction. Single vessel disease without collateral support. Chronic kidney disease, particularly in relation to VSR. Large infarction, especially for septal or…

…30–40% and in death of approximately 35–45%. In chronic coronary syndrome, cessation has been associated with a 36% reduction in premature mortality compared…

…or sudden cardiac arrest. Chronic coronary dissection presenting as heart failure, although this is described as uncommon. In pregnancy associated ACS, STEMI is more frequent…

…while cardiomyocyte swelling, interstitial oedema and tissue inflammation produce extravascular compression. In the most severe form, termed no reflow, structural and functional microvascular impairment persists…

…upper reference limit (URL). It is considered acute when there is a rise and/or fall in cTn values. An elevated cTn alone does not…

…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…

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

…2), obesity, smoking, obstructive sleep apnea and chronic obstructive pulmonary disease (COPD). Moreover, certain other tachyarrhythmias predispose to developing atrial fibrillation: atrial flutter, AVNRT and…

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