Cardiology Myocardial ischemia and infarction Definition and Pathophysiology Chronic coronary syndromes (CCS) comprise the clinical manifestations of chronic structural and/or functional disease involving the…

…ratio (UACR) above 30 mg/g—or both. The eGFR is generally estimated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI…

…LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical signs, and an LVEF below 40%…

…be asymptomatic and identified during angiography performed for another indication. When clinically significant, it may present with chronic angina, an anginal equivalent or exertional dyspnoea…

…or are associated with high event risk. The apparent differences between thresholds reflect different guideline frameworks and clinical pathways rather than a single universal classification…

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…

…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…

…adiposity and may correlate more closely with outcomes than BMI, particularly in women. For European populations, waist circumference above 94 cm in men or 80…

…connect a defibrillator or AED and defibrillate. Watanabe et al studied 132 patients who unexpectedly experienced sudden cardiac arrest while being monitored with Holter ECG…

…a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has identified the relevant endotype and its…

…or intolerance limit escalation of beta blocker or CCB therapy. Nicorandil and trimetazidine are additional options in selected patients. Treatment choices should be integrated with…

…is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction, immune cell recruitment, extracellular matrix remodelling, and thrombosis interact…

…exercise or other situations with increased myocardial load. Symptoms are exacerbated by increasing the level of exertion ( i.e increasing the myocardial load), and vice…

…NSTEMI is confirmed by a typical rise and/or fall of high sensitivity cardiac troponin (hs cTn), with at least one value above the 99th…

…is a chronic and serious condition. Mortality in pulmonary embolism is up to 20%, and roughly 30% of patients with pulmonary embolism or deep vein…

…exercise or other situations with increased myocardial load. Symptoms are exacerbated by increasing the level of exertion ( i.e increasing the myocardial load), and vice…

…unexpected or does not fit the clinical picture. 4. Where possible, take the plasma osmolality, urine osmolality and urine sodium before treatment. 5. With severe…

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

…reduces preload and afterload, further reducing myocardial workload. Levosimendan is used in severe acute or chronic heart failure. Consider urgent angiography in patients with unknown…

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

…list (metformin, NSAIDs, RAAS blockade, gabapentin, direct oral anticoagulants) and refer to nephrology at an eGFR < 30, with rapid deterioration, or with A3 albuminuria.

…Long term efficacy data remain limited, and the possibility that chronic If channel blockade could increase sympathetic activity, with adverse remodelling or pro arrhythmic c

…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…

…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…

…develops acutely or subacutely. It is uncommon for chronic pericardial effusions to cause sudden cardiac arrest since these cases tend to be recognized and managed…

…reveals calcification of the pericardium. With MRI or CT, the thickness of the pericardium can be measured and in most cases, a thickening is noted…

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

…considerations Type 1 Contrast staining of the arterial wall with multiple lumens or radiolucent channels The classic appearance and usually readily recognized Type 2 Long…

…and Pathophysiology ST segment elevation myocardial infarction (STEMI) is an acute coronary syndrome characterized clinically by acute myocardial ischaemic symptoms or equivalent presentations together with…

…with reduced perfusion but preserved 18F FDG uptake represent a perfusion–metabolism mismatch and may indicate viable, hibernating myocardium. Clinical Indications Suspected or Known Chronic…

…kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease…

…both vasopressor and inotropic effects (Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or…

…akin to chronic neuropathic pain. This syndrome presents with a dry or minimally productive cough and a tickle or sensitivity in the throat, and is…

…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…

…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…

…with PCI. PCI of chronic total occlusion lesions may improve angina and quality of life, but randomized trials have not demonstrated reductions in mortality or…

…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…

…integrated with clinical variables rather than applied in isolation. A multidisciplinary heart team, including an interventional cardiologist and cardiac surgeon, is recommended when both revascularization…

…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…

…hypoxic cardiac arrest : Trauma and injuries : Direct trauma can cause airway injuries, resulting in obstruction. Central nervous system (CNS) injuries might cause apnea or hypoventilation…

…both vasopressor and inotropic effects (Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or…

…occlusion or stenosis. If the ischemia persists for 20 minutes, myocardial infarction ensues, resulting in permanent wall motion abnormalities. Figure 1. Standardized myocardial segmentation and…

…or chronic. Bradycardia (second line option). 10.0–20.0 μg/kg/min ++++ ++++ ++ +++++ High dose dopamine additionally induces α1 stimulation and thereby vasoconstriction with…

…contraindicated Head of the bed 30–45° Stress ulcer prophylaxis During mechanical ventilation, in coagulopathy, or with a history of gastrointestinal bleeding Refeeding syndrome There…

…cancer, chronic cardiac or pulmonary disease, a pulse ≥ 110/min, a systolic blood pressure < 100 mmHg and a saturation < 90 per cent. An…

…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…

…settings: After ACS , whether managed medically or with revascularization. After elective PCI for CCS , particularly after stent implantation. In both situations, DAPT is generally a…

…Population to which SCORE2 and SCORE2 OP apply SCORE2 and SCORE2 OP are intended for apparently healthy people or for individuals with elevated BP who…

…heart level Measure in both arms at the first visit; a difference 15 mmHg suggests vascular disease, and the arm with the higher reading is…

…the massive transfusion protocol. Plasma and platelets: in ongoing bleeding with coagulopathy, or as part of balanced transfusion in massive haemorrhage. Transfusion thresholds in the…

…the unit. Preparation and equipment A device capable of both CPAP and bilevel ventilation, or alternatively flow generated CPAP with a PEEP valve. Masks in…

…after stabilisation or piperacillin–tazobactam 4 g × 4 IV plus gentamicin 5–7 mg/kg IV as a single dose Urosepsis with shock and suspected…

…the adverse effects and the important precautions. A hypertensive emergency is defined by a markedly raised blood pressure in combination with new or progressive acute…

…months despite adequate treatment — malignancy (Marjolin's ulcer, basal cell carcinoma) and vasculitis do occur. Wound debridement 1. Cleanse with lukewarm tap water or saline…

…itching and urticaria are usually due to histamine release, not allergy. Concurrent MAO inhibitor, particularly with pethidine. Caution: untreated sleep apnoea, a concurrent benzodiazepine or…

…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…

…resistance, and never catheterising urethrally when urethral injury is suspected. Indications Acute urinary retention. Chronic urinary retention with renal impairment or a large residual volume…

…calculate this ratio, guiding clinical decisions about intervention or monitoring. Below, we outline the methodology and clinical applications of shunt fraction calculation. Echocardiographic Calculation of…

…consisting of individuals with CKD, limiting its accuracy when applied to healthy populations or those with acute kidney injury. Influence of Muscle Mass and Diet:…

…in patients with multivessel disease or left main coronary artery disease . It integrates multiple variables, including the number of lesions, their location, and specific characteristics…