…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…

…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…

…to fluid retention and worsening congestion The clinical course may be chronic and relatively stable or punctuated by episodes of worsening heart failure requiring hospitalization…

…When clinically significant, it may present with chronic angina, an anginal equivalent or exertional dyspnoea. Patients may continue to have lifestyle limiting symptoms despite guideline…

…occur at a low level of exertion, or are associated with high event risk. The apparent differences between thresholds reflect different guideline frameworks and clinical…

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…

…patients with HFpEF can have pathophysiological characteristics that differ from those of non obese patients, and obesity complicates assessment of intravascular volume in both ambulatory…

…is not an absolute rule. While it often holds true for cardiac arrests caused by chronic or acute ischemic heart disease, it is often not…

…of patients with CAD. The pathophysiology of refractory angina is heterogeneous. In obstructive CAD, symptoms may result from extensive or diffuse epicardial disease, chronic total…

…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…

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…

…artery disease has been classified into the following three syndromes: Stable angina pectoris : Symptoms appear primarily during exercise or other situations with increased myocardial load…

…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…

…artery disease has been classified into the following three syndromes: Stable angina pectoris : Symptoms appear primarily during exercise or other situations with increased myocardial load…

… 2. Is the hyponatraemia acute or chronic? Severe symptoms require immediate treatment with hypertonic sodium chloride, whether the hyponatraemia is acute or chronic. The aim…

…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…

…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…

…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…

…patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2…

…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…

…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…

…Conventional thoracic X ray sometimes reveals calcification of the pericardium. With MRI or CT, the thickness of the pericardium can be measured and in most…

…Ongoing chest discomfort with electrical or haemodynamic instability. Cardiac arrest or cardiogenic shock. Features that favour ACS rather than chronic stable angina include sudden symptom…

…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…

…or chronic The severity of ischaemia and whether infarction has occurred The extent and degree of myocardial involvement The anatomical territory, including anterior, inferoposterolateral or…

…cardiovascular event risk. Quantify myocardial blood flow when PET is used. SPECT is recommended in suspected chronic coronary syndrome with moderate or high pre test

…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…

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

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

…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…

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…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…

…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…

…disease (CAD) refers to clinically significant atherosclerotic disease affecting two or more major epicardial coronary arteries. It frequently coexists with left main coronary artery disease…

…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…

…CNS) injuries might cause apnea or hypoventilation. Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD…

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

…is particularly important in the setting of chronic or acute coronary artery disease. All types of ischemia– chronic, acute, or subacute –lead to regional abnormalities…

…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…

…gives 1 point each for age 80 years, cancer, chronic cardiac or pulmonary disease, a pulse ≥ 110/min, a systolic blood pressure < 100 mmHg…

…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…

…people with: Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific risk assessment or risk categorization is applicable Moderate or severe chronic…

…normal readings at home or on 24 hour recording. Masked hypertension: normal in the office but raised outside it — associated with the same risk as…

…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…

…10–14 days including oral step down or gentamicin 4.5 mg/kg IV as a single dose Urosepsis with complicating factors cefotaxime 1 g …

…target. Chronic hypertension shifts autoregulation in the brain and kidneys towards higher pressures. Too rapid a normalisation can therefore cause cerebral, coronary or renal ischaemia…

…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…

…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…

…surgical or percutaneous closure in ASD/VSD. Serial measurements track shunt progression in chronic conditions. Post Intervention Monitoring : Assess residual shunts after device closure or…

…GFR Levels: The MDRD equation tends to underestimate GFR in individuals with near normal or mildly reduced kidney function (eGFR 60 mL/min/1.73…

…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…