…angina, angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), post ACS or post revascularization states, and heart failure of ischaemic or cardiometabolic origin…

…fatigue and oedema. This definition does not depend on left ventricular ejection fraction (LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the…

…73 m² Abnormal urinalysis or renal imaging Risk of progression rises with proteinuria and depends on cause 2 60 mL/min/1.73 m² Abnormal…

…presentation and symptoms A CTO may be asymptomatic and identified during angiography performed for another indication. When clinically significant, it may present with chronic angina…

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…

…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…

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…

…Virtually all patients with STE ACS exhibit elevated troponin levels, and are thereby diagnosed as ST elevation myocardial infarction (STEMI) . Chronic Coronary Syndromes (CCS) Coronary…

…Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial accumulation of…

…Virtually all patients with STE ACS exhibit elevated troponin levels, and are thereby diagnosed as ST elevation myocardial infarction (STEMI) . Chronic Coronary Syndromes (CCS) Coronary…

…in patients with reduced left ventricular ejection fraction (LVEF). They are also recommended in patients within one year of MI and in those with LVEF…

…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…

…seizures or coma in a pregnant woman with preeclampsia. HELLP syndrome—haemolysis, elevated liver enzymes or transaminases, and thrombocytopenia—is generally regarded as a severe…

…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…

…Since the left ventricle is not filled normally, there is more room for the right ventricle, the filling of which increases and the septum bulges…

…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…

…Chronic At least 48 hours Unknown Treated as chronic with respect to the correction limits The brain adapts to prolonged hypotonicity by extruding electrolytes and…

…Cystatin C based eGFR With an atypical muscle mass, or to confirm a creatinine based value The mean of creatinine and cystatin C The most…

…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…

…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…

…or extensive MI with necrosis and scar formation Diffuse myocardial fibrosis Reversible ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic stunning Adverse left ventricular …

…cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS), peripheral artery disease (PAD), and acute coronary syndromes (ACS). Its…

…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

CPR Tamponade and cardiac arrest Cardiac arrest associated with tamponade has an exceptionally poor prognosis. In the vast majority of these cases, the tamponade develops…

…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…

…above 6.0 kPa despite optimal medical treatment with bronchodilators, steroids and controlled oxygen. Acute on chronic hypercapnic failure in obesity hypoventilation and neuromuscular disease…

…single dose Urosepsis with shock and suspected ESBL meropenem 1 g × 3 IV Do not treat asymptomatic bacteriuria. The exceptions are pregnancy and the period…

…kPa) and avoidance of hypoxia, since hypercapnia raises the intracranial pressure. Circulation Parameter Target Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or…

…and measure the ankle brachial index with Doppler. 4. Culture only in the presence of clinical signs of infection — all chronic wounds are colonised, and…

…up to 10 mL with sodium chloride) before intravenous titration. Half of all opioid dosing errors arise at the dilution step, and an undiluted syringe…

…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…

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

…like the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) equation may offer improved accuracy. Additionally, considering factors such as patient demographics, muscle mass, and clinical…

…chronic Bradycardia (second line alternative) Medium dose : 3.0 10.0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1, releases norepinephrine and thus increases…

…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…

…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…

…is particularly relevant in adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant…

…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…

…objective, particularly in patients with left ventricular dysfunction and/or MVD. Nevertheless, the optimal extent and timing of intervention depend on the clinical setting, haemodynamic…

…AKI is negligible or very low. Risk rises substantially with chronic kidney disease, particularly diabetic kidney disease and advanced CKD. The clinical course is often…

…driven atherothrombosis, while interruption of antiplatelet therapy after recent stenting is associated with increased risk of major adverse cardiovascular events (MACE) and stent thrombosis. Premature…

…any statin regimen. The treatment sequence for patients with chronic coronary syndrome is: Lifestyle intervention and a maximally tolerated high intensity statin. Add ezetimibe if…

…is consistent with chronic myocardial injury. Non ischaemic conditions, including myocarditis, rapid ventricular rate atrial fibrillation, marked anaemia, hypertensive emergency, heart failure, and end stage…

…segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS), acute coronary syndrome (ACS), myocardial infarction, and repeat target lesion revascularization…

…major adverse cardiovascular events (MACE), heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), and peripheral artery disease (PAD). Figure 1 (below) shows…

…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…

…lesions are: Ventricular septal rupture (VSR), producing an acute left to right shunt. Ventricular free wall rupture, producing haemopericardium and cardiac tamponade. Papillary muscle rupture…

…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…

…during pregnancy or after delivery. The clinical context is particularly important. SCAD should be considered in a young or middle aged woman with ACS and

…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…

…MI caused by restenosis Type 5 MI associated with coronary artery bypass grafting (CABG) Types 4b and 4c fulfil the criteria for type 1 MI…

…chronic coronary syndromes and acute coronary syndromes HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD with…

…and trauma . Chronic aortic regurgitation If aortic regurgitation develops gradually, then the ventricle will adapt to the volume overload. Unfortunately, adaptation implies that the left…

…tachyarrhythmia (only sinus tachycardia is more common). The prevalence of atrial fibrillation correlates strongly with age. Approximately 10% of individuals aged 80 years and above…

…atrial fibrillation. Acute and paroxysmal cases are common in clinical practice. Chronic flutter is, however, very rare. Thus, as compared with atrial fibrillation, atrial flutter…