…than by ejection fraction alone. Heart failure with preserved ejection fraction (HFpEF) is characterized by: Symptoms and/or signs of HF. A left ventricular ejection…

…Constrictive pericarditis also leads to right sided heart failure, which is explained by the fact that high pressure in the right atrium leads to a…

…predominantly by atrial tissue; its midregional pro ANP assay may provide information comparable to BNP and NT proBNP in heart failure (HF). The biologically active…

…Sudden severe dyspnoea. Acute pulmonary oedema. Hypotension. Progressive heart failure. Cardiogenic shock. Complete transection of a papillary muscle may cause immediately overwhelming MR. Partial rupture…

…or cardiac arrest with suspected pulmonary embolism. Urgent bedside echocardiography, looking for right ventricular strain. If CT pulmonary angiography can be performed immediately, do it…

…decades. Potential explanations for this trend include an ageing population, increased incidence and prevalence of cancer, heart failure, obesity, type 2 diabetes and physical inactivity…

…the normal heart axis is between –30° and 90°. If the axis is more positive than 90° it is referred to as right axis deviation…

…the normal heart axis is between –30° and 90°. If the axis is more positive than 90° it is referred to as right axis deviation…

…diagnosed cases). Paroxysmal atrial flutter. Chronic atrial flutter. The observant will notice that the classification differs slightly from that of atrial fibrillation. Acute and paroxysmal…

…It is uncommon for chronic pericardial effusions to cause sudden cardiac arrest since these cases tend to be recognized and managed before circulatory collapse occurs…

…million deaths annually worldwide. The most common cause of sudden cardiac death is acute or chronic coronary artery disease (ischemic heart disease). Cardiomyopathies (dilated or…

…atrial fibrillation and atrial flutter. Ischemic heart disease Both acute and chronic ischemic heart disease (including complications) can cause embolisms. Left ventricular aneurysm with thrombus…

…opioid is rarely the right choice in nociplastic or neuropathic pain, in chronic non cancer pain, or in headache. A failure to improve function is…

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

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

…the next unit. In chronic anaemia with a treatable cause — iron deficiency, B12 deficiency, folate deficiency — transfusion is rarely the right measure. Contraindications Anaemia that…

…post ACS or post revascularization states, and heart failure of ischaemic or cardiometabolic origin. Major clinical presentations The principal outpatient presentations include: Reproducible stress induced…

…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…

…neurohormonal systems, particularly the renin–angiotensin–aldosterone system. In heart failure, the interaction between the cardiac and renal axes may produce cardiorenal syndrome. Worsening renal…

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…

…dyslipidaemia, coronary artery disease (CAD), atherosclerosis, heart failure (HF), atrial fibrillation and cardiovascular events. In clinical practice, obesity is conventionally defined by a body mass…

…recent evidence and recommendations for the evaluation and treatment of chronic coronary syndromes (CCS). Ischemic heart disease, coronary heart disease (CAD) and coronary artery disease …

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…

…recent evidence and recommendations for the evaluation and treatment of chronic coronary syndromes (CCS). Ischemic heart disease, coronary heart disease (CAD) and coronary artery disease …

…precipitating factors such as anaemia, uncontrolled hypertension, thyrotoxicosis, tachyarrhythmia, uncontrolled heart failure, and concomitant valvular disease. Risk factor modification, physical activity, dietary and lifestyle measures…

…be selected according to clinical judgement. Low to moderate probability: greater than 5% to 50% in the chronic coronary syndrome pathway. Coronary CT angiography (CCTA…

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…

…hypertension, thyrotoxicosis, tachyarrhythmias, uncontrolled heart failure, and concomitant valvular heart disease. In patients with ANOCA/INOCA, symptoms may persist despite non obstructive coronary anatomy. Such…

…take months or years to develop (e.g. myocardial remodeling in heart failure or after myocardial infarction). Ventricular arrhythmias are easier to induce in the…

…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…

…Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced…

…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…

…constitute a cornerstone in the management of cardiovascular disease, heart failure, and chronic kidney disease (CKD). These agents interfere with the renin angiotensin aldosterone system…

…ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic stunning Adverse left ventricular (LV) remodeling Ischemic cardiomyopathy is the leading cause of heart failure with…

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

…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…

…arterial hypertension (PAH). The threshold is not absolute: patient phenotype, risk factors for heart failure with preserved ejection fraction, echocardiographic findings, and left atrial size…

…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…

…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…

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

…0.5 or toe pressure < 30 mmHg. Decompensated heart failure — compression of both legs acutely increases preload. Untreated deep vein thrombosis in the acute…

…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…

…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…

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

…1.73 m². Advantages of MDRD eGFR Clinical utility: The MDRD equation has been instrumental in identifying and staging chronic kidney disease (CKD), facilitating early…

…Few Dopamine medium dose Cardiogenic shock Vasodilatory shock Heart failure (HF), acute Heart failure (HF), chronic Bradycardia (second line alternative) Medium dose : 3.0 10…

…including the number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions (CTOs), calcification, and thrombus presence. These factors are weighted…

…Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive Pulmonary Disease (COPD) : Associated with higher perioperative risk. Clinical Applications Personalized Decision Making : SYNTAX Score II…

…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…

… 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…

…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…

…the coronary anatomy is suitable. In cardiogenic shock, the principal precipitating mechanisms include ischaemia related heart failure, acute severe mitral regurgitation, and other mechanical complications…

…the presence of substantial pre existing CKD, particularly when congestive heart failure or other causes of ischaemic AKI coexist. Risk assessment Patient related risk factors…

…major or life threatening bleeding. The clinical presentation, whether ACS or chronic coronary syndrome (CCS). Whether and how PCI was performed. The need for non…

…Place in lipid lowering therapy General treatment sequence High intensity statin therapy remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome…

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