…ischemia and infarction Definition and pathophysiology A chronic total occlusion (CTO) is a complete or nearly complete coronary arterial obstruction that has persisted for at…

…progression of native coronary artery disease. The chronic total occlusion is an important predictor of incomplete anatomical revascularization with PCI. PCI of chronic total occlusion…

…abnormalities. Assessment of wall motion abnormalities is particularly important in the setting of chronic or acute coronary artery disease. All types of ischemia– chronic, acute…

…CABG), or percutaneous coronary intervention (PCI), including attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA)…

…Their duration is short; they typically disappear within minutes after a total occlusion in a coronary artery occurs (then of course, the ST segment will…

…left main coronary artery disease . It integrates multiple variables, including the number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions …

…The bolus can be repeated, usually up to a total of three boluses, if severe symptoms persist and the initial rise is insufficient [3,6…

…cause. PAH reflects marked pulmonary arterial remodelling, with fibroproliferative, plexogenic, and sometimes thrombotic changes that may result in near total obliteration of affected vessels. Genetic…

…An increase of 1 2 mEq/L per hour for a total of 4 6 mEq/L in 24 hours may be targeted. Chronic Hyponatremia…

… nasal masks and total face masks are alternatives in intolerance. A hydrocolloid dressing for the bridge of the nose applied before the mask goes on…

…need 5–15 mg of morphine in total. If more than that is required without effect, reconsider the pain mechanism instead of continuing to increase…

…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…

…sex; low body mass index; larger arterial sheaths; greater intensity of procedural anticoagulation; complex coronary anatomy and technically difficult PCI. For peri procedural stroke specifically…

…altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation…

…correlates best with total cumulative dose—may be a better predictor of long term tolerability. Hemodynamic Effects Amiodarone acts as a peripheral and coronary vasodilator…

…Pathophysiology Chronic coronary syndromes (CCS) comprise the clinical manifestations of chronic structural and/or functional disease involving the epicardial coronary arteries and/or the coronary…

…quality of life. The underlying aetiology is heterogeneous. Chronic heart failure evaluation should therefore seek reversible or treatable causes. The source material identifies coronary disease…

…m², the probability of coronary artery disease (CAD) increases in an approximately linear manner. At an eGFR of 15 mL/min/1.73 m², cardiovascular…

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…

…important cause of cardiovascular disease (CVD), cardiovascular risk factor clustering, disability and premature mortality. Cardiovascular conditions associated with obesity include hypertension, dyslipidaemia, coronary artery disease…

…which causes atherothrombosis resulting in partial (incomplete) occlusion of the coronary artery. NSTE ACS results in one of the following diagnoses: Non ST Elevation Myocardial…

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…

…which causes atherothrombosis resulting in partial (incomplete) occlusion of the coronary artery. NSTE ACS results in one of the following diagnoses: Non ST Elevation 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 relieving…

…or chronic chest pain attributable to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of obstructive coronary artery disease (CAD) before diagnostic testing…

…severe preeclamptic phenotype or variant. Pathophysiology The precise mechanism of preeclampsia remains incompletely established. Proposed contributors include chronic uteroplacental ischaemia, an exaggerated maternal inflammatory response…

…parietal and visceral leaves of the pericardium are most often fused. The process most often affects the entire pericardium. Constrictive pericarditis is most often chronic…

CPR It is commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being…

…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…

…ACE) inhibitors are foundational therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction …

…of chronic kidney disease, ACE inhibitors slow the rate of decline of kidney function in a manner that extends beyond the reduction of systemic arterial…

…encompasses several physiological states. Brief coronary occlusion or relatively prolonged moderate ischemia may produce post ischemic stunning. In the absence of infarction, contractile recovery can…

…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…

…having an infarction. The degree of troponin elevation does not by itself establish the mechanism. Increased concentrations may result from acute coronary atherothrombosis, oxygen supply…

…chronic pericardial effusions to cause sudden cardiac arrest since these cases tend to be recognized and managed before circulatory collapse occurs. The leading causes of…

…be counteracted with simultaneous administration of norepinephrine. All patients with severe acute heart failure who receive levosimendan should be monitored invasively (e.g. arterial line…

…applies where you work. They assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick…

…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…

…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…

…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…

Indications Acute myocardial infarction. Unstable coronary artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA…

…identifying and staging chronic kidney disease (CKD), facilitating early intervention and management. Standardization: Its widespread adoption has led to standardized reporting of eGFR in clinical…

…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…

…II Anatomical SYNTAX Score : Derived from the original SYNTAX Score, which evaluates the complexity of coronary lesions. Clinical Variables : Age : Older patients have a higher…

…to chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations arising from structural or functional abnormalities of the coronary arteries or coronary…

…atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and aggregation contribute importantly to arterial thrombus formation, recurrent coronary occlusion, and stent…

…lipid, or BP disorders Pregnancy Established ASCVD includes previous acute coronary syndrome, chronic coronary syndromes, coronary revascularization, stroke, transient ischaemic attack, and peripheral arterial disease…

…coronary syndrome. Patients with stable or chronic atherosclerotic coronary disease, many of whom have a previous acute coronary syndrome. The available evidence supports consideration of…

…with normal renal function, the occurrence of contrast induced AKI is negligible or very low. Risk rises substantially with chronic kidney disease, particularly diabetic kidney…

…whether ACS or chronic coronary syndrome (CCS). Whether and how PCI was performed. The need for non cardiac surgery. The presence of an indication for…

…High intensity statin therapy remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease…

…elevation without evidence of ischaemia represents acute myocardial injury rather than MI. Persistent elevation without a significant dynamic change is consistent with chronic myocardial injury…

…restenosis (ISR) is recurrent narrowing within a previously implanted coronary stent. It represents a form of arterial hyperplastic disease arising after percutaneous coronary intervention (PCI)…

…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…

…In chronic coronary syndrome, the recommended LDL C objective is: LDL C <1.4 mmol/L (<55 mg/dL) , and A reduction of at least…

…medicine Definition and pathophysiology Peripheral artery disease (PAD) is a clinical disorder caused by stenosis or occlusion of the aorta or arteries supplying the limbs…

…Hypertension. Absence of an adequate collateral circulation. A first or anterior infarction. Single vessel disease without collateral support. Chronic kidney disease, particularly in relation to…

…acute coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to chronic limb…

…separation within the coronary arterial wall, usually through formation of an intramural haematoma that compresses the true lumen. The resulting reduction in coronary blood flow…