…to chronic lung disease, hypoxia, or sleep disordered breathing Group 4: Chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease Group 5: PH with…

…may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is particularly associated with elevated central venous pressure, which is transmitted to…

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

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

…immediately life threatening; reported in hospital mortality was 42.4% for STEMI associated mechanical complications and 18% for those associated with NSTEMI. The timing of…

…operating theatre. Careful electrocardiographic and haemodynamic monitoring with ECG, a central venous catheter and an arterial line is necessary to achieve an optimal result. Overview…

…Increasing severity of mitral regurgitation is associated with worse outcomes. Pulmonary hypertension secondary to left heart disease may occur because elevated left sided filling pressures…

…Ischemic heart disease Both acute and chronic ischemic heart disease (including complications) can cause embolisms. Left ventricular aneurysm with thrombus Cardiomyopathies Valve prosthesis Devices (pacemaker…

…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…

…or neoplastic etiologies. Other causes include immobilization, sarcoidosis, thyrotoxicosis, familial hypocalciuric hypercalcemia, Addison's disease, renal insufficiency, therapeutic interventions with tamoxifen or lithium, thiazide administration…

…The unstable patient Hypotension (systolic < 90 mmHg for 15 minutes, or a need for a vasopressor), obstructive shock or cardiac arrest with suspected pulmonary…

…adherence. Opioids, benzodiazepines and other sedating drugs. Thromboembolic risk, for example immobilisation, cancer and previous venous thromboembolism. A documented decision on the ceiling of care…

…leg ulcers. Chronic venous oedema, lipodermatosclerosis, stasis dermatitis. Prevention of recurrence after a healed venous ulcer. After deep vein thrombosis with post thrombotic syndrome. Differential…

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

…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…

…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…

…minority with symptoms having all of the traditional aggravating and relieving characteristics of angina; many patients report less characteristic symptoms, while others present primarily with…

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

…angiography performed for another indication. When clinically significant, it may present with chronic angina, an anginal equivalent or exertional dyspnoea. Patients may continue to have…

…immune mediated fibroproliferative response to endothelial injury [2] . The process initiates with endothelial dysfunction, a state provoked by systemic risk factors such as hypertension, hyperglycemia…

…cells. Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells…

…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…

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…

…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…

…Nicorandil and trimetazidine are additional options in selected patients. Treatment choices should be integrated with management of precipitating factors such as anaemia, uncontrolled hypertension, thyrotoxicosis…

…an ischaemic mechanism. Clinical assessment and estimation of pre test probability Symptoms and clinical context The assessment begins with the clinical presentation, including the character…

…oedema, hepatic complications, renal impairment, and cerebrovascular accidents. HELLP syndrome is associated with substantial morbidity and mortality. Pregnancy related hypertension also influences obstetric management. In…

…the result of chronic inflammation of the pericardium. In principle, all causes of pericarditis can result in constrictive pericarditis. In high income countries, idiopathic pericarditis…

…infarction or ischemic episode to result in ventricular arrhythmia, it must coincide with other pro arrhythmogenic factors. The emergence of ventricular tachycardia or ventricular fibrillation…

…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…

…people with a low muscle mass — the elderly, the undernourished, amputees, patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic…

…therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial…

…function, and potassium should be evaluated within 1 to 2 weeks after initiation of ACE inhibitors, especially in patients with preexisting azotemia, hypotension, hyponatremia, diabetes…

…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…

…therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS), peripheral artery disease (PAD)…

…a rise and/or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction. Cardiac troponin identifies injury to…

…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…

…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…

…reported with acetylsalicylic acid. Discontinue acetylsalicylic acid at the first sign of skin rash, mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other…

…critical, especially in individuals with near normal kidney function, alternative equations like the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) equation may offer improved accuracy…

…days Norepinephrine Shock (any) Hypotension (any) 0.01–3.0 μg/kg/min Safe for peripheral use +++++ +++ ++ 0 Potent vasoconstrictor with mild inotropic effect…

…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…

…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…

…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…

…is applicable Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or definite familial hypercholesterolaemia Other markedly abnormal single risk factors…

…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…

…of shock. Patients with moderate to severe chronic kidney disease have a higher burden of comorbidity and an increased risk of in hospital complications, including…

…substantially with chronic kidney disease, particularly diabetic kidney disease and advanced CKD. The clinical course is often more rapidly reversible than that of other forms…

…also demonstrated increased ischaemic complications. In a large network meta analysis, 3 month DAPT, but not 6 month DAPT, was associated with higher rates of…

…of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease, and other very high risk settings described…

…without a significant dynamic change is consistent with chronic myocardial injury. Non ischaemic conditions, including myocarditis, rapid ventricular rate atrial fibrillation, marked anaemia, hypertensive emergency…

…angina caused by disease in the treated segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS), acute coronary syndrome (ACS)…

…offering profound benefits in major adverse cardiovascular events (MACE), heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), and peripheral artery disease (PAD)…

…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…

…therefore address the entire arterial circulation. PAD is associated with increased cardiovascular morbidity and mortality, as well as limb complications. Atherosclerotic lesions generally affect large…

…premature death, recurrent infarction and limb threatening complications. Among patients with established peripheral artery disease, those who stop smoking have approximately twice the five year…