…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

…cardiac and renal axes may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is particularly associated with elevated central venous pressure…

…factor and as a driver of hypertension, diabetes, dyslipidaemia and systemic inflammation. It is also associated with respiratory disorders, notably obstructive sleep apnoea (OSA) and…

…of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has identified the relevant endotype and…

…Clinical presentation and symptoms A new episode of hypotension, recurrent chest pain, pulmonary congestion, a new cardiac murmur, or jugular venous distension in the days…

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

…by symptoms and/or signs of HF with LVEF 41–49%. In this group, structural abnormalities such as left atrial enlargement or left ventricular hypertrophy…

…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…

…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…

…Hypotension Arrhythmias and ECG changes Cardiac arrest Treatment Furosemide 1 mg/kg IV. Hydrocortisone 300 mg IV. Pamidronate 30 90 mg IV. Causal treatment of…

…of 0 indicates low risk. Anticoagulation A DOAC is the first choice in pulmonary embolism without malignancy and without antiphospholipid syndrome. The doses in venous…

…No risk of hypercapnia and a normal blood gas Usually 94 to 98 percent An individually documented target prescription, for example in chronic hypercapnia Follow…

…70% of all leg ulcers. Chronic venous oedema, lipodermatosclerosis, stasis dermatitis. Prevention of recurrence after a healed venous ulcer. After deep vein thrombosis with post…

…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…

…pressure causes compression of the atria and the ventricles (particularly the former). Even small pressure elevations on the right side can compromise venous return to…

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

…The absence of chest pain does not exclude clinically important CCS. Silent or minimally symptomatic disease may occur in patients with diabetes and autonomic neuropathy…

…characteristic clinical phenotype of breathlessness, fatigue and oedema. This definition does not depend on left ventricular ejection fraction (LVEF). Heart failure with reduced ejection fraction…

…Additional features associated with greater difficulty include a previously failed attempt, a blunt proximal stump, vessel bending, calcification and an occlusion length of at least…

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…

…in line with the European guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment of chronic coronary…

…atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial accumulation of apolipoprotein B containing…

…in line with the European guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment of chronic 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…

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

…morbidity and mortality. Their incidence has increased in parallel with older maternal age at first childbirth and the rising prevalence of obesity. Gestational hypertension is…

…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…

…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…

…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…

…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…

…management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial infarction (MI) care. Despite their proven morbidity and…

…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…

…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 …

…dosing Definition and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary…

…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…

…within a couple of hours should be intubated, not given another hour. Indications CPAP: Acute cardiogenic pulmonary oedema with hypoxaemia and marked work of breathing …

…severe piperacillin–tazobactam 4 g × 4 IV Exacerbation of COPD with an indication for antibiotics amoxicillin 750 mg × 3 PO 5–7 days or doxycycline…

…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…

…time, coach actively, and do not accept a trace you would not be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea, wheeze…

…glans and meatus with the cleansing solution in circular movements from the centre outwards. Change the swab between strokes. 3. Instil 10–20 mL of…

…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…

…and costly direct measurements of GFR. Limitations of MDRD eGFR Accuracy at Higher GFR Levels: The MDRD equation tends to underestimate GFR in individuals with…

…pressure and pulse pressure with minimal effect on CO. Minimal chronotropic effect. Increases coronary blood flow. Atrial or ventricular arrhythmias Bradycardia Peripheral (digital) ischemia Hypertension…

…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…

…the time of assessment. Ongoing chest discomfort with electrical or haemodynamic instability. Cardiac arrest or cardiogenic shock. Features that favour ACS rather than chronic stable…

…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…

…risk varies considerably according to age and the presence of concomitant risk factors. In contrast, patients with confirmed hypertension generally require BP lowering treatment without…

…In patients with previous myocardial infarction and residual inflammation, defined by hsCRP ≥2 mg/L, it produced a modest reduction in a composite of cardiovascular…

…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…

…the occurrence of contrast induced AKI is negligible or very low. Risk rises substantially with chronic kidney disease, particularly diabetic kidney disease and advanced CKD…

…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…

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

…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…

…diameter A high degree of residual stenosis Long lesion length Diabetes Untreated edge dissection DES have reduced restenosis compared with BMS, and newer generation DES…

…heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), and peripheral artery disease (PAD). Figure 1 (below) shows weight loss effects of novel…

…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…

…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…

…40% and in death of approximately 35–45%. In chronic coronary syndrome, cessation has been associated with a 36% reduction in premature mortality compared with…