…precapillary pulmonary vascular component. PAWP is used to distinguish pulmonary venous hypertension caused by left heart disease from pulmonary vascular disease. Although a PAWP of…

Cardiology Nephrology Definition and pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months…

…musculoskeletal and psychological complications. Symptoms and conditions that should prompt assessment include: Hypertension Dyspnoea Exercise intolerance Congestive HF CAD Palpitations or suspected atrial fibrillation OSA…

Cardiology Myocardial ischemia and infarction Definition and Pathophysiology Refractory angina is a chronic syndrome of persistent ischaemic symptoms despite the exhaustion of conventional therapeutic options…

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

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

…Hypertension and diabetes contribute to its development, and obesity is increasingly recognized as an important contributor. Older age, female sex, atrial fibrillation (AF), chronic kidney…

…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…

…increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is not affected by the concurrent use…

…etiologies when promptly and appropriately addressed. Both venous and arterial blood gases can be utilized for the analysis of electrolyte levels. Electrocardiography (ECG) serves as…

…DOAC is the first choice in pulmonary embolism without malignancy and without antiphospholipid syndrome. The doses in venous thromboembolism include an initial high dose phase…

…and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive ventilation is not immediately required. 8…

…in the presence of clinical signs of infection — all chronic wounds are colonised, and a culture taken without clinical suspicion leads only to unnecessary antibiotics…

…are common differential diagnoses which represent contraindications for thrombolysis. Venous thromboembolism is a chronic and serious condition. Mortality in pulmonary embolism is up to 20…

…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…

…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…

…state. Patients may remain stable for prolonged periods, but chronic coronary disease can progress or destabilize abruptly, leading to an acute coronary syndrome (ACS). Clinical…

…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…

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…

…Despite this prolonged course, its major complications—including myocardial infarction, unstable angina and stroke—may occur abruptly and without preceding warning. Initiation and progression of…

Cardiology Evaluation and management of stable coronary artery disease Chronic coronary syndromes (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris…

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…

ECG Evaluation and management of stable coronary artery disease Chronic coronary syndrome (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris…

…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…

…but symptom characteristics and clinical judgement must be incorporated. In symptomatic individuals without known CAD, newer clinical prediction algorithms are preferred over older approaches based…

…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…

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…

…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…

…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 …

…heart failure, and chronic kidney disease (CKD). These agents interfere with the renin angiotensin aldosterone system (RAAS) by inhibiting the enzyme responsible for the conversion…

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

…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…

…steroids and controlled oxygen. Acute on chronic hypercapnic failure in obesity hypoventilation and neuromuscular disease. Hypercapnic failure in cardiogenic pulmonary oedema that does not improve…

…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…

…that distinguishes obstructive from restrictive impairment of lung function, and COPD cannot be diagnosed without it . The quality of the test determines its entire value…

…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…

…Initial loading dose: 300–500 mg as soon as possible after symptom onset. Prophylaxis against cardiovascular complications (after acute myocardial infarction, unstable coronary artery disease…

…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…

…HF), acute Heart failure (HF), chronic Bradycardia (second line alternative) Medium dose : 3.0 10.0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1…

…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…

…infarction. It may be acute, when serial troponin values show a dynamic change, or chronic, when troponin elevation persists without such a change. Myocarditis, sepsis…

… 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…

…specific risk assessment or risk categorization is applicable Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or definite familial hypercholesterolaemia…

…lowering and other guideline directed therapies. Anti inflammatory treatment seeks to reduce this residual risk without necessarily altering lipid concentrations, blood pressure or other conventional…

…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…

…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…

…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…

…Inclisiran, with or without statin therapy Approximately 50% reduction The absolute reduction depends on the pretreatment LDL C concentration and the accompanying lipid lowering regimen…

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

…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)…

…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…

…FH are principal settings in which these drugs have received approval. In chronic coronary syndrome, the recommended LDL C objective is: LDL C <1.4…

…circulation. PAD is associated with increased cardiovascular morbidity and mortality, as well as limb complications. Atherosclerotic lesions generally affect large and medium sized arteries. Pathological…

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