…The vast majority of cases can be characterized by echocardiography. In comparison with adult subjects, the echocardiographic evaluation in pediatric patients requires a different approach…

…of their previous training and profession. Read Dr Rawshani's book Below follows a review, compiled by Dr Araz Rawshani, of the most widely used…

…is due to the fact that atrial flutter is caused by a macro re entry circuit (a large re entry circuit) and re entry circuits…

…block cannot be diagnosed using surface ECG (i.e. ECG recorded on the body surface). This is because the electrical potentials generated by the sinoatrial…

…nuanced symptoms in clinical practice and it is fundamental to be able to differentiate benign from serious etiologies. Therefore, when encountering a patient with chest…

Cardiology Clinical medicine Definition and Pathophysiology An abdominal aortic aneurysm (AAA) is diagnosed when the abdominal aortic diameter exceeds 3 cm. Most AAAs are located…

…diagnosed without proteinuria when clinical symptoms or laboratory abnormalities indicate end organ injury. Eclampsia is the occurrence of new onset seizures or coma in a…

Cardiology Definition and terminology Heart failure (HF) is a complex clinical syndrome characterized by symptoms and signs resulting from structural or functional impairment of ventricular…

…NSTEMI is diagnosed when typical ischaemic symptoms occur without persistent ST segment elevation, accompanied by a rise and subsequent fall in cardiac specific troponin attributable…

…to a specific, identifiable underlying cause. It should be considered in every patient with newly diagnosed or referred hypertension, with particular vigilance when the clinical…

Emergency medicine Lathundar Differential Diagnosis of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome…

…frequently referred to as stable angina pectoris , has traditionally been defined and managed as a distinct clinical entity. The hallmark of stable coronary artery disease…

…frequently referred to as stable angina pectoris , has traditionally been defined and managed as a distinct clinical entity. The hallmark of stable coronary artery disease…

…circumference, waist to hip ratio, or dual X ray absorptiometry are recommended to more accurately diagnose clinical obesity and assess cardiovascular risk. 4 Furthermore, ectopic…

…not always be straightforward to diagnose on the ECG. Moreover, many clinicians remain uncertain about the implications of sinus tachycardia. A crucial task is to…

…or diuretic induced, but it is absent in most diagnosed patients. Reliance on hypokalaemia alone therefore misses a substantial proportion of cases. The cardiorenal and…

…exercise tests should not be maximal, which means that the clinician must set a lower goal regarding workload (e.g. reaching 70% of maximal pulse…

…on the other hand, is caused by a complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive…

…Denmark, Netherlands and United Kingdom reported a novel ECG syndrome characterized by widespread ST segment depressions and an increased risk of sudden cardiac arrest. They…

…thrombus is often asymptomatic and cannot be diagnosed reliably by examination alone. Assessment should include evaluation for: Hemodynamic instability or cardiogenic shock. Clinical heart failure…

…of myocardial ischaemia rather than by a particular symptom intensity alone. The characteristic symptom is chest discomfort, but the clinical manifestations of ischaemic heart disease…

…is called vegetation. As a rule, some kind of damage to native (own) valves is required to become vulnerable and contaminated by bacteria . Infections are…

…the more pronounced the symptoms. Stable angina pectoris is diagnosed by means of exercise stress testing (exercise ECG). The purpose of the stress test is…

…presence of myocardial necrosis. NSTEMI is confirmed by a typical rise and/or fall of high sensitivity cardiac troponin (hs cTn), with at least one…

…Ramon, described this syndrome in 1992. The syndrome is characterized by a rather peculiar ECG and the patients experience syncope, life threatening ventricular arrhythmias, cardiac…

…cTn concentration at presentation and its serial change A simplified interpretation is shown below. Clinical and diagnostic pattern Likely triage or diagnosis Low likelihood symptoms…

…infarction Definition and Clinical Purpose Myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) or positron emission tomography (PET) is a radionuclide based…

…May be accompanied by diaphoresis, dyspnoea, nausea, vomiting, fatigue, faintness, or belching. Radiation to both arms or shoulders has a particularly strong association with myocardial…

…a long way. Treatment with anticoagulation is highly effective in reducing stroke risk. Wrfarin and novel oral anticoagulants can reduce the risk of stroke by…

…addressed in isolation, distinguishing between them in clinical scenarios may remain challenging. Effective management of tachycardia requires a comprehensive understanding of differential diagnoses, therapeutic strategies…

…clinical practice, however, it is difficult to achieve peak oxygen uptake because it requires maximal exertion, which patients rarely achieve. Patients are usually limited by…

…arrest & sinoatrial pause (sinus pause/arrest): ECG characteristics & clinical implications A sinoatrial arrest occurs when the sinoatrial node does not discharge an impulse for ≥2…

…with ventricular tachycardia from a clinical perspective, with emphasis on ECG diagnosis, definitions, management, and clinical characteristics. Ventricular tachycardia is a highly nuanced arrhythmia that…

…followed by direct transfer to a PCI centre [1,5]. Situation Practical target : : ECG after first medical contact Within 10 minutes STEMI diagnosis to wire…

…ECGs and with the clinical context. 1. Rhythm Check Is the ventricular rate regular at 50–100 beats/min? Is there a P wave in…

…assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease. It combines a structured family history, clinical evaluation, cardiac investigations…

…all clinicians, it is reasonable to acquire an understanding of the overarching concepts. Arrhythmogenesis (mechanisms of arrhythmias) is presented in this chapter, followed by in…

Arrhythmias and arrhythmology Emergency medicine Pharmacology & dosing Definition and Pathophysiology Bradycardia encompasses a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within…

… it may represent the posterior component of a broader infarct territory. Clinical Presentation and Symptoms The source material addresses posterior infarction primarily in the context…

…of transmural infarction (STEMI) but may be caused by extensive subendocardial ischemia (NSTEMI). Establishing a diagnosis of Q wave infarction requires that pathological Q waves…

…calculation of Qp/Qs is a cornerstone in managing patients with intracardiac shunts. By integrating anatomical measurements and Doppler hemodynamics, clinicians gain valuable insights into…

…a rapid assessment of the airway is paramount to evaluate for impending respiratory compromise. Diagnostics The diagnosis of ACE inhibitor induced cough is primarily clinical…

…is usually normal when the patient is not experiencing ischaemia. A minority of patients have clinical evidence of systemic vasospasm, particularly migraine or Raynaud phenomenon…

…Clinicians frequently find it difficult to differentiate between Mobitz type 1 and Mobitz type 2. A very simple rule of thumb can be applied to…

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

…frequently non classical. Contemporary clinical populations include only a minority with symptoms having all of the traditional aggravating and relieving characteristics of angina; many patients…

…cannot deliver blood at a rate appropriate to tissue requirements unless filling pressures are elevated. The syndrome is therefore defined by symptoms and signs of…

…and infarction ECG Definition and Pathophysiology Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions characterized by a recent change in symptoms or signs…

…only a limited representation of usual blood pressure and may be biased by the clinical environment. Out of office measurement is consequently central to diagnosis…

…The clinical phenotype is driven principally by lifelong LDL C elevation and may be discovered through: Routine lipid testing showing severe hypercholesterolaemia. A personal history…

…hypertrophy and kidney injury. The syndrome is therefore both a clinical risk factor cluster and a marker of broader metabolic dysfunction. Associated abnormalities may include…

…neurally mediated hypotension. Clinical Presentation and Symptoms Vasovagal syncope is frequently preceded by prodromal symptoms, including diaphoresis, a "warm sensation," and nausea. Patients may also…

…electrocardiographic curiosity into a major focus of contemporary cardiac electrophysiology [1] . Recognized as a primary inherited arrhythmia syndrome, BrS is characterized by a distinct electrocardiographic…

…other relevant investigations. Clinical Presentation and Symptoms Natriuretic peptide testing is particularly useful when symptoms suggest HF but the diagnosis remains uncertain. Acute HF generally…

…ACS) and confirmed by angiography or pathology. The Academic Research Consortium framework additionally distinguishes definite, probable, and possible stent thrombosis for clinical research and outcome…

…detail below. The clinical definitions and recommendations presented in this chapter are in line with guidelines issued by the American Heart Association (AHA), American College…

…pain perception in patients without demonstrable ischaemia. The absence of obstructive disease therefore does not establish a benign diagnosis. ANOCA/INOCA is associated with recurrent…

…myocardial infarction as the final diagnosis. The underlying process usually involves acute thrombotic obstruction of an epicardial coronary artery. A vulnerable atherosclerotic plaque and thrombogenic…

…were followed by almost two decades without any major breakthrough in the management of heart failure. In 2014 the PARADIGM HF study introduced a new…

…R Wave Peak Time : Some criteria define LBBB by a prolonged time to the R wave peak ($\ge 60$ msec) in the left precordial…