…risk factors The principal determinant of risk is baseline renal function. The risk is increased by: CKD, especially advanced CKD; diabetic kidney disease; older age…

…Predisposing factors The likelihood of SAMS increases with higher statin doses and with several patient and treatment related factors: Age older than 80 years Female…

…is not uniformly present. The proportion of painless or silent STEMIs is greater in patients with diabetes mellitus and increases with age. STEMI may present…

…PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise from pulmonary vascular disease, left sided cardiac disease…

…is confined to the left ventricle. ARVC causes ventricular tachycardia and sudden cardiac arrest; the disease is one of the most common causes of sudden…

…the day of the test can therefore be given dexamethasone. That is the practical key: the patient does not have to be left unprotected for…

…blood pressure, left ventricular dysfunction, contraindications, or intolerance limit escalation of beta blocker or CCB therapy. Nicorandil and trimetazidine are additional options in selected patients…

Cardiology Emergency medicine Surgery & trauma Definition and Pathophysiology Aortic dissection is a major form of acute aortic syndrome (AAS), alongside intramural haematoma, penetrating atherosclerotic ulcer…

…than confined to a single lesion. Consequently, local revascularization must be accompanied by systemic treatment aimed at stabilizing the broader atherosclerotic disease. Pathophysiology Mechanisms of…

…reentry. In the common form of typical atrial flutter, the reentrant circuit is confined to the right atrium and travels in a counterclockwise direction. The…

…therapy (DAPT) is the combined use of aspirin and an oral P2Y12 receptor inhibitor. It is central to the prevention of platelet mediated coronary thrombosis…

…Caution • Avoided in hypertensive emergencies with left ventricular failure (due to negative inotropic effect). • Used cautiously in patients with asthma (due to risk of bronchospasm)…

…with inotropic and vasopressor effects, and they often need to be combined in order to optimise or correct the haemodynamics. Most agents exert both vasopressor…

…cardiac contractile force (contractility). Several endogenous and synthetic agents exist and are frequently combined to achieve the desired hemodynamic outcome. Most agents exhibit both vasopressor…

…is a nonselective beta adrenoceptor blocker devoid of intrinsic sympathomimetic activity that also prolongs cardiac repolarization, thereby exerting combined class II and class III antiarrhythmic…

…to assess left ventricular systolic function. These methods elucidate slightly different aspects of systolic function and their combined use allows for careful mapping of systolic…

…cardiac contractile force (contractility). Several endogenous and synthetic agents exist and are frequently combined to achieve the desired hemodynamic outcome. Most agents exhibit both vasopressor…

…recurrent malignant effusion (often combined with pleurodesis), and in chest trauma and postoperatively. Emergency needle decompression: a clinical suspicion of tension pneumothorax in a haemodynamically…

…heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive…

…from whole grains. These combined effects may improve inflammation, insulin resistance, glucose metabolism, hypertension, atherogenic dyslipidaemia, endothelial biology and platelet related pathways. The source material…

…induced myocardial ischaemia. Detect and characterize myocardial scar. Estimate the risk of major adverse cardiovascular events. Assess left ventricular volumes, regional wall motion, and ejection…

…CKD), which itself promotes cardiovascular disease and amplifies cardiovascular and all cause mortality. The excess risk is mediated by the combined effects of hyperglycaemia, hypertension…

…at the top. Refer to Figure 1 . Patients with left ventricular hypertrophy may instead display normalization of secondary T wave inversions (lead V5, V6, aVL…

…placed perpendicular to the long axis of the left ventricle, as illustrated in Figure 1. One obvious disadvantage of M mode is that it only…

…preferably anteroposteriorly : one anteriorly over the praecordium to the left of the sternum, the other on the back between the left scapula and the spine…

…and harms In secondary prevention trials involving patients with previous vascular disease, aspirin reduced the combined incidence of non fatal MI, non fatal ischaemic stroke…

…atherosclerotic plaque, and the severity and distribution of coronary stenosis. Modern cardiac CT can acquire a three dimensional cardiac dataset within approximately 5–15 seconds…

…CFR may occur with angiographically insignificant epicardial disease because of abnormalities in the coronary resistance vessels. Left ventricular hypertrophy also reduces coronary flow reserve: myocardial…

…beats/min. The reduction in the combined outcome of cardiovascular death or heart failure hospitalisation was related to the magnitude of heart rate reduction. Ivabradine…

…dL). The proportional reduction in cardiovascular risk is related to the absolute reduction in LDL C, regardless of the drug used to achieve it. Absolute…

…Advanced ECG interpretation, combined with clinical assessment and imaging modalities, has been shown to improve the identification of these patients. Although current (2025) guidelines continue…

…combined epicardial + microvascular resistance. IMR: distal pressure × hyperemic mean transit time — isolates microvascular resistance. Only indices that detect microvascular disease as an independent cause of…

…whereas contemporary decision making increasingly combines anatomical imaging with functional assessment. A central practical principle is that the visual severity of a stenosis does not…

…and lower thrombogenicity. Stent thrombosis Early metallic stents reduced acute closure but introduced the risk of thrombosis related to the intravascular foreign body. First generation…

…medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease. It combines a structured family history…

…coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological stress. The physiological basis is an…

…the full range of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both. The clinical consequences of extracellular volume expansion…

…from injured cardiomyocytes at substantially lower concentrations than earlier generation assays. They can identify troponin concentrations in approximately 50–95% of healthy individuals, whereas sensitive…

…risk factors or an elevated estimated risk. It combines lifestyle intervention with treatment of risk factors when indicated. Risk estimation is particularly important when deciding…

…perform systematic interpretation may actually be detrimental. We have therefore compiled a pocket guide with a universal interpretation algorithm. These 22 pages includes all you…

…term ischemia was coined in 1858 by Virchow (the same Virchow who unraveled thrombosis). He used te term to describe a reduction of blood flow…

…approximately one third of patients with inferior infarction. Extensive involvement is less common in patients with inferoposterior left ventricular infarction, while infarction confined predominantly to…

…believed that early repolarization was a benign condition, which is why the term benign early repolarization was coined. This notion was overturned in 2008 when…

…efficacy of compressions and defibrillation diminishes considerably. Extracorporeal Life Support (ECLS) emerges as the sole therapeutic alternative for such situations. Presently, this treatment is confined…

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…

…Reproduction and characterization of symptoms Heart rate and blood pressure responses to exercise Detection of exercise induced arrhythmias Identification of exercise related ST segment changes…

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