…disease, particularly diabetic kidney disease and advanced CKD. The clinical course is often more rapidly reversible than that of other forms of acute tubular necrosis…

Procedurer The test measures the ability of the adrenal cortex to respond to maximal ACTH stimulation, and it is rarely the injection itself that determines…

…angina pectoris. The location of the pain beneath the xiphoid and epigastrium, combined with patient denial, often leads to a mistaken impression of indigestion. STEMI…

…hypertension (CTEPH) and chronic thromboembolic pulmonary disease Group 5: PH with unclear or multifactorial mechanisms PAH is a distinct and uncommon form of precapillary PH…

…Complete intolerance is uncommon. Most patients who report intolerance can ultimately take some form of statin therapy after systematic reassessment and rechallenge. The principal manifestation…

…uncomplicated acute coronary syndrome when LVEF is 40% is not definitive. Observational studies have yielded conflicting results, and the appropriate duration of therapy in p

…variable penetrance and expressivity. Recessive forms exist, although they are rare (Naxos disease, Carvajal syndrome). The prevalence of ARVC is between 0.02 and 0…

…trauma Definition and Pathophysiology Aortic dissection is a major form of acute aortic syndrome (AAS), alongside intramural haematoma, penetrating atherosclerotic ulcer, aortic pseudoaneurysm and traumatic…

…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…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiology Dual antiplatelet therapy (DAPT) is the combined use of aspirin and an oral P2Y12 receptor inhibitor…

…Postoperative hypertension. Mechanism of action Combined beta adrenergic and alpha adrenergic blocker with rapid onset of action. Labetalol has less antihypertensive efficacy as compared with…

…Nitroprusside Figure 1. The approximate position of each drug according to its vasoconstrictor effect (vertical axis) and its positive inotropic effect (horizontal axis). Grey =…

…Several endogenous and synthetic agents exist and are frequently combined to achieve the desired hemodynamic outcome. Most agents exhibit both vasopressor and inotropic effects (Figure…

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

…function and their combined use allows for careful mapping of systolic function. It is important to be familiar with the advantages and disadvantages of each…

…Several endogenous and synthetic agents exist and are frequently combined to achieve the desired hemodynamic outcome. Most agents exhibit both vasopressor and inotropic effects (Figure…

…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…

…of foods habitually consumed rather than isolated nutrients considered independently. For cardiometabolic health, the most favourable patterns generally contain more minimally processed, fibre rich and…

…flow and myocardial flow reserve with PET. Evaluate myocardial viability, particularly when combined with metabolic imaging. Contribute to assessment of cardiac inflammation, infective endocarditis, and…

…is mediated by the combined effects of hyperglycaemia, hypertension, dyslipidaemia, obesity, smoking and other conventional risk factors, together with diabetes specific vascular and metabolic abnormalities…

…calcium and magnesium. Note that some patients may exhibit combined electrolyte imbalance. The ECG may be used to estimate the severity of electrolyte imbalances and…

…its temporal and axial resolution is very high, as compared with 2D echocardiography. M mode is useful for quantifying the mobility of structures and measuring…

…or to resolution of the underlying cause. Contraindications Hypothermia with a body temperature below about 30 °C — the hypothermic myocardium is irritable and pacing can…

…disease, aspirin reduced the combined incidence of non fatal MI, non fatal ischaemic stroke, and vascular death from 8.2% to 6.7% per year…

…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…

…pressure derived index of the functional effect of an epicardial stenosis. CFR reflects the combined influence of epicardial stenosis, resting flow and microvascular vasodilator capacity…

…sinus rhythm and a heart rate above 70 beats/min. The reduction in the combined outcome of cardiovascular death or heart failure hospitalisation was related…

…reflects the concentration of circulating atherogenic particles because each apoB containing particle carries one apoB molecule. LDL C, non HDL C and apoB are usually…

…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…

…minority of intermediate lesions. Over the past three decades, invasive physiological indices, led by fractional flow reserve (FFR), have been validated against outcomes and shown…

…ventricular function and the anticipated benefit–risk balance of revascularization. Coronary angiography remains primarily an anatomical examination, whereas contemporary decision making increasingly combines anatomical imaging…

…principally by neointimal hyperplasia. Contemporary DES combine a metallic scaffold, a polymeric or polymer free drug delivery system, and an antiproliferative agent. Their development has…

…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…

…ischaemia and to estimate prognosis in patients with suspected or established coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and…

…consider inotropic support Persistent congestion despite initial therapy Increase diuretic dose and/or combine diuretic classes Diuretic resistance or end stage renal failure Consider renal…

…95% of healthy individuals, whereas sensitive, but not high sensitivity, assays detect troponin in approximately 20–50%. Their greater analytical sensitivity improves diagnostic accuracy and…

…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…

…of missing important abnormalities and also speeds up the ECG interpretation. Press the Download button to download the pocket guide. Download Become a member and…

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

…low output, or persistent severe symptoms require close monitoring and consideration of invasive haemodynamic assessment when precise measurements are needed to guide therapy. Diagnostics Electrocardiography…

…al it was reported that early repolarization was associated with 3–5 times as great a risk of idiopathic ventricular fibrillation and sudden cardiac arrest…

…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…

…inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction, immune cell recruitment, extracellular matrix remodelling, and thrombosis interact to produce focal…

…increases in heart rate, myocardial contractility and blood pressure. When coronary blood flow cannot increase adequately because of flow limiting disease, myocardial ischaemia may develop…

…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…