…coronary artery disease (CAD). It offers visual and numerical insights into myocardial blood flow under rest and stress conditions. MPI uses radiotracers in combination with…

…the left ventricle during diastole. The hemodynamic consequences of aortic regurgitation depend on whether the condition develops acutely or gradually. Acute aortic regurgitation Acute aortic…

…different position or a different vessel. Choice of site Vessel Advantages Disadvantages : : : Internal jugular vein (right) Best ultrasound conditions, a straight course to the superior…

…objectively verifiable fatigable symptoms. Assessment of whether residual weakness in a patient with known myasthenia responds to further cholinesterase inhibition. The test has a sensitivity…

Cardiology Genetic and miscellaneous conditions Clinical Red Flags Raising Suspicion of Cardiac Amyloidosis Demographic and Clinical Context Cardiac amyloidosis should be suspected in patients older…

Cardiology Genetic and miscellaneous conditions Definition and classification Coronary anomalies are congenital abnormalities involving the origin, course, distribution, or termination of the coronary arteries. They…

Cardiology Genetic and miscellaneous conditions Definition and scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who…

Cardiology Genetic and miscellaneous conditions Definition and pathophysiology Familial hypercholesterolaemia (FH) is an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL…

ECG Genetic and miscellaneous conditions J wave syndromes: early repolarization pattern, Brugada syndrome, hypercalcemia and hypothermia The J wave – also referred to as Osborn's…

ECG Genetic and miscellaneous conditions Eletrical alternans: an ECG sign of pericardial effusion and cardiac tamponade The pericardial space (cavity) always contains a small amount…

ECG Genetic and miscellaneous conditions Pericarditis, myocarditis and perimyocarditis: ECG changes and clinical features The pericardium is a double walled sac in which the heart…

…conditions Takotsubo cardiomyopathy (broken heart syndrome, apical ballooning syndrome, stress induced cardiomyopathy) Takotsubo cardiomyopathy (broken heart syndrome) is a rather peculiar and certainly acute condition…

Info A comprehensive list of conditions and drugs that may prolong the QT interval, and cause torsade de pointes (TdP) and long QT syndrome (LQTS…

Arrhythmias and arrhythmology ECG Genetic and miscellaneous conditions Brugada syndrome: A life threatening arrhythmia with unknown prevalence Pedro Brugada and his two brothers, Josep and…

Arrhythmias and arrhythmology ECG Genetic and miscellaneous conditions The early repolarization pattern and syndrome: from ECG criteria to management Although the early repolarization pattern has…

CPR Sepsis induced cardiac arrest Sepsis is a life threatening condition characterized by systemic inflammatory response syndrome (SIRS), disseminated intravascular coagulation (DIC), and hypoperfusion manifesting…

Echocardiography Pericardial diseases: effusion and tamponade A long series of conditions can affect the pericardium (pericardium). The most common of these are acute pericarditis (perimyocarditis…

Echocardiography Tricuspid valve stenosis Tricuspid stenosis is a rare condition that may be caused by rheumatic valvular disease, congenital heart disease, Whipple’s disease, or…

Arrhythmias and arrhythmology Continous medical discussion: the ECG blog Genetic and miscellaneous conditions A novel potentially life threatening cardiac arrhythmia syndrome identified with ECG The…

…cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration, particularly in patients with marked tolerance…

…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…

Cardiology Endocrinology & metabolism Definition and Pathophysiology Type 2 diabetes mellitus (T2DM) is a major cardiovascular risk condition. It is associated with a two to four…

Echocardiography Endocarditis Endocarditis implies that a bacterial infection engages the heart valves and this is a serious condition. The focus of infection on the flap…

…load, which the ventricle counteracts by developing hypertrophy. Hypertrophic cardiomyopathy implies left ventricular hypertrophy under normal loading conditions. Recommended reading Ventricular Pressure Volume Relationship: Preload…

…treatment of bradycardia (bradyarrhythmia) Acute bradycardia with hemodynamic instability Acute bradycardia with hemodynamic effects is a potentially life threatening condition and should be managed urgently…

…and sick sinus syndrome Sinus node dysfunction is an umbrella term for conditions that either affect the automaticity of the sinoatrial node or block the…

…interpretation Standard display of ECG leads in the 12 lead ECG Numerous conditions that can be diagnosed using the 12 lead ECG require that ECG…

…Skin symptoms may be absent, and circulatory shock does not have to be present for the condition to be serious [1]. Intramuscular adrenaline (epinephrine) is…

…Indications Condition Procedure : : Acute paronychia with fluctuance or visible pus Incision and drainage Acute paronychia without pus formation Antibiotics and soaks alone Ingrown nail with…

…a vasopressor and early source control. Sepsis is a dynamic condition. Investigation and treatment must therefore proceed in parallel and must not wait for complete…

…torsade de pointes. This condition is primarily attributed to specific genetic mutations: loss of function mutations in KCNQ1 (LQT1) and KCNH2 (LQT2), and gain of…

…torsade de pointes. This condition is primarily attributed to specific genetic mutations: loss of function mutations in KCNQ1 (LQT1) and KCNH2 (LQT2), and gain of…

…or the His Purkinje system. The underlying pathophysiology varies widely and may involve intrinsic cardiac disease, extrinsic systemic conditions, or pharmacologic effects. Inflammatory heart disease…

…Symptoms and conditions that should prompt assessment include: Hypertension Dyspnoea Exercise intolerance Congestive HF CAD Palpitations or suspected atrial fibrillation OSA or daytime symptoms suggestive…

…chronic lung disease or hypoxia, chronic thromboembolic obstruction, or a range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis and classification must integrate haemodynamics…

…syndrome (DI LQTS) [1]. The condition arises in the setting of both modifiable and nonmodifiable risk factors. Modifiable risk factors include electrolyte abnormalities such as…

…while simultaneously affecting systemic perfusion. Aortic stenosis is a serious condition with poor long term outcomes. Patients with low flow low gradient aortic stenosis (discussed…

…enlargement refers to abnormally large atria or abnormally large ventricles. These conditions are referred to as atrial enlargement and ventricular enlargement . From a hemodynamic standpoint…

…predominantly ischemic heart disease. However, most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not…

…Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes…

…increase heart rate Chronotropic incompetence is an independent predictor of overall and cardiovascular mortality. The condition is very common among individuals with heart failure. Notably…

…effects and lack of compelling data regarding morbidity and mortality benefits, digoxin has been ousted repeatedly from the standard of care for these conditions. However…

…to study velocities, volumes, and pressure conditions in the heart. These techniques allow for the calculation of all clinically relevant hemodynamic parameters, with few exceptions…

…Intermittent bradycardia The following conditions may cause intermittent bradycardia: Extrasystoles (premature ventricular beats or premature atrial supraventricular beats) can cause transient AV blocks by affecting…

…half of the heart, it is important to familiarize yourself with the principles of hemodynamics and conditions prevailing on the right side. Echocardiography is the…

…exhibit ST segment elevations, but the condition should be managed as STEMI (ST Elevation Myocardial Infarction) in terms of treatment and interventions. As discussed previously…

…are common in myocardial ischemia and infarction. These conditions may be seen as signs of ischemia, which is why one must be familiar with them…

…the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular (AV) dissociation. Importantly, for the…

…in the ventricles. A wide range of conditions may cause ventricular tachycardia and the ECG is as nuanced as are those conditions. Regardless of etiology…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…pressure monitoring in haemodynamic instability or during ongoing vasoactive treatment. Conditions in which blood pressure must be kept within narrow limits: aortic dissection, intracerebral haemorrhage…

…deprivation, urinary retention or a new sedative drug, for example — may be enough to precipitate the condition [1,2]. Delirium is common but often missed…

…circulatory shock require a specific protocol and early specialist involvement. DKA and HHS are dynamic conditions. Treatment must be guided by the clinical response and…

…of tachyarrhythmia with wide QRS complexes (QRS duration ≥ 0.12 s): the commonest cause is ventricular tachycardia, which is a potentially life threatening condition. Note…

…Relative: Condition Comment : : Left main stenosis Known — perform the test only on a clear indication and with full preparedness Moderate to severe aortic stenosis without…

…blood pressure is often at least 180/120 mmHg, but no absolute threshold defines the condition. A rapid rise in blood pressure can cause serious…

…always weighs more heavily). A joint prosthesis: the aspiration must be performed by an orthopaedic surgeon under strictly sterile conditions. For corticosteroid injection there is…

…Contraindications Type Condition : : Absolute Suspected base of skull fracture or a marked midfacial fracture — the tube can pass through a fracture in the cribriform plate…

…and the examination is needed for the diagnosis. Before audiometry or the fitting of a hearing aid. Recurrent otitis externa in which the wax retains…

…until the saturation can be measured reliably. Conditions in which oxygen is given irrespective of the saturation (see below). Oxygen does not relieve breathlessness in…