…biomarkers because they are extremely sensitive and specific for myocardial injury. Elevated levels of cardiac troponins is firm evidence of myocardial necrosis (i.e infarction…

…which is a manifestation of post cardiac injury syndrome (PCIS). PCIS is an umbrella term that also includes post pericardiotomy syndrome and post traumatic pericarditis…

…mortality and atrial fibrillation. Consequently, alcohol should not be initiated as a cardiovascular preventive strategy. A drink equivalent contains approximately 12–14 g of ethanol…

…6. Stop immediately in the event of coughing, stridor, cyanosis or marked breathlessness — withdraw the tube to the pharynx and start again . If the tube…

…or crushing, although stabbing or burning sensations may occur. Pain usually involves the central chest or epigastrium, may radiate to the arms, and less often…

…also contributes to the extension and severity of ischemic injury. In its most severe form, known as no reflow, structural and functional impairments sustain vascular…

…influences. The severity of myocardial injury is determined not only by the epicardial obstruction but also by the vulnerability of the myocardium and coronary microcirculation…

…capillary refill and pulse, and active movement of every tendon crossing the wound. A tendon injury can be painless and gives normal passive movement — test…

…ischaemic myocardial injury may coexist, and certain disease entities can span both categories; for example, acute heart failure may occur in the context of acute…

…a crushing sensation across the precordium and may radiate to the neck, shoulder, jaw, back, upper abdomen, and left or right arm. Onset and evolution…

…form of cardiovascular disease. It has been the number one killer in Western and high income countries for more than half a century, causing approximately…

…broad spectrum hydroxamic acid based inhibitor of histone deacetylase... <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Abexinostat+AND+(%22QT%22+OR+Torsad " PubMed…

…intrapericardial pressure due to the tamponade. The increased pressure causes compression of the atria and the ventricles (particularly the former). Even small pressure elevations on…

…ACS) and acute myocardial infarction (AMI) Acute coronary syndromes occur when atherosclerotic plaques disrupt, resulting in the activation of thrombocytes and coagulation factors causing the…

…Ventricular fibrillation is the result of numerous re entry circuits , causing rapid and chaotic ventricular depolarizations, rendering the left ventricle incapable of generating effective contractions…

…directed medially and slightly caudally, parallel to the posterior surface of the patella. The shoulder The patient sits with the arm hanging relaxed and slightly…

…close to the upper border of the rib, never at the lower border where the neurovascular bundle lies, and the drainage is stopped for coughing…

…should inquire about historical clues suggesting alternative etiologies, such as a sensation of postnasal drip, frequent throat clearing, sneezing, and rhinorrhea, which may indicate upper…

…expertise and a dedicated multidisciplinary Shock Team. Evaluation and physical examination Assessment should establish: The ACS presentation and its urgency. The presence or absence of…

…guidewire crossing within 30 minutes. The clinical rationale for CTO PCI is principally the reduction of myocardial ischaemia and improvement of symptoms and quality of…

…Endocrinology & metabolism Pharmacology & dosing Definition and pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose lowering…

…and angiographic findings. OMI is defined by acute coronary artery occlusion causing transmural ischemia and requiring urgent reperfusion, even in the absence of classic ST…

…The length of the refractory period (see Basic Cardiac Electrophysiology) varies with heart rate. The length is shortened as heart rate increases and vice versa…

…that of reverberations. Figure 4. Mirror image artifact. Side lobe artifact A 2D image is formed by allowing the ultrasound beam to sweep back and…

…or coughing before cardiac arrest also speak for anaphylaxis (airway obstruction caused by a foreign body is an important differential). Treatment of anaphylaxis and cardiac…

…threatening arrhythmias and cardiac arrest, with hyperkalemia being the most prevalent electrolyte disturbance observed in cardiac arrest scenarios. Hypocalcemia, although capable of causing cardiac arrest…

…Bradycardia causing hemodynamic instability is a potentially life threatening condition and should be managed urgently. The risk of cardiogenic shock is high and pharmacological interventions…

…range of 50 120 mmHg. This process is primarily mediated by local metabolic mechanisms, which adjust vascular tone in response to myocardial oxygen demand, and…

…narrowing of the RVOT (right ventricular outflow tract). Carcinoid heart disease : Carcinoid syndrome is a paraneoplastic syndrome that occurs due to carcinomas secreting kallikrein and…

…restoration of sinus rhythm (or any other rhythm with normal ventricular rate and activation). Recovery may, however, take several months. Table 1. Arrhythmias causing tachycardia…

…thrombolysis and PCI wire crossing. Exact times are needed for continued management and quality follow up. STEMI: time targets and choice of reperfusion Primary PCI…

…effect of adenosine, which can be given during the recording and unmask the atrial activity. The investigation is diagnostic, not therapeutic. An unstable patient should…

…therapy) Bradycardia causing torsade de pointes Brugada syndrome 2.0–10.0 μg/min Safe for peripheral use 0 +++++ +++++ 0 Powerful chronotropic and inotropic…

…thiazide and loop diuretics. Diagnostics Electrocardiogram (ECG) The ECG is the primary diagnostic tool for evaluating acquired QT prolongation. The upper 99% limits of normal…

…Suspicion of Cardiac Amyloidosis Demographic and Clinical Context Cardiac amyloidosis should be suspected in patients older than 65 years presenting with heart failure and increased…

…events Angiographic stenosis severity is an imperfect predictor of future myocardial infarction or sudden death. Lesions causing only mild obstruction may rupture, thrombose and occlude…

…symptoms causing impaired quality of life. Women with suspected angina are more likely than men to have non anginal symptoms such as dyspnoea and fatigue…

…separate chapter discusses Long QT syndrome (LQTS). A complete list of drugs causing QT prolongation can be found here. Corrected QT intervals (QTc) can be…

…itself, establish that anticoagulation should be withheld when the thromboembolic risk is substantial. Clinical presentation and symptoms The clinical manifestations of AF are variable. AF…

…long QT, and bundle branch block. Cardiac monitoring is indicated for patients with a high pretest probability of arrhythmia causing syncope. In hospital monitoring is…

…other ECG changes (see below) should lead to a suspicion of ARVC. The gradual loss of myocardium leads to ventricular dilation and right heart failure…

…Two types of failure to capture should be distinguished: Genuine failure to capture occurs when a stimulus that is expected to result in activation fails…

…flutter. The observant will notice that the classification differs slightly from that of atrial fibrillation. Acute and paroxysmal cases are common in clinical practice. Chronic…

…tumors of the myocardium; in these cases, the tumor can debut with ventricular arrhythmias that result in asystole and sudden death. In echocardiography, tumour should…

…The discrepancy between traditional figures and recent studies is due to the dramatic decrease in the incidence of acute coronary syndromes over the past decades…

…therapy) Bradycardia causing torsade de pointes Brugada syndrome 2.0–10.0 μg/min Safe for peripheral use 0 +++++ +++++ 0 Powerful chronotropic and inotropic…

…leaflet of the mitral valve. The anterior leaflet is anatomically divided into three segments referred to as A1 (anterior segment), A2 (middle segment), and A3…

…increased workload STATUS OF CORONARY ARTERY SETTING EFFECT ECG REACTION Normal coronary artery (no atherosclerosis) At rest Oxygen supply is adequate and ischemia cannot occur…

…causing vasodilation. Dobutamine Dobutamine is a chronotropic and inotropic agent. It increases heart rate, myocardial contractility, and blood pressure, thereby simulating the effects of exercise…

…causing minimal radiation exposure. It is metabolically inert and diffuses freely across cell membranes, allowing for precise quantification of myocardial blood flow and assessment of…