…or cold exposure. The absence of chest pain does not exclude clinically important CCS. Silent or minimally symptomatic disease may occur in patients with diabetes…

…the presence of right ventricular load. This condition implies that the right ventricle is pressure and/or volume loaded. The load itself leads to impaired…

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…

…point) A: Age 75 and older (2 points) D: Diabetes Mellitus (1 point) S: Prior Stroke or TIA or thromboembolism (2 points) V: Vascular disease …

…or leg, or a non healing distal ulcer. Before compression treatment of a leg ulcer — compression in arterial insufficiency can cause necrosis. Screening in diabetes…

…in South Asians, who have substantially elevated risk of cardiovascular disease and diabetes at BMI levels of 23 kg/m 2 or higher. Body surface…

…shift. For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed, with clinicians focusing primarily on hemoglobin A1c (HbA1c) reduction, blood…

…goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator or institutional…

…initiation or during routine therapy. Potential clinically important complications and treatment related syndromes include: Hypovolaemia Falls and syncope, particularly in older adults Euglycaemic diabetic ketoacidosis…

…Thumb ECG or event recorder, 2–4 weeks Less often, with syncope Implantable loop recorder Contraindications None. Practical obstacles are skin disease or allergy to…

…patients with diabetes and anyone with dizziness Definitions White coat hypertension: a raised office reading but normal readings at home or on 24 hour recording…

…Comment : : : Reticulocytes 20–100 ×10⁹/L Distinguishes a production defect from haemolysis or bleeding Ferritin 15–300 µg/L (women 10–150) An acute phase…

…mmol/L or previously known diabetes Plasma glucose ≥ 33.3 mmol/L Ketones Blood ketones, beta hydroxybutyrate, ≥ 3.0 mmol/L. Alternatively urine ketones ≥ 2+…

…or glucagon. In a person without diabetes, a hypoglycaemic disorder is defined primarily by Whipple's triad : 1. Symptoms or signs consistent with hypoglycaemia. 2…

…In impaired consciousness or DKA: remove the pump and change to an infusion or injections Drugs for type 2 diabetes in inpatients Agent The acutely…

…and in patients with diabetes or renal failure the index may be falsely normal because of medial sclerosis — in that case add toe pressure measurement…

…absolute contraindications, but be cautious and consider referral in: Diabetes with neuropathy or peripheral arterial disease — a risk of osteomyelitis and poor healing. Check the…

…intact if it can be seen at all, and ask specifically about a previous perforation or grommets. 2. Instil a cerumenolytic and wait 15–30…

…hypersensitivity to the preparations. Relative: Poorly controlled diabetes — expect a raised blood glucose for 2–5 days. Suspected or known tendon rupture. No response to…

…without being found. Indications A traumatic wound that gapes and cannot be expected to heal with good function or cosmesis without apposition. A wound that…

…than LDL C alone. It is particularly informative when triglyceride rich lipoproteins are increased, as commonly occurs with obesity, diabetes, prediabetes, insulin resistance, metabolic syndrome…

…Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory…

…quality of life and self efficacy Address modifiable cardiovascular risk factors Support smoking cessation Improve management of hypertension, dyslipidaemia, and diabetes mellitus Reduce anxiety and…

…cardiovascular disease, pulmonary disease, advanced age, smoking, diabetes, hypertension, cancer, etc – are the most important risk factors for poor outcomes. The vast majority of infections…

Cardiology Clinical medicine Introduction Cardiovascular disease becomes increasingly prevalent with advancing age, while its clinical expression and management become progressively more complex. Older adults, often…

…year risk as follows: Risk category 10 year risk of fatal or non fatal CVD Low <2% Moderate ≥2% to <10% High ≥10% to <20%…

…territory. Recent neurological symptoms are particularly important in determining management. The benefit of carotid revascularisation is greatest in patients with a recent TIA or stroke…

…The underlying aetiology is heterogeneous. Chronic heart failure evaluation should therefore seek reversible or treatable causes. The source material identifies coronary disease, hypertension, diabetes, obesity…

…urinalysis or renal imaging Risk of progression rises with proteinuria and depends on cause 2 60 mL/min/1.73 m² Abnormal urinalysis or renal…

…or patients with diabetes [4]. Associated Findings: The sudden onset of symptoms coupled with diaphoresis should always raise concern for a cardiovascular cause [4]. 2…

…Diabetes mellitus Untreated edge dissection Components and mechanisms of DES A conventional durable polymer DES consists of: A balloon expandable metallic scaffold A durable or…

…shared environmental or behavioural factors rather than a single gene disorder. This distinction is important in premature coronary disease, hypertension, type 2 diabetes and hyperlipidaemia…

…Recognised causes include: Diabetes and insulin resistance Thyroid disease Kidney disease Excessive alcohol consumption Diets high in carbohydrate or fat Glucocorticoids Beta blockers Oestrogen therapy…

…stability Diabetes status Renal dysfunction and other important comorbidities Frailty Liver cirrhosis Cognitive function and life expectancy, especially in older adults Previous sternotomy or CABG…

…patients with diabetes. Insulin resistance is accompanied by compensatory hyperinsulinaemia and, with progression, hyperglycaemia and pancreatic β cell dysfunction. These abnormalities initiate self perpetuating metabolic…

…Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial disease, and management should therefore address the entire arterial circulation. PAD is associated with increased…

…and treatment. It is associated with lower cardiovascular and all cause mortality and with reduced incidence or burden of hypertension, type 2 diabetes, coronary disease…

…blood pressure only while taking four or more antihypertensive agents. Possible clinical settings suggesting PA include: Grade 2 or 3 hypertension Resistant hypertension Sustained blood…

…to established, modifiable determinants of cardiovascular disease. The principal targets include blood pressure, lipid abnormalities, diabetes and glycaemic status, body weight, smoking, diet, physical inactivity…

…medical assistance rather than self presenting to an emergency department or contacting primary care first. If ischaemic discomfort persists, emergency medical services should be called…

…stent diameter less than 3 mm, long stent length Large thrombotic burdens increase procedural risk because thrombus can fragment, embolize to other coronary branches or…

…heart failure 1 Hypertension 1 Age ≥75 years 2 Diabetes mellitus 1 Prior stroke or TIA 2 Vascular disease 1 Age 65–74 years 1…

…and diabetes [1]. Although TdP and subsequent sudden death are rare, the arrhythmia is precipitated by an extensive list of "torsadegenic" or "QT liability" drugs…

…cardiomyopathy, congestive heart failure, congenital heart disease, diabetes mellitus (both type 1 and type 2), obesity, smoking, obstructive sleep apnea and chronic obstructive pulmonary disease…

…heart failure is now the most frequent complication of diabetes ( Shah et al, McMurray et al ). Management of heart failure progressed rapidly during the 1970s…

…heart failure is now the most frequent complication of diabetes ( Shah et al, McMurray et al ). Management of heart failure progressed rapidly during the 1970s…

…target levels for patients with and without diabetes. The threshold for hypertension is currently 140 mm Hg systolic or 90 mm Hg diastolic (140/90…

…each time overcoming the aortic resistance, which is typically 110 mmHg or more. It is straightforward to understand why systolic function is fundamental to global…

…with poor circulation, above all the lower leg in a patient with peripheral arterial disease or diabetes — the wound may not heal. Over superficial nerves…

…standardized method to evaluate the anatomical complexity of CAD, particularly in patients with multivessel disease or left main coronary artery disease . It integrates multiple variables…

…evaluated within 1 to 2 weeks after initiation of ACE inhibitors, especially in patients with preexisting azotemia, hypotension, hyponatremia, diabetes mellitus, or in those taking…

…or all cause mortality. Absolute benefit is modest. Across the updated systematic review, absolute reductions in major ASCVD events ranged from 0.8% to 2…

…statin, defined as atorvastatin less than 10 mg daily or an equivalent dose of another statin. Approximately 45% of participants had type 2 diabetes. Over…

…atherosclerosis and premature myocardial infarction Coronary microvascular dysfunction Myocarditis and pericarditis Coronary or large vessel arteritis Pulmonary arterial vasculopathy and pulmonary hypertension Arterial and venous…

…classification, remains incompletely established. Data concerning premature menopause and subsequent hypertension or diabetes are insufficient to support firm conclusions. Systemic inflammatory and autoimmune diseases, including…

…diabetes, emergency angiography, previous stroke, renal failure, and heart failure have been identified as important risk factors. Severe atherosclerosis of the axillary or subclavian arteries…

…the occurrence of contrast induced AKI is negligible or very low. Risk rises substantially with chronic kidney disease, particularly diabetic kidney disease and advanced CKD…

…fraction (HFmrEF) is a clinical syndrome defined by the combination of symptoms and/or signs of heart failure and a left ventricular ejection fraction (LVEF)…

…and/or signs of HF with LVEF 41–49%. In this group, structural abnormalities such as left atrial enlargement or left ventricular hypertrophy, or echocardiographic…

…or ischaemic events attributable to renarrowing within the stented segment or at its margins. Angiographic restenosis has traditionally been described as a follow up diameter…