…or when the volume limit is reached. Indications Diagnostic aspiration: a new pleural effusion of unclear cause. An effusion not confidently explained by heart failure…

…is based on the following three components: Cardiac troponins – Elevation of cardiac troponins in peripheral blood is mandatory to establish a diagnosis of myocardial infarction…

…such as connective tissue disease. No single pain descriptor is diagnostic. The severity of pain also has limited discriminatory value. Features suggesting myocardial ischaemia Ischaemic…

…NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical…

…commonest error in paracentesis is not performing it. Every patient admitted with ascites should undergo a diagnostic paracentesis , because spontaneous bacterial peritonitis often lacks abdominal…

… An unstable pulmonary embolism is a reperfusion problem; a stable pulmonary embolism is a diagnostic pathway. The unstable patient Hypotension (systolic < 90 mmHg for…

…An ABI ≤ 0.90 is diagnostic of peripheral arterial disease and at the same time indicates a substantially increased risk of myocardial infarction and stroke…

…Sepsis is a dynamic condition. Investigation and treatment must therefore proceed in parallel and must not wait for complete diagnostic certainty. Sepsis is defined as…

…punch in a case of bullous dermatosis misses the subepidermal split. Choose the technique according to the diagnostic question, not according to what is quickest…

…in symptoms or clinical signs, with or without diagnostic electrocardiographic abnormalities and with or without an acute rise in cardiac troponin. The spectrum ranges from…

…term relationship with cardiovascular risk is therefore graded, although practical clinical care requires diagnostic and treatment thresholds. The 2024 European guideline defines hypertension as an…

…months and have health implications. Diagnostic criteria include an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m², excess urinary albumin excretion…

…Infarction (STEMI) The diagnosis of STEMI relies on specific electrocardiographic thresholds for ST segment elevation measured at the J point. The diagnostic criteria require new…

…injection under fluoroscopy. The procedure is performed by advancing guidewires and diagnostic catheters from a percutaneous arterial access site to the aortic root, engaging the…

…The following table summarizes the common diagnostic criteria for complete and incomplete LBBB: Feature Complete LBBB Incomplete LBBB QRS Duration $\ge 120$ msec [3…

…with progression, hyperglycaemia and pancreatic β cell dysfunction. These abnormalities initiate self perpetuating metabolic and inflammatory pathways that injure the vasculature, heart and kidneys. Advanced…

…and cardiac resynchronization therapy (CRT) devices. Implantable loop recorders are diagnostic devices rather than pacing or defibrillation systems, but their stored data may also be…

…The pre test probability is central because the clinical value of any diagnostic test depends not only on its sensitivity and specificity but also on…

…It is a PCI related myocardial infarction when angiography or autopsy documents thrombosis and the diagnostic criteria used for type 1 myocardial infarction are fulfilled…

…2024, the diagnosis of DKA requires three components: diabetes or hyperglycaemia, ketosis and metabolic acidosis. A very high glucose value is no longer required [1]…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…important indication and an emergency procedure . An unclear arthritis, as part of the diagnostic work up. Haemarthrosis after trauma. A symptomatic effusion causing pain or…

…must never delay it. Indications Suspected meningitis or encephalitis. Suspected subarachnoid haemorrhage with a normal or non diagnostic CT. Suspected neuroborreliosis, neurosyphilis or another CNS…

…wave. The whole value of the investigation lies in the ratio between the number of atrial and ventricular complexes — more atrial than ventricular complexes, the…

…despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is a clinical diagnosis supported by echocardiography: Finding Comment : : Hypotension, distended neck…

…during the initiation of an ACE inhibitor to prevent symptomatic hypotension. Diagnostics The source material does not cover specific diagnostic modalities such as ECG, imaging…

…acute kidney injury, and death. The risk profile differs between diagnostic angiography and PCI, and is strongly influenced by the clinical setting, vascular access route…

…descending artery (LAD) is most commonly involved. The reported prevalence depends substantially on the diagnostic method. Myocardial bridging has been identified in approximately 0.5…

…inconclusive. The principal diagnostic strength of CCTA is its ability to exclude significant anatomical CAD with high sensitivity and a high negative predictive value, particularly…

…syndrome Exercise ECG may be used in selected patients with suspected chronic coronary syndrome when the result is expected to influence diagnostic strategy or management…

…Diagnostic phenotype Criterion HFmrEF Symptoms and/or signs of heart failure Required LVEF 41–49% Natriuretic peptides BNP ≥35 pg/mL or NT proBNP ≥125…

…Diagnostic Framework The diagnostic pathway combines three principal domains: Clinical presentation and vital signs The 12 lead ECG The hs cTn concentration at presentation and…

…Structural and functional mechanisms may coexist. The formal diagnostic construct for MVA incorporates four components: Symptoms suggestive of myocardial ischaemia. Objective evidence of myocardial ischaemia…

…50% or more in any potential infarct related artery. MINOCA is not a definitive disease diagnosis. It is a descriptive and provisional classification that should…

…grafting rather than percutaneous coronary intervention (PCI). A CTO may be discovered incidentally during diagnostic angiography. Collateral vessels may maintain distal perfusion and permit visualization…

…the criteria for type 1 MI. Procedural myocardial injury may also occur without satisfying the diagnostic threshold for periprocedural MI. This distinction is clinically important…

…and its treatment options have been addressed. ANOCA/INOCA should not be labelled refractory before further diagnostic evaluation. The underlying endotype must first be defined…

…pre existing symptoms to the medication. No single diagnostic test can distinguish a pharmacological SAMS effect from a nocebo response. Predisposing factors The likelihood of…

…pathophysiological rationale ST segment elevation myocardial infarction (STEMI) is a working diagnosis based on persistent ST segment elevation or an equivalent electrocardiographic pattern in a…

…The initial evaluation should be structured to establish a working diagnosis of STEMI rapidly, identify haemodynamic or electrical instability and determine the appropriate reperfusion pathway…

…supplied by the narrowed artery. The principal diagnostic endpoint is a new or worsening regional wall motion abnormality (RWMA) during stress. A fixed abnormality that…

…reperfusion therapy. This approach fails to identify a substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting…

…coronary artery disease (discussed below). Moreover, prognostication, selection of diagnostic tests, and treatment strategies have been updated. For example, exercise stress testing is no longer…

Arrhythmias and arrhythmology ECG Diagnosis and management of narrow and wide complex tachycardia All clinically significant supraventricular and ventricular tachyarrhythmias have been reviewed in previous…

…There are several ECG indexes, which generally have high diagnostic specificity but low sensitivity. These indexes were developed several decades ago but they are still…

…therefore critical. The 12 lead electrocardiogram (ECG) is an immediately available diagnostic tool that can provide essential clues to LMCA occlusion or critical stenosis. This…

…typically ranges from 120 to 250 beats per minute. To fulfill the diagnostic criteria for EAT, the ventricular rate must exceed 100 beats per minute…

…The value of exercise stress testing is evident from the fact that exercise capacity (cardiopulmonary capacity) is one of the strongest predictors of cardiovascular and…

…index of microcirculatory resistance (IMR). This review synthesizes the physiological basis, diagnostic performance, and outcome evidence for each index, situates two recent noninferiority trials of…

…coronary artery disease (discussed below). Moreover, prognostication, selection of diagnostic tests, and treatment strategies have been updated. For example, exercise stress testing is no longer…

…in patients with structural heart disease, VT necessitates a nuanced, multidisciplinary approach to diagnosis and management. Over the past decade, the landscape of VT management…

…commonly called vestibular neuritis, but posterior circulation stroke is the most important dangerous differential diagnosis. Clear focal neurological findings are absent in roughly half of…

…8. Document the diagnosis and communicate it at every handover. Recognise it Core criteria Core criterion Meaning : : Acute onset The change has developed over hours…

…injection has gone to the right place — immediate pain relief is a diagnostic finding — and appears to reduce the risk of a post injection flare…

…The quality of the test determines its entire value: a poorly performed manoeuvre gives a falsely low FVC and thus a falsely normal FEV₁/FVC…

…to vital organs than systolic blood pressure alone. Predictive Value : Elevated MAP has been associated with an increased risk of cardiovascular diseases, such as stroke…

…diagnosis is suspected when alternative etiologies are excluded by diagnostic testing or failed therapeutic trials. If alternative causes of cough are suspected, specific diagnostic pathways…

…increased transmural dispersion, EAD mediated TdP, and alterations in reentry pathways. Proarrhythmic events occur in 5% to 10% of patients receiving antiarrhythmic agents, and this…

…suggest a typical circuit. A diagnostic pitfall arises because typical circuits occurring in diseased atria—most frequently following surgery or extensive ablation, or under the…

…carotid bruit is an important marker of cardiovascular risk, although the source material does not provide diagnostic sensitivity or specificity for bruit detection. Its pr