…sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy. The cardiovascular implications of lower alcohol intake remain…

…obstruction) of the left main coronary artery (LAD) or 2 epicardial coronary arteries (Felker et al). Left ventricular dilation entails a markedly elevated risk of…

…angina (VA), formerly termed Prinzmetal or variant angina, is myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces…

…after acute coronary syndromes in patients with reduced left ventricular ejection fraction (LVEF). They are also recommended in patients within one year of MI and…

…and symmetric. Their duration is short; they typically disappear within minutes after a total occlusion in a coronary artery occurs (then of course, the ST…

…arrhythmias. Definitions and ECG criteria for ventricular rhythm and idioventricular rhythm Ventricular rhythm exists if 3 or more consecutive beats have a ventricular origin. The…

…muscle rupture. The risk of rupture is greater for the posteromedial papillary muscle, which only receives blood supply from one coronary artery (Coronary arteries). Chronic…

…setting of acute coronary syndrome, AF is the most frequent supraventricular arrhythmia. It may predate the coronary event, be detected for the first time, or…

…is caused by a complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive myocardial ischemia (referred to…

…either LCX or the right coronary artery (RCA). For details, refer to chapter The Coronary Arteries. Mitral valve disease A wide range of conditions may…

…for assessing ventricular function. For better or worse, ejection fraction has become virtually synonymous with left ventricular function. An obvious drawback with the use of…

…with lesion anatomy, clinical presentation, bleeding risk, the anticipated need for non cardiac surgery, procedural complexity, and the relative merits of PCI and coronary artery…

…is still indicated with continuing ischaemia, shock, serious arrhythmia or acute heart failure. Routine opening of a persistently occluded infarct related artery in a stable…

…safe in patients with coronary artery disease since it does not increase heart rate, and reduces myocardial oxygen consumption. Time to onset of action: 5…

…coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI), including attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive…

…in patients with suspected or established coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological…

…of 10 years' duration, or in diabetes with age 50 years. Risk assessment in known coronary or cerebrovascular disease. Follow up after vascular surgery or…

…primarily for instability. Evaluation and physical examination Initial assessment should establish whether AF is associated with acute haemodynamic compromise, pulmonary oedema, or evidence of coronary…

…attempts and their duration. Triggers for smoking and anticipated barriers to cessation. Exposure to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled…

…results from abrupt reduction in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery. Plaque erosion or rupture exposes thrombogenic material to…

…of life if the circulation is temporarily supported by ECMO. Furthermore, ECMO might be required to facilitate procedures such as percutaneous coronary intervention (PCI) or…

…branches of the same coronary artery or another coronary artery, will alleviate the ischemia, improve myocardial function and increase resistance to episodes of more severe…

…instability or transiently toxic concentrations, adenosine requires a rapidly delivered bolus to achieve sufficiently high concentrations at its clinical site of action—the coronary artery…

…capacity, expressed by exercise duration, workload or metabolic equivalents, is among the strongest predictors of mortality in patients with cardiovascular disease after accounting for age…

…in persons who are otherwise healthy. The majority of those with LAFB, however, have significant heart disease. Myocardial infarction, coronary artery disease, left ventricular hypertrophy…

…contraction of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and…

…contraction of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and…

…contraction of smooth muscle cells. As compared with nitroprusside, nicardipine induces relatively greater venodilation than arteriolar dilation. Effects Nicardipine causes dilation of the coronary and…

…days duration. Vernakalant does not convert atrial flutter to sinus rhythm. Vernakalant is only administered in a monitored clinical setting appropriate for cardioversion. Administration of…

…thrombosis (coronary or pulmonary), tension pneumothorax. No drug has been shown to improve the neurological outcome in cardiac arrest. High quality compressions with minimal interruptions…

…or treatment with sodium nitroprusside. In most hypertensive emergencies the following is aimed for: 1. Lower the mean arterial pressure by no more than about…

…with PCI or without revascularization, although the exact antithrombotic strategy may differ when long term OAC is also indicated. Possible shortening of DAPT A duration…

…or with prolonged periods of VF (fine VF resistant to defibrillations), the purpose of CPR is to induce myocardial electrical activity by generating adequate coronary…

…for the management of acute coronary syndromes with persistent ST segment elevations (i.e STEMI, ST segment elevation acute myocardial infarction). 1 Initial diagnosis of…

…lasting more than 20 minutes; new severe angina; an accelerating pattern with increasing frequency, duration, or severity; a lower threshold for symptom provocation; or angina…

…failure of ischaemic or cardiometabolic origin. Major clinical presentations The principal outpatient presentations include: Reproducible stress induced angina or ischaemia associated with obstructive epicardial coronary…

…Although both troponin T and I may be chronically elevated in patients with renal failure, this is more pronounced for troponin T ( Seng et al )…

…occurs in diastole or the decompression phase during CPR). High aortic pressure and low right atrial pressure favor coronary blood flow. A CPP of approximately …

…of the universal definition of MI. Clinically, UA is defined by one or more of the following patterns: Angina at rest, usually prolonged for more…

…established. Limited data are available for children with sickle cell anemia. Method of Administration Route : Oral. Prasugrel can be taken with or without food. Administering…

…ischemic events or stent thrombosis. Stable coronary disease and elective PCI For chronic coronary syndromes treated with elective PCI, the standard DAPT duration is six…

…particularly when the clinical presentation is compatible with acute coronary syndrome. Recurrent or persistent symptoms should prompt repeat ECG acquisition and consideration of additional leads…

…The reader should already be familiar with the classification of acute coronary syndromes. Subsequent chapters will deal with ST segment elevation myocardial infarction (STEMI) and…

…a substantially more diverse genetic basis. Pathogenic or likely pathogenic variants in relevant DCM genes were identified in approximately 22% of cases in one large…

…of all cause death and cardiovascular death, compared to patients without such disturbances, including those with RBBB and LBBB. This was reported in the Coronary…

…minute) should never be used for mor than 10 minutes. Administer sodium thiosulfate (cyanide into thiocyanate) and terminate infusion of nitroprusside if cyanide toxicity is…

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

…myocardial ischaemia caused by an acute coronary process. Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction…

…hypertrophy, or echocardiographic evidence of impaired filling, make the diagnosis more likely. HFpEF and HFmrEF together account for approximately half of patients with symptomatic HF…

…individuals with poor neurological recovery. The specificity of absent pupillary reflex for predicting a poor neurological outcome was 68.8%. This implies that approximately one…

…or annual growth 3 mm. Limitations Formulas assume normal body habitus Ethnic variations may require adjusted thresholds Always correlate with imaging measurements Not valid for…

…The incidence is 10–34% among patients with premature ventricular contractions and/or nonsustained ventricular tachycardia who are referred for electrophysiological evaluation (Hasdemir et al…

…portion of the pulmonary artery may also be dilated in patients with pulmonary hypertension. Echocardiography in pulmonary regurgitation Echocardiography is the modality of choice for…

…with more severe neurological deficits, and carry higher rates of mortality and long term disability compared to non cardioembolic ischemic strokes. Consequently, the cornerstone of…

…tricuspid regurgitation is more pronounced. Echocardiography is the preferred method for diagnosing tricuspid regurgitation. Causes of tricuspid regurgitation The most common causes of tricuspid regurgitation…

…prevent, or alleviate, the pressure increase in the left ventricle and left atrium. Chronic aortic regurgitation leads to dilatation and hypertrophy of the left ventricle…

…size and form of the thrombus, it will occlude the main pulmonary artery or its branches. The larger the thrombus, the more proximal the occlusion…

…al). ARVC is more malignant in men, the reason for which remains elusive. Gene mutations can be confirmed in roughly 60% of individuals with ARVC…

…Valve replacement can be performed with biological or mechanical prostheses. The former is preferred due to the lower risk of thrombosis and evidence demonstrating long…

…depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given for the pain…