…Patients with significant heart disease (known or unknown) may not achieve the expected maximum heart rate and it may be hazardous to push them towards…

…Assessment Before Prescription Physical activity should be assessed and prescribed using the components of: Frequency Intensity Time or duration Type Progression The prescription should be…

…it typically does not slow ventricular tachycardia (VT) rates. It may also be effective in fetal, pediatric patients, and young adults with congenital heart disease…

…oxygen supply. The most characteristic manifestation of ischemic heart disease is angina pectoris developing during physical activity; myocardial oxygen demand increases during physical activity, but…

…an underlying disease or substance effect, which may require attention. Therefore, management of sinus tachycardia always requires that each of these causes be assessed thoroughly…

…reduction is not demonstrated in every intervention study. Cardiovascular Risk Assessment Screening for cardiovascular and kidney disease All patients with diabetes should be assessed for…

…movement of every tendon crossing the wound. A tendon injury can be painless and gives normal passive movement — test actively against resistance, tendon by tendon …

…syndrome must be actively considered [1]. Do the following early: 1. Assess airway, work of breathing, level of consciousness and circulation. 2. Give controlled oxygen…

…Treatment of the alcohol use disorder and planned follow up , not merely detoxification. Benzodiazepines reduce the severity of withdrawal and the risk of seizures and…

…control of the bleeding. Activate the protocol in Activation must be based on an overall assessment, not on a single threshold value. The combination of…

…or pulseless electrical activity (PEA). Evaluation and Physical Examination The source material does not provide specific details regarding the physical examination maneuvers for patients with…

…focus on ventricular fibrillation and pulseless electrical activity (PEA). These are highly lethal arrhythmias that lead to death if cardiopulmonary resuscitation is not started immediately…

…pressure or other conventional risk factors. Colchicine is an established anti inflammatory drug that may inhibit inflammasome activity, reduce interleukin 1β and interleukin 6…

…is a chronic inflammatory disease of the arteries. It has become increasingly clear in the past few decades that atherosclerosis is not caused by the…

…directly attributable to CVD. Excess mortality becomes apparent approximately 7–10 years after diagnosis and is associated with persistent disease activity, rheumatoid factor and anti…

Cardiology Clinical medicine Definition and pathophysiology Peripheral artery disease (PAD) is a clinical disorder caused by stenosis or occlusion of the aorta or arteries supplying…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…of baseline stenosis does not reliably predict the site of future STEMI; rather, it is the biological composition and inflammatory activity of the plaque that…

…activity, a large meal, emotional upset, or cold exposure. The absence of chest pain does not exclude clinically important CCS. Silent or minimally symptomatic disease…

Cardiology Clinical medicine Definition and Scope Primary prevention aims to prevent the clinical manifestation of cardiovascular disease (CVD) in individuals without established clinical CVD. It…

…clearance of circulating LDL cholesterol (LDL C). Increased PCSK9 activity therefore contributes to higher LDL C concentrations. The genetic evidence provides the rationale for therapeutic…

…presence of obstructive coronary artery disease (CAD), in non obstructive coronary arteries, or in patients with intermediate lesions that do not produce physiologically significant flow…

…thyrotoxicosis, tachyarrhythmia, uncontrolled heart failure, and concomitant valvular disease. Risk factor modification, physical activity, dietary and lifestyle measures, high intensity statin therapy, and appropriate antithrombotic…

…advanced atrial disease, or the use of antiarrhythmic drugs. In such clinical scenarios, an atypical ECG presentation does not definitively exclude a typical flutter circuit…

…vasodilation. Although primarily defined by these mechanisms, levosimendan also exhibits some type 3 phosphodiesterase inhibitor (PDEI) activity, which may contribute to its inotropic profile. The…

…is not an absolute rule. While it often holds true for cardiac arrests caused by chronic or acute ischemic heart disease, it is often not…

…perfusion defects in areas supplied by the disease artery. Thus, vasodilators replicate the effects of exercise on coronary arteries, without the need for physical activity…

…means that the automaticity is diminished). Chronotropic incompetence (inability of the sinoatrial node to adequately increase its automaticity during physical activity). Sinus arrest & sinus pause…

…and peripheral artery disease. Prognosis is generally worse when diabetes coexists with these conditions. However, the cardiovascular effects of SGLT2 inhibitors are not explained simply…

…lower jaw, neck, or occipital region. It typically occurs at rest, lasts longer than ordinary angina, and does not reliably resolve when activity stops or

…plaque stability, thrombogenic responses and immune activity. Statin intolerance refers to adverse effects attributed to statin treatment that improve or resolve after reducing the dose…

…of cardiovascular mortality in general. This is not surprising given the adverse effects of long periods of tachycardia and desynchronized atrial and ventricular activity. Fortunately…

…in previous sections. However, given that each arrhythmia has been addressed in isolation, distinguishing between them in clinical scenarios may remain challenging. Effective management of…

…severe symptoms, provided that first line therapies have failed and the patient does not have structural heart disease or reduced left ventricular function. Persistent or…

…tachycardia (VT) may emerge due to increased/abnormal automaticity, re entry or triggered activity. All types of myocardial cells may be engaged in initiation and…

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…

…poorly performed manoeuvre gives a falsely low FVC and thus a falsely normal FEV₁/FVC. Set aside time, coach actively, and do not accept a…

ECG Myocardial ischemia and infarction Acute Myocardial Infarction: Definition & Criteria Acute myocardial infarction is the most severe complication of coronary artery disease. The most common…

Cardiology Pharmacology & dosing Definition and Therapeutic Rationale Hypertension is a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It…

…coexistence of defined clinical and laboratory components; the diagnostic criteria themselves are not reproduced in the available source material. Waist circumference is particularly important because…

…slightly curved in the horizontal plane. It is initially directed forward but then turns left to activate the left atrium ( Figure 2 , left hand side)…

…in its final third. The right bundle branch does not give off any Purkinje fibers during its course through the interventricular septum. It starts to…

…secondary prevention intervention for patients with cardiovascular disease, including those recovering from myocardial infarction. It extends beyond exercise training to incorporate individualized physical activity counselling…

…may precede the full tachycardia. It is characterized by short, rapid bursts of atrial activity. In the majority of cases, the arrhythmia is self limiting…

…finding in acute coronary syndromes). Between 3 8 minutes, pulseless electrical activity (PEA) develops. PEA progresses to asystole within minutes, as outlined in the studies…

…and high retention, with a linear relationship between myocardial blood flow and measured tracer activity over a wide range (Murthy et al.). As evident in…

…via the autonomic nervous system. It attenuates carotid sinus baroreceptor activity and acts centrally and peripherally to enhance vagal tone. These sympatho inhibitory effects decrease…

…pressure. Loss of consciousness. Electromechanical dissociation or pulseless electrical activity despite ongoing sinus rhythm on the ECG. Subacute rupture may be suggested by: Nausea. Hypotension…

…Approximately 50% of cases exhibit biventricular cardiomyopathy, although the disease is less pronounced in the left ventricle. Rarely the condition is confined to the left…

…In the United States, more than 500,000 individuals (adults and children) experience a cardiac arrest (Heart Disease and Stroke Statistics). The CARES registry reported…

…detail. Symptom during exercise stress testing Perceived exertion The patient's perceived exertion is a way of estimating the intensity of the physical activity. It…

…of the mitral valve orifice. There are many causes of mitral stenosis, the most common of which are rheumatic heart disease, congenital malformations, radiation complications…

…exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy…

…has not been shown to reduce stroke risk, and detection may lead to inappropriate anxiety and invasive procedures. Symptomatic disease Symptoms of carotid disease include…

Cardiology Nephrology Definition and pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months…

…and CABG. Physical examination findings are not specific to left main disease. The examination should nevertheless assess the consequences of extensive myocardial ischaemia, including heart…

…Weight status BMI (kg/m2) Obesity class Disease risk Underweight <18.5 — — Healthy weight 18.5–24.9 — — Overweight 25.0–29.9 — Increased Obesity…

…significant geographical variations. Roughly 25% of children with congenital heart disease require intervention during their first year of life ( Triedman et al ). According to the…

…managed as a distinct clinical entity. The hallmark of stable coronary artery disease is exercise related angina pectoris (chest pain); symptoms of ischemia appear during…