…are of utmost importance, particularly in the setting of (confirmed or suspected) myocardial ischemia. As a clear example, consider a patient with ischemic heart disease…

…with reported inter observer variability (κ values ranging from 0.45 to 0.76). Lack of Clinical Variables : The original SYNTAX Score focuses solely on…

…Recent studies on COVID 19 and cardiovascular disease Cardiovascular implications of COVID 19 have been elucidated in recent studies from China and Italy (1–5…

…serious (e. g. malignancy, amyloidosis). In case of suspicion of pericardial disease, in the first place, an echocardiographic examination is done. With echocardiography, good conditions…

…pediatric and neonatal care must have knowledge of age related variations in the ECG, as well as cardiac diseases that may affect infants and children…

…pediatric and neonatal care must have knowledge of age related variations in the ECG, as well as cardiac diseases that may affect infants and children…

Indications Acute myocardial infarction. Unstable coronary artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA…

…with inflammatory rheumatic disease have a higher cardiovascular risk than the general population. This excess risk has been documented across a broad range of conditions…

…sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation be…

…the article follows: [...] Of every 10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle…

…cardiomyopathies and channelopathies. Nevertheless, apparently sporadic disease may result from: Incomplete penetrance of a variant inherited from a parent. A de novo variant. Less commonly…

…structural heart disease, etc. Over the years, a large number of parameters have been introduced to assess left ventricular function. The majority of these parameters…

…management, treatment response and outcomes of cardiovascular disease. The biological differences between females and males arise partly from the chromosomal distinction between XX and XY…

…development of heart failure in the preserved and mildly reduced EF ranges, and obesity is increasingly recognised as a potential contributor. Coronary artery disease is…

…leading to stimulation of beta adrenergic receptors) and parasympathetic withdrawal. Sinus tachycardia secondary to disease and medications : A wide range of diseases and medications may…

…infectious diseases physician early in a high risk course, in instability, with resistance problems, or with suspected fungal infection 10 Document the times of triag

…Table 1. Causes of aortic regurgitation Bicuspid aortic valve Rheumatic heart disease Calcified aortic valves Idiopathic aortic dilatation (aneurysm) Hypertension Aortic dissection, proximal Marfan syndrome…

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

…For example, exercise stress testing is no longer recommended in the initial evaluation of patients with suspected coronary artery disease (i.e CCS). The new…

…updated. For example, exercise stress testing is no longer recommended in the initial evaluation of patients with suspected coronary artery disease (i.e. CCS). The…

…reduce stroke risk, and detection may lead to inappropriate anxiety and invasive procedures. Symptomatic disease Symptoms of carotid disease include: TIA; ischaemic stroke; focal neurological…

…is due to the dramatic decrease in the incidence of acute coronary syndromes over the past decades. Furthermore, early revascularization in acute coronary syndromes (STEMI…

Cardiology Principles of myocardial perfusion imaging Myocardial perfusion imaging (MPI) is a non invasive technique for detecting and quantifying coronary artery disease (CAD). It offers…

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…

…ostia. It remains the reference standard for defining the extent of coronary artery disease because it provides anatomical information while permitting functional assessment and, when…

Myocardial ischemia and infarction Definition and Pathophysiology Left main coronary artery disease (LMCAD) refers to atherosclerotic narrowing of the left main coronary artery, which supplies…

…disease (CAD), atherosclerosis, heart failure (HF), atrial fibrillation and cardiovascular events. In clinical practice, obesity is conventionally defined by a body mass index (BMI) of…

…on lesion location, severity, length, the presence of multilevel disease and collateral circulation. Flow limitation may be clinically silent, manifest as exertional symptoms, or progress…

…significant coronary artery disease, potentially resulting in false negative findings. Radiotracers in myocardial perfusion imaging Radiotracers are designed to identify ischemic areas of the myocardium…

…of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome associated with ischemic heart disease…

…central clinical danger is progressive aortic wall disruption, rupture and compromise of branch vessels. Type A disease may cause cardiac tamponade, severe acute aortic regurgitation…

…are the strongest predictors of adverse outcomes. Non acute or asymptomatic bradycardia Non acute bradycardia is a common finding in both healthy and diseased individuals…

…cardiovascular disease. It has been the number one killer in Western and high income countries for more than half a century, causing approximately 20% of…

…most persuasive when the initial probability is high enough that the result meaningfully increases the likelihood of disease and can justify further investigation or treatment…

…disease will increase in parallel with the prolongation of survival. Neonatal screening with pulse oxymetry The majority of all congenital heart defects are detected early…

…Figure 1. Flowchart showing the natural course of coronary artery disease and classification of acute coronary syndromes into STEMI, NSTEMI and unstable angina using ECG…

…discomfort) Chest pain during exercise is one of the strongest predictors of coronary artery disease. The severity of the pain may be graded from 0…

…Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is needed for management. Cryoglobulinaemia, cold agglutinin disease…

…associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy. The cardiovascular implications of lower alcohol intake remain controversial. Epidemiological studies have…

…of significant LMCA disease, including acute occlusions, subtotal stenoses, and discusses associated clinical presentations, prognostic implications, and management strategies. In the GRACE ECG substudy of…

…explain the marked differences in characteristics and outcomes across the data sources for out of hospital cardiac arrest (OHCA) and in hospital cardiac arrest (IHCA…

…mean transit time — isolates microvascular resistance. Only indices that detect microvascular disease as an independent cause of ischemia, including with non obstructive epicardial arteries (ANOCA…

…stable or chronic atherosclerotic coronary disease, many of whom have a previous acute coronary syndrome. The available evidence supports consideration of low dose colchicine as…

…earlier after coronary occlusion and progress over time. Experimentally, necrosis advances from the subendocardium towards the subepicardium over several hours. The extent and tempo of…

…the broader atherosclerotic disease. Pathophysiology Mechanisms of acute coronary syndrome The major mechanisms producing acute coronary syndromes are: Plaque rupture with exposure of thrombogenic material…

…8. Document the ceiling of care and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is…

…choice of device therapy and also suggest whether other interventions (e.g. heart failure management, evaluation for coronary artery disease, etc .) are warranted. Management of…

…of deceased patients. Historically referred to as coronary thrombosis, the term myocardial infarction ultimately prevailed. The need for a standardized global definition led to early…

…over PCI in multivessel disease. A British Cardiovascular Intervention Society myocardial jeopardy score is an alternative method for estimating the extent and severity of CAD…

…heart disease (including complications) can cause embolisms. Left ventricular aneurysm with thrombus Cardiomyopathies Valve prosthesis Devices (pacemaker, ICD CRT) Endocarditis Cardiac tumors Atherosclerosis of the…

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…

…continuity equation All valvular stenoses must be graded in order to optimize management according to disease severity. The most important parameter, for grading of stenoses…

…Advantages of MDRD eGFR Clinical utility: The MDRD equation has been instrumental in identifying and staging chronic kidney disease (CKD), facilitating early intervention and management…

…diffuse, leading to underestimation of the overall disease burden. Angiography also provides limited information about plaque composition, vulnerability and the risk of future plaque rupture…

…myocardial perfusion imaging Diagnosis of coronary artery disease (CAD) : Myocardial perfusion imaging can confirm or rule out CAD in patients with symptoms suggestive of CAD…

Echocardiography Pulmonary (pulmonic) stenosis Pulmonary stenosis is virtually always a consequence of congenital heart disease. The stenosis can be fixed or dynamic, depending on the…

…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…

Cardiology Definition and purpose Cardiovascular risk assessment estimates an individual’s probability of experiencing cardiovascular disease (CVD) over a defined period. SCORE2 and SCORE2 Older…

…and types of cardiomyopathies Cardiomyopathy implies that the myocardium is structurally and functionally altered, and the pathological changes are not explained by coronary heart disease…