…exceeding those seen with native vessel PCI. Mechanisms The principal mechanism is distal embolization of atheromatous and thrombotic material. Plaque or thrombus may be dislodged…

Drugs and electrolyte imbalance ECG ECG changes due to electrolyte imbalance (electrolyte disorder) The normal cardiac action potential may be altered by electrolyte imbalance, owing…

…over extensor tendons, are characteristic clinical manifestations of untreated FH and may develop when the disorder is not recognized early in life. Corneal arcus and…

…an isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial disease, and management should therefore address the entire…

…slope greater than 2 mmHg/L/min may help identify a postcapillary mechanism. Clinical classification The clinical classification comprises five groups: Group 1: Pulmonary arterial…

Echocardiography Hypertrophic cardiomyopathy (HCM): from pathophysiology to echocardiography Hypertrophic cardiomyopathy is a genetic disorder that causes left ventricular hypertrophy under normal loading conditions. Hypertrophic cardiomyopathy…

…Inherited connective tissue disorders, including Marfan syndrome and Ehlers–Danlos syndrome. FMD may be clinically occult and can affect multiple vascular territories, including the renal…

…a disorder of autonomic reflexes. It typically occurs after attaining an upright posture or following painful stimuli and emotional stress. By the age of 60…

…4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not…

…pH 7.45 is alkalaemia. A normal pH does not exclude an acid base disorder 2 Which process explains the pH? A low pH with…

…is primarily a disorder of water balance. The plasma sodium reflects the ratio between the body's exchangeable sodium and potassium and the total body…

…and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction, immune cell recruitment, extracellular matrix remodelling…

…thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting the relevant…

…permit vascular remodelling and renal impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated with a greater likelihood…

…Brugada syndrome. This disorder is easy to diagnose with a simple blood test and the ST segment elevations resolve after normalization of potassium levels. Brugada…

…The ECG in Brugada syndrome Brugada syndrome is a rare channelopathy (an electrical disorder caused by mutations in cardiac ion channels) which predisposes the individual…

…hypoglycaemic disorder is defined primarily by Whipple's triad : 1. Symptoms or signs consistent with hypoglycaemia. 2. A documented low plasma glucose during the symptoms…

…assess the literature. Medical conditions Category Condition Congenital conditions Jervell and Lange Nielsen syndrome Romano Ward syndrome Idiopathic congenital long QT syndrome (LQTS) Metabolic disorders…

…protein misfolding disorder characterized by the extracellular deposition of misfolded fibrillar proteins in the myocardium, leading to a diffuse infiltrative cardiomyopathy [8, 15]. The deposited…

…coronary artery disease. What is the evidence? The evidence is vast. Some examples follow. Consider people with the genetic disorder familial hypercholesterolemia (FH), which is…

…suggesting an autoimmune disorder or known malignancy may suggest specific, nonidiopathic etiologies [2]. Summary of Pain Characteristics The following table synthesizes the key differential diagnoses…

…patients with established peripheral artery disease, those who stop smoking have approximately twice the five year survival of those who continue. After acute coronary syndrome…

…hyperkalemia and hypokalemia can induce life threatening arrhythmias and cardiac arrest, with hyperkalemia being the most prevalent electrolyte disturbance observed in cardiac arrest scenarios. Hypocalcemia…

…is generally regarded as a severe preeclamptic phenotype or variant. Pathophysiology The precise mechanism of preeclampsia remains incompletely established. Proposed contributors include chronic uteroplacental ischaemia…

…involvement, and atrioventricular block (AVB) may indicate septal involvement in the inflammatory process. A broad spectrum of pharmacologic agents can induce bradycardia or conduction disorders…

…PA), also termed primary hyperaldosteronism or Conn syndrome, comprises disorders in which aldosterone secretion is inappropriately increased, relatively autonomous from angiotensin II and plasma potassium…

…and miscellaneous conditions A novel potentially life threatening cardiac arrhythmia syndrome identified with ECG The ECG may be used to diagnose several cardiac genetic disorders…

…Collectively, these disorders are associated with excess cardiovascular disease (CVD), although the cardiovascular phenotype varies substantially between diseases. Cardiovascular involvement extends beyond conventional atherosclerotic coronary…

…Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin—except low dose heparin). Patients with gastrointestinal disorders…

…and musculoskeletal disorders may mimic myocardial ischaemia, including severe oesophageal spasm and acid reflux. Clinical Presentation and Symptoms Characterising the presenting symptom The symptom should…

…may clarify the mechanism of an acute coronary syndrome or guide percutaneous coronary intervention (PCI). ICA therefore has three principal roles: Defining the anatomical distribution…

…electrolyte disorders). QT duration is inversely related to heart rate; QT duration increases at slow heart rates and vice versa . Hence, the QT duration must…

…concentration in the absence of evidence of ischaemia. Classification of myocardial infarction The Fourth Universal Definition separates MI into five principal types. Type Mechanism or…

…with the electronics in the pulse generator or dislodgement or fracture of the leads. External causes are less common and include electrolyte disorders, metabolic disorders…

…also present in individuals without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states…

…amount of fluid in the pericardial space. It can be caused by numerous local and systemic disorders. Accumulation of fluid in the pericardial space may…

…This leads to compensatory dilatation of chambers. The mechanism underlying ventricular and atrial dilation proceeds from Laplace's law, which states that increased pressure results…

…the patient, depending on preferences. The operator should have an elbow rest, and also avoid bending the back during the examination. Work related musculoskeletal disorders…

…coronary artery disease) as the underlying cause. Other common causes are cardiomyopathy (hypertrophic or dilated), arrhythmogenic right ventricular cardiomyopathy, Brugada syndrome, early repolarization. Electrolyte disorders…

…electrolyte disorders , congenital heart disease and catecholamine induced ventricular tachycardia . The vast majority of patients with ventricular tachycardia either have coronary artery disease (ischemic heart…

…They supersede risk models that estimate cardiovascular mortality alone because non fatal events constitute an important component of the overall burden of atherosclerotic cardiovascular disease…

…associated with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational diabetes Small for gestational age delivery…

…Symptoms may resemble those of obstructive epicardial coronary disease or vasospastic angina. The clinical presentation is not sufficiently specific to identify the underlying mechanism. Microvascular…

…are not apparent on conventional angiography. Coronary vasomotor disorders may involve epicardial spasm or abnormalities of the coronary microcirculation. Microvascular angina reflects myocardial ischaemia caused…

…mass. Waist circumference and the waist to hip ratio provide additional information about visceral adiposity and may correlate more closely with outcomes than BMI, particularly…

…gastrointestinal disorders. Radiation of discomfort to the trapezius ridge is not seen in STEMI and suggests pericarditis instead. Pain is not uniformly present. The proportion…

…or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency Concomitant interacting medications The SLCO1B1 rs4149056 polymorphism is associated…

…depression). As mentioned above there are numerous other conditions that affect the ST T segment and it is fundamental to be able to differentiate these…

…is the predominant cause, accounting for approximately 60% of HFrEF cases in Western populations [14] . Non ischemic etiologies encompass a highly heterogeneous group of disorders…

…myocarditis and electrolyte disorders. Because the rate (60–100 beats per minute) is on a par with the rate in sinus rhythm and there is…

…kidney dysfunction, sleep disordered breathing, cancer related disease and cardiac amyloidosis among the relevant clinical settings or comorbidities. HFrEF is distinguished from heart failure with…