…prolonged alcohol exposure the nervous system adapts through reduced GABA mediated inhibition and increased glutamatergic activity. When the alcohol level suddenly falls, the compensatory excitation…

…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…

…therefore does not normally need investigation on the basis of an isolated, asymptomatic low sensor reading alone. Symptoms Autonomic symptoms Early warning symptoms are due…

…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…

…of serious arrhythmias. This is possible because there is a correlation between the severity of electrolyte imbalance and the visible ECG changes. Specific electrolyte disorders…

…with neuroleptic and anti histamine properties. Sleep disorder Aceprometazine is often used in combination with meprobamate for the treatment of sleep disorders. <a href="http:/…

…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…

…adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have…

…therefore not simply a disorder of lipid storage. Its biology includes: accumulation and modification of lipids within the intima; recruitment of innate and adaptive inflammatory…

…despite the absence of a flow limiting epicardial coronary stenosis. It is therefore a disorder of coronary microvascular perfusion rather than persistent obstruction of the…

…A compensated simple disorder, or two opposing primary disorders It is therefore not enough to ask which of the pCO₂ and the HCO₃ deviates most…

…and hyperthyroidism; follow up and investigation of the cause of increased flow are appropriate. Exercise PH is defined by an mPAP/cardiac output slope greater…

…to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other…

…acute coronary disorder caused by separation within the coronary arterial wall, usually through formation of an intramural haematoma that compresses the true lumen. The resulting…

…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…

…follow. Consider people with the genetic disorder familial hypercholesterolemia (FH), which is caused by genetic mutations affecting the elimination of LDL cholesterol from the blood…

…Epidemiological aspects of hypertrophic cardiomyopathy (HCM) Hypertrophic cardiomyopathy is equally common among men and women. The prevalence in a Western population is approximately 0.2…

…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…

…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…

…impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated with a greater likelihood of cure. When to investigate…

…ECG examples of each condition are presented below. The ECG in Brugada syndrome Brugada syndrome is a rare channelopathy (an electrical disorder caused by mutations…

…on the initial part of the ST segment. Hyperkalaemia may cause ST segment elevations in V1–V3 that resemble those in Brugada syndrome. This disorder…

…total of 4 6 mEq/L in 24 hours may be targeted. Chronic Hyponatremia ( 48 hours duration): Due to cellular adaptations, rapid correction carries the…

…of acute myocardial ischaemia, electrocardiographic findings, cardiac biomarkers, imaging, angiography, and, occasionally, pathological examination. Pathologically, infarction represents myocardial cell death caused by prolonged ischaemia. The…

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

…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…

…laboratory abnormalities indicate end organ injury. Eclampsia is the occurrence of new onset seizures or coma in a pregnant woman with preeclampsia. HELLP syndrome—haemolysis…

…No single pain descriptor is diagnostic. The severity of pain also has limited discriminatory value. Features suggesting myocardial ischaemia Ischaemic discomfort commonly: Is substernal and…

…2010 ). At the time of J 60 and J 80, there is minimal chance that there are any electrical potential differences in the myocardium. Current…

…results in thickening of the leaflets and may coexist with mitral stenosis. Idiopathic degeneration (Barlow's disease), degeneration associated with connective tissue disorders (Marfan syndrome…

…to Optimization of the ultrasound image). Only the key principles are mentioned here. Modern ultrasound systems use harmonic imaging , which means that the machine emits…

…from sudden cardiac death. Atrial fibrillation and ventricular arrhythmias were observed in the fifth decade of life in several family members. Imaging studies did not…

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

…fibrosis, thereby increasing the risk of ventricular arrhythmias. Clinical Presentation and Symptoms Patients with bradycardia or intermittent conduction disorders frequently present with presyncope or syncope…

…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…

…Reliance on hypokalaemia alone therefore misses a substantial proportion of cases. The cardiorenal and cerebrovascular consequences of unrecognized PA make early case detection clinically important…

…impression of indigestion. STEMI pain can simulate pain from acute pericarditis, pulmonary embolism, acute aortic dissection, costochondritis, and gastrointestinal disorders. Radiation of discomfort to the…

…adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast…

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

…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…

…coronary disorders. The investigation should be undertaken when its diagnostic or therapeutic consequences are likely to outweigh procedural risks. This balance forms part of shared…

…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…

…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…

…wide simply because the ectopic impulses that cause these rhythms spread partially or entirely outside of the ventricular conduction system, and thus the ventricular depolarization…

…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…

…Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon…

…Electrolyte disorders, acidosis, hypoxemia and ischemia all aggravate the risk of developing ventricular fibrillation, in any situation. ECG features of ventricular fibrillation The ECG shows…

…Behçet disease can cause both arterial and venous thrombosis. In SLE, renal artery involvement may contribute to difficult to control hypertension. The cardiovascular consequences of

…vasomotor disorders. Endothelial activation can promote the release of adhesion molecules, inflammatory cytokines, and vasoconstricting mediators, producing abnormal vascular responses and potentially increasing the future…

…respiratory disorders, notably obstructive sleep apnoea (OSA) and obesity hypoventilation syndrome, which further increase cardiovascular burden. Obesity may be a particularly important cause of HF…

…on left ventricular ejection fraction (LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical signs…