…muscle cells, leading to a white, platelet rich thrombus. Myocardial vulnerability, largely driven by coronary microvascular dysfunction, also contributes to the extension and severity of…

…sodium loading. It is the most common form of secondary hypertension. Aldosterone acts principally through the mineralocorticoid receptor (MR). After entering target cells, it binds…

…Where resources permit, objective assessment may include directly observed treatment or detection of prescribed medications in blood or urine samples. In patients with an estimated…

…while supine Sudden onset of palpitations followed by syncope Severe coronary artery or structural heart disease High risk features on examination include: Unexplained systolic blood…

…occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration…

…during the examination. Work related musculoskeletal disorders are a common cause of pain and sickness absence for ultrasound practitioners (Harrison et al). When performing emergency…

…in this pattern. Endothelial dysfunction may contribute to both microvascular and epicardial vasomotor disorders. Endothelial activation can promote the release of adhesion molecules, inflammatory cytokines…

…Malignancy: A history suggesting an autoimmune disorder or known malignancy may suggest specific, nonidiopathic etiologies [2]. Summary of Pain Characteristics The following table synthesizes the…

…on QT prolongation or risk of torsade de pointes in PubMed. Drug with neuroleptic and anti histamine properties. Sleep disorder Aceprometazine is often used in…

…vasoconstriction, adhesion of circulating cells, inflammatory cell entry into the intima, and thrombus formation. Atherosclerosis is therefore not simply a disorder of lipid storage. Its…

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

…rise can cause osmotic demyelination syndrome [1,2]. Hyponatraemia is primarily a disorder of water balance. The plasma sodium reflects the ratio between the body…

…a body mass index (BMI) of ≥30 kg/m2. Severe obesity is generally defined as BMI ≥35 kg/m2, while BMI ≥50 kg/m2 has…

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

…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…

…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…

Cardiology Respiratory medicine Definition and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise…

…an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic…

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

…Cardiac Amyloidosis Definition and Pathophysiology Cardiac amyloidosis (CA) is a protein misfolding disorder characterized by the extracellular deposition of misfolded fibrillar proteins in the myocardium…

…dissection (SCAD) is an acute coronary disorder caused by separation within the coronary arterial wall, usually through formation of an intramural haematoma that compresses the…

…eject blood into the aorta during systole. In aortic stenosis, there is increased resistance in the aortic valve itself, due to the reduced area of…

…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…

…Skipping a step is a common reason why mixed acid base disorders are missed. The blood gas describes the physiology at the moment of sampling…

…but do not delay treatment of a neurologically compromised patient. Continuous glucose monitoring reflects interstitial glucose and lags behind the blood glucose during rapid changes…

…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…

…managed as chronic hyponatremia. Degree of hyponatremia P/S Na + Common effects Mild 130 125 mmol/l Cognitive disorders, vertigo, balance disorder. Moderate 115 125…

…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…

…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…

…This helps explain the neurological manifestations of preeclampsia and the potential for stroke even at blood pressure levels that might otherwise be considered only moderately…

…include electrolyte disorders, metabolic disorders, hypoxemia, antiarrhythmic drugs, or electromagnetic disturbance caused by other machines/devices. Below follows ECG tracings demonstrating each type of failure…

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

…s disease), degeneration associated with connective tissue disorders (Marfan syndrome, Ehlers Danlos syndrome), osteogenesis imperfecta typically causes prolapse of P2 (Figure 1). Myocardial ischemia affecting…

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

…competing risk of death from non cardiovascular causes, an important consideration in older populations. Risk prediction is particularly relevant in adults with elevated blood pressure…

…conduction disorders frequently present with presyncope or syncope. Diagnosing transient or paroxysmal AV block in these individuals can be challenging. A high suspicion of intermittent…

…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…

…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…

…assessed. QT prolongation may be congenital (due to genetic mutations) or acquired (secondary to medications, electrolyte disorders). QT duration is inversely related to heart rate…

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

…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…

…end of the QRS complex (it typically causes J point depression). The reason for such electrical potential difference is that not all ventricular myocardial cells…

…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…

…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…

…after reperfusion in an occluded coronary artery. It also occurs as side effect of drugs, hypoxia, myocarditis and electrolyte disorders. Because the rate (60–100…

…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…

…Asian ancestry Previous muscle disease or a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency Concomitant…

…be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome…

…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…

…the heart cannot provide blood flow commensurate with the body’s requirements, or can do so only at the expense of abnormally high filling pressures…