…Despite congestive heart failure, a third or fourth heart sound is rarely heard due to restrictive pathophysiology and impaired ventricular relaxation [10]. There is also…

…hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory cell entry into…

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

…failure (HF) is a complex clinical syndrome characterized by symptoms and signs resulting from structural or functional impairment of ventricular filling or ejection of blood…

…conventional risk factors have sex dependent effects: Blood pressure rises more steeply in women from young adulthood, resulting in a greater lifetime burden of hypertension…

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

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

…by the lead in the other chamber, resulting in inappropriate inhibition of the pacemaker in the latter chamber. This type of oversensing is referred to…

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

…MVA) is myocardial ischaemia caused by structural or functional abnormalities of the coronary microcirculation. These abnormalities may impair coronary flow reserve (CFR), reduce microcirculatory conductance…

…rhabdomyolysis, septicemia (sepsis), osteolytic cancer metastases, abnormal calcium absorption (gastrointestinal) and resorption (from primary urine), renal failure, small bowel syndrome, parathyroid gland surgery, use of…

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

…and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise from pulmonary vascular disease…

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…

Arrhythmias and arrhythmology Cardiology Definition and Pathophysiology Vasovagal syncope represents the most common form of neurally mediated syncope (NMS), a disorder of autonomic reflexes. It…

…No reflow is impaired anterograde myocardial perfusion despite the absence of a flow limiting epicardial coronary stenosis. It is therefore a disorder of coronary microvascular…

…with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not merely detoxification. Benzodiazepines reduce the severity of withdrawal…

…together with the clinical picture, medication, fluid balance, renal function, electrolytes and supplemental oxygen [1]. Distinguish between: Acidaemia and alkalaemia , which describe the current pH…

…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…

…heritable aortopathies, selected congenital heart diseases, pulmonary arterial hypertension and thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected…

…however. Delayed recognition may permit vascular remodelling and renal impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated…

…is hereditary with an autosomal dominant inheritance pattern, meaning that only one mutated gene is necessary to develop the disorder. Till now (2016) more than…

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

…or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor…

…syndrome Romano Ward syndrome Idiopathic congenital long QT syndrome (LQTS) Metabolic disorders Hypokalemia Hypomagnesemia Hypocalcemia Starvation Anorexia nervosa Liquid protein diets Hypothyroidism Bradyarrhythmia Sinus bradycardia…

…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…

…history of pain exacerbation with inspiration, along with a pleural friction rub, helps differentiate it from angina pectoris [5]. 5. Pulmonary Hypertension Pain Characteristics: Severe…

…Depression, schizophrenia, schizoaffective disorder, HIV infection or other circumstances that may affect cessation or treatment monitoring. Single question screening can identify unhealthy drug use requiring…

…effects Mild 130 125 mmol/l Cognitive disorders, vertigo, balance disorder. Moderate 115 125 mmol/L Headache, nausea, vomiting, muscle cramps, apathy, confusion, impaired reflexes…

Cardiology Clinical medicine Definition and clinical classification Hypertensive disorders of pregnancy comprise chronic or pre existing hypertension, gestational hypertension, and preeclampsia. Collectively, they affect approximately…

Arrhythmias and arrhythmology Critical care Pharmacology & dosing Definition and Pathophysiology Bradycardia and conduction disorders arise from dysfunction within the sinus node, the atrioventricular node (AVN…

…hyperaldosteronism or Conn syndrome, comprises disorders in which aldosterone secretion is inappropriately increased, relatively autonomous from angiotensin II and plasma potassium, and resistant to suppression…

…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…

…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…

…heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive…

…including gastrointestinal, musculoskeletal, and anxiety related disorders. The immediate objective is not simply to establish whether the patient has ACS. It is to determine whether…

…injection under fluoroscopy. The procedure is performed by advancing guidewires and diagnostic catheters from a percutaneous arterial access site to the aortic root, engaging the…

…for depolarization and repolarization. It is measured from the beginning of the QRS complex to the end of the T wave. Prolonged QT duration predisposes…

…time. Experimentally, necrosis advances from the subendocardium towards the subepicardium over several hours. The extent and tempo of injury are influenced by collateral flow, myocardial…

…triggered activity is a less frequent cause. The atrial rate typically ranges from 120 to 250 beats per minute. To fulfill the diagnostic criteria for…

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

…and thus regurgitation. Ischemia manifests with myocardial akinesia or dyskinesia, which impairs papillary muscle function. Likewise, myocardial infarction affecting the papillary muscle or its connected…

…even positioned vertically, which is important to obtain images from apical windows. The patient's left arm should be placed under the patient's head…

…arrhythmogenic right ventricular cardiomyopathy, Brugada syndrome, early repolarization. Electrolyte disorders, acidosis, hypoxemia and ischemia all aggravate the risk of developing ventricular fibrillation, in any situation…

…hemodynamic compromise. The rapid ventricular rate, which may be accompanied by already impaired ventricular function, does not allow for adequate filling of the ventricles, which…

…used in adults aged ≥70 years. SCORE2 OP accounts for the competing risk of death from non cardiovascular causes, an important consideration in older populations…

…and troponin elevation resembling acute myocardial infarction. These disorders require distinction from true MINOCA because their management is different. Takotsubo syndrome and myocarditis should not…

…In particular, it cannot distinguish adipose tissue from lean mass. Waist circumference and the waist to hip ratio provide additional information about visceral adiposity and…

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

…potential ( Figure 13 ). The ST segment extends from the J point to the onset of the T wave. Because of the long duration of the…

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