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

…Definition and clinical concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of acute…

…Assessing the haemodynamic significance of lesions whose angiographic severity is uncertain. Supporting decisions regarding revascularization and, in selected patients, identifying microvascular or vasomotor coronary disorders…

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

…carotid, vertebral and coronary arteries. In one study cited in the source material, FMD was identified in 86% of patients with SCAD. SCAD should therefore…

…stopping statins. There are three main questions discussed in media, blogs and on social plattforms: Is high cholesterol a true cause of coronary artery disease?…

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

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…used for an initial assessment of pH and the metabolic component, but it should not be regarded as fully interchangeable with an arterial sample [3]…

…lipid, or BP disorders Pregnancy Established ASCVD includes previous acute coronary syndrome, chronic coronary syndromes, coronary revascularization, stroke, transient ischaemic attack, and peripheral arterial disease…

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

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

…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

…lithium, thiazide administration, and over supplementation of calcium and vitamin D. ECG in hypercalcemia Typical ECG changes: Shortened QT interval. Attenuated T wave amplitude. Prolonged…

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…

…patterns in detail. Physical manifestations Tendinous xanthomas, particularly over extensor tendons, are characteristic clinical manifestations of untreated FH and may develop when the disorder is…

…disorders, but it may also arise de novo after delivery. New onset postpartum preeclampsia is increasingly recognized as a significant cause of maternal morbidity and…

…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…

…CABG) Types 4b and 4c fulfil the criteria for type 1 MI because they represent coronary atherothrombotic events in the setting of a stent thrombosis…

…is important because it maximizes the contact surface between the transducer and the skin. Generous use of gel is recommended. In addition to the gel…

…is often used in combination with meprobamate for the treatment of sleep disorders. <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Aceprometazine+AND+(%22QT…

…local and systemic disorders. Accumulation of fluid in the pericardial space may lead to increased intrapericardial pressure, which in turn affects ventricular relaxation (and thus…

…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…

Cardiology Endocrinology & metabolism Definition and pathophysiology Primary aldosteronism (PA), also termed primary hyperaldosteronism or Conn syndrome, comprises disorders in which aldosterone secretion is inappropriately increased…

…reproductive and pregnancy related history. Female specific or female predominant factors associated with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of…

…Prophylaxis against recurrence of cerebrovascular disease: 75–80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant…

…the vulnerability caused by marked local differences in repolarization. This article is part of the comprehensive chapter: How to read and interpret the normal ECG

… rather, it is an indicator of increased cardiovascular risk and a setting in which secondary hypertension is relatively common. Patients presumed to have resistant hypertension…

…highly heterogeneous group of disorders. Idiopathic dilated cardiomyopathy (DCM) is frequently diagnosed when ischemic, valvular, and hypertensive causes are excluded. However, advances in molecular diagnostics…

…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…

…HF), atrial fibrillation and cardiovascular events. In clinical practice, obesity is conventionally defined by a body mass index (BMI) of ≥30 kg/m2. Severe obesity…

…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…

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

…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…

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

…re entry or triggered activity. All types of myocardial cells may be engaged in initiation and maintenance of this arrhythmia. As mentioned above VT causes…

…with placebo, whereas approximately 10% of patients in registries and routine clinical practice report muscle symptoms. This discrepancy reflects, at least in part, the nocebo…

…approximately 5% of presentations in some populations. Despite this relatively low prevalence, missed myocardial infarction remains consequential, and historically 2–6% of patients discharged with…

…to electrolyte imbalance (electrolyte disorder) The normal cardiac action potential may be altered by electrolyte imbalance, owing to changes in intra and extracellular electrolyte concentrations…

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

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

…and bundle branch block. Cardiac monitoring is indicated for patients with a high pretest probability of arrhythmia causing syncope. In hospital monitoring is reserved for…

…the extent of microvascular obstruction and the territory supplied by the treated vessel. Possible manifestations include: Persistent or recurrent myocardial ischemia Deterioration in ventricular function…

…use disorder and planned follow up , not merely detoxification. Benzodiazepines reduce the severity of withdrawal and the risk of seizures and delirium [1,2]. In…

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

…asymmetric, i.e its distribution in the left ventricular myocardium varies. Septal hypertrophy, apical hypertrophy and hypertrophy of the left ventricular free wall are common…

…five years of stopping but may remain elevated thereafter. The overall health benefit is greater still when reductions in non cardiovascular morbidity and mortality are…

…a reduced level of consciousness, seizures, confusion, a change in behaviour, collapse or an acute neurological deficit. Hypoglycaemia can cause hemiparesis, aphasia and radiological changes…

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

…in V2 and V3. This may be confused with right bundle branch block. Paper speed 50 mm/s. Type 1 Brugada syndrome reminds somewhat of…

…particularly in early disease and in optimally treated patients; their absence therefore does not exclude HFrEF. Clinical evaluation should define: The severity of symptoms and…