…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…

…A high suspicion of intermittent infrahisian block should be maintained, particularly in older patients and those exhibiting a bundle branch block (BBB) or an intraventricular…

…with prolongation of the Q T interval and sudden death. Am Heart J 1957;54:59 68. Brugada P, Brugada J. Right bundle branch block…

…30%) and dyspnea (10%). The major ECG findings in ARVC are T wave inversion in V1–V3 (in the absence of right bundle branch block…

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

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

…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…

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

…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…

…because myocardial injury may occur without myocardial ischaemia. Non ischaemic myocardial injury may accompany numerous cardiac and systemic disorders, including: Cardiac causes Systemic causes Heart…

…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…

…and also avoid bending the back during the examination. Work related musculoskeletal disorders are a common cause of pain and sickness absence for ultrasound practitioners…

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

…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…

…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…

…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…

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…

…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…

…in patients on low dose acetylsalicylic acid for cardioprotection. Pharmacokinetic interactions Methotrexate: NSAIDs inhibit tubular secretion of methotrexate, increasing plasma levels and risk of toxicity…

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

…acquired (secondary to medications, electrolyte disorders). QT duration is inversely related to heart rate; QT duration increases at slow heart rates and vice versa . Hence…

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

…Non ischemic etiologies encompass a highly heterogeneous group of disorders. Idiopathic dilated cardiomyopathy (DCM) is frequently diagnosed when ischemic, valvular, and hypertensive causes are excluded…

…Sjögren syndrome, gout and antiphospholipid syndrome (APS). Collectively, these disorders are associated with excess cardiovascular disease (CVD), although the cardiovascular phenotype varies substantially between diseases…

…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…

…Definition and pathophysiology Spontaneous coronary artery dissection (SCAD) is an acute coronary disorder caused by separation within the coronary arterial wall, usually through formation of…

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

…without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. EAT typically has an…

…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…

…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…

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

…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…

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

…and optical coherence tomography (OCT) can reveal lesions that are not apparent on conventional angiography. Coronary vasomotor disorders may involve epicardial spasm or abnormalities of…

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

…is a correlation between the severity of electrolyte imbalance and the visible ECG changes. Specific electrolyte disorders 1. Sodium Increased (hypernatremia) and decreased (hyponatremia) sodium…

…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…

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…

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

…treatment and treatment of the precipitating illness the prognosis is considerably better [3,5]. Pathophysiology Alcohol enhances inhibitory signalling via gamma aminobutyric acid, GABA, and…

…Caused by autosomal dominant single nucleotide polymorphisms resulting in amino acid substitutions that destabilize the normal tetrameric TTR protein, favoring dissociation, misfolding, and amyloidogenesis [9…

…ventricular myocardium varies. Septal hypertrophy, apical hypertrophy and hypertrophy of the left ventricular free wall are common. General hypertrophy is less common. Hypertrophic cardiomyopathy causes…

…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…

…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…

…FH). Heterozygous FH results in high LDL cholesterol levels (but nothing else) and increases the risk of acute myocardial infarction by more than 50 times…

…LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical signs, and an LVEF below 40%…