…greater afterload and consequently increasing diastolic pressure), sarcomere structure, the composition of extracellular matrix (extracellular fibrosis reduces compliance), pericardial status, etc . Diastolic Dysfunction and Diastoli

…is the result of diminishing ATP concentration in the myocardium. ATP depletion results in cellular dysfunction and renders the defibrillation ineffective. The likelihood of successful…

…to dysfunction in the conduction system. The J point and the ST segment The ST segment corresponds to the plateau phase (phase 2) of the…

…ECG Conventional surface ECG can reveal the following types of pacemaker dysfunction: Failure to capture (FTC) , which means that the pacemaker stimulations do not result…

Cardiology The ischemic cascade The ischemic cascade describes the sequence of events during myocardial ischemia, beginning with perfusion abnormalities and ultimately leading to chest pain…

…diseases Cardiovascular effects of COVID 19 Coronavirus disease 2019 (COVID 19) has caused a global public health crisis. It is believed that the virus was…

…lesion specific and largely independent of resting hemodynamics; guideline reference standard. Requires pressure wire + vasodilator (cost, time, patient discomfort); falsely normal in microvascular dysfunction (diabetes…

…block): definition, causes, diagnosis & management This article covers the fundamental principles of atrioventricular (AV) blocks, which are classified into three types: first degree, second degree…

…factors. Plaque erosion Plaque erosion is increasingly recognized and is present in at least one third of acute coronary syndromes in the cited material. Eroded…

…potentially indicating microvascular dysfunction or other pathologies. The software allows for detailed regional analysis of myocardial perfusion, highlighting specific segments of the left ventricle that…

…article. A rehearsal follows. Reversible causes of sinus node dysfunction Age related degenerative disease (development of fibrosis) of the sinoatrial node. Myocardial ischemia/infarction. Perimyocarditis…

…node dysfunction (SND). If a person with ECG signs of SND is symptomatic, the condition is classified as sick sinus syndrome (SSS) . Causes of tachycardia…

…node dysfunction) are at high risk of developing atrial fibrillation, and vice versa. The pathophysiological explanation for this may be a general degeneration of the…

…warrant it. The contemporary diagnostic strategy also recognises that symptoms of myocardial ischaemia may arise from obstructive atherosclerotic CAD, coronary microvascular dysfunction or vasospasm. A…

…The causes of death among these patients are complications related to PACS: 60% die from neurological injuries. 30% die from hemodynamic failure and multiorgan dysfunction…

…threatening organ dysfunction caused by a dysregulated host response to infection. Clinically this usually corresponds to an acute increase in the SOFA score of at…

…it is actually a complicated and fundamental aspect of ventricular function. Impaired diastolic function (i.e diastolic dysfunction ) may lead to diastolic heart failure (i…

…or fascicular block may become worse. Particularly, the degree of AV block may increase. QRS complex QRS duration becomes prolonged. ST segment ST segment depression…

…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:/…

…Right ventricular dysfunction due to pressure/volume overload is the most common cause. Ebstein's anomaly The prevalence of Ebstein's anomaly is approximately 1…

…occur across the full range of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both. The clinical consequences of extracellular…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

…through the AV node, resulting in increased AV block. Sinus node dysfunction can be caused by supraventricular tachyarrhythmias (e.g. atrial fibrillation). Typically, periods of…

…myocardial ischemia (affecting the sinoatrial node), sinus node dysfunction or side effects of digoxin treatment. If the rhythm becomes completely regular when holding the breath…

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

…categories. However, the emergence of incretin based therapies, starting with glucagon like peptide 1 receptor agonists (GLP 1 RAs) and evolving into multi receptor agonists…

…common to provide the patient with a permanent pacemaker to continue optimal medical treatment. Sick sinus syndrome (sinus node dysfunction), a common cause of brady

…or cold exposure. The absence of chest pain does not exclude clinically important CCS. Silent or minimally symptomatic disease may occur in patients with diabetes…

…mastering the nuances of anticoagulation requires an intimate understanding of the underlying pathophysiology, which is classically framed by Virchow’s triad: blood stasis, endothelial dysfunction…

…angina pectoris), ventricular dysfunction (heart failure) and arrhythmias. The annual risk of sudden cardiac arrest is <1% and median survival is 3 years. Long term…

…lysis, and the quality of tissue level perfusion after epicardial flow is restored. Microvascular obstruction may persist despite successful PCI because of endothelial dysfunction, leukocyte…

…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…

…The chronically dysfunctional myocardium in ischemic cardiomyopathy is therefore heterogeneous. Irreversibly scarred regions may alternate with viable segments that are dysfunctional because of repeated ischemic…

…worsen the hemodynamic situation. Thus, chronic aortic regurgitation gradually leads to impaired contractile function and the development of myocardial fibrosis. Contractile dysfunction further aggravates the…

…dysfunction in the right bundle branch, such that the electrical impulse is blocked. Figure 1 illustrates the components of the ventricular conduction system, including the…

…biomarkers, and no imaging evidence of RV dysfunction. Catastrophic or “supermassive” PE refers to refractory cardiogenic shock or the need for ongoing cardiopulmonary resuscitation. Mechanical…

…or CABG, daily or weekly angina remains present in approximately 2%–24% of patients with CAD. The pathophysiology of refractory angina is heterogeneous. In obstructive…

…hypertrophy and kidney injury. The syndrome is therefore both a clinical risk factor cluster and a marker of broader metabolic dysfunction. Associated abnormalities may include…

…imaging can determine whether dysfunctional myocardium or myocardium supplied by a diseased vessel, is viable and could benefit from revascularization. Evaluating the success of revascularization :…

…diastolic dysfunction or increased filling pressures, including raised natriuretic peptides. HF with mildly reduced ejection fraction (HFmrEF) is defined by symptoms and/or signs of…

…Type 2 myocardial infarction (MI) is defined as an ischaemic myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand…

…haematuria with clots (a three way catheter). Instillation therapy and contrast studies of the urinary tract. Wound healing with a sacral pressure sore or extensive…

…who have high risk occupations or participate in competitive athletics. In the context of Brugada syndrome (BrS), pharmacologic challenge with sodium channel blockers (ajmaline or…

…40%. Ongoing or newly recognized LV systolic dysfunction. A patient may also present because of complications of the underlying infarction or LV remodeling, including heart…

…thrombus. Myocardial vulnerability, largely driven by coronary microvascular dysfunction, also contributes to the extension and severity of ischemic injury. In its most severe form, known…

…cardiac tumors The hemodynamic effect of the tumor depends on its size and location. Tumors can reduce cardiac output by causing obstruction or valve dysfunction…

…Sinus node dysfunction (SND) is a common cause of chronotropic incompetence. Definition of chronotropic incompetence: the age expected maximal heart rate Chronotropic incompetence is defined…

…stress. This dysfunction compromises the endothelial barrier, upregulating the expression of vascular cell adhesion molecule 1 (VCAM 1) and intercellular adhesion molecule 1 (ICAM 1)…

…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…

…are tall and narrow at the top. Refer to Figure 1 . Patients with left ventricular hypertrophy may instead display normalization of secondary T wave inversions…

…particularly PDE3 and PDE5, which break down cAMP and cGMP. It also inhibits the cellular reuptake of adenosine into endothelial cells. Further, it inhibits adenosine…

…form part of the broader cardiovascular kidney metabolic syndrome, in which adiposity, insulin resistance, diabetes, hypertension, CKD and CVD reinforce one another. Dysfunctional adipose tissue…

…the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and organ dysfunction…

…sinus node dysfunction or second degree and third degree heart block in the absence of a pacemaker. Use of intravenous rhythm control antiarrhythmics (class I…

…of ACE inhibitors, especially in patients with preexisting azotemia, hypotension, hyponatremia, diabetes mellitus, or in those taking potassium supplements. When managing albuminuria or CKD, the…

…and the feasibility of complete revascularisation. The clinical evaluation includes: Symptom burden and functional limitation Evidence of heart failure Haemodynamic stability Diabetes status Renal dysfunction…

…pressures are reduced. The central management principle is preservation of adequate right ventricular preload while supporting left ventricular performance and systemic circulation. Improvement in left…

…chronic, systemic proinflammatory state. This circulating inflammation leads to coronary microvascular endothelial dysfunction, characterized by the upregulation of adhesion molecules (e.g., VCAM 1) a

…Secondary ST T changes occur invariably in the presence of LBBB. The following ECG criteria and characteristics are used to diagnose LBBB: QRS duration ≥0…

…the diagnosis is Mobitz type 1 (Wenckebach block) . Electrophysiology of second degree AV block Mobitz type 1 The dysfunction in the AV node in Mobitz…