…syndrome (CCS). Whether and how PCI was performed. The need for non cardiac surgery. The presence of an indication for oral anticoagulation (OAC). Clinical context…

…lead configuration when records are incomplete. A full device check should be available within the recommended interval before elective surgery. In the absence of malfunction…

…surgery on the oesophagus or upper gastrointestinal tract, ileus and ongoing upper gastrointestinal bleeding. Marked agitation or inability to cooperate. Copious secretions without an effective…

…contrast, within selected high risk populations, prevalence may be sufficiently high for targeted screening to be cost effective. For asymptomatic stenosis of at least 70%…

…Atrial fibrillation with onset during hyperthyroidism (thyrotoxicosis), alcohol overdose, thoracic surgery, acute myocardial infarction, pericarditis/myocarditis or pulmonary embolism is often a reversible arrhythmia with…

…Predictive Value : While effective in PCI treated patients, its predictive ability is less robust in CABG treated patients, as surgery can bypass complex lesions irrespective…

…days to attain a steady state concentration before further adjusting the dose. Electrophysiology Sotalol prolongs the effective refractory periods of the atrium, atrioventricular (AV) node…

…Age related degenerative disease (fibrosis) Myocardial ischemia/infarction Lesions due to heart surgery Myocarditis Collagen disease Amyloidosis Risk of supraventricular tachyarrhythmia (tachycardia) Sinus node dysfunction…

…Sodium imbalance Neither hyponatremia nor hypernatremia typically cause discernible ECG changes. Hyponatremia Effective management of hyponatremia requires careful identification of its etiology, severity (Table 2)…

…excitation with atrial fibrillation and a very rapid ventricular rate. Elective or subacute: Symptomatic persistent atrial fibrillation where rhythm control is the aim. Atrial flutter…

…next check. Interruption before an elective procedure The duration of interruption is governed by the bleeding risk of the procedure and by renal function. In…

…frequent during PCI than during purely diagnostic angiography. Elective PCI has reported mortality of 0.1–0.3%, large myocardial infarction in fewer than 3…

…present chapter focuses principally on ACS, for which the evidence and recommendations differ from those applicable to elective PCI. Clinical presentation and symptoms The source…

…dedicated physical examination algorithm. Diagnostics Non invasive assessment of ischaemia and viability Objective evidence of ischaemia is important before elective CTO PCI. Demonstration of both…

Cardiology Pharmacology & dosing Definition and pharmacological basis Ivabradine is a selective inhibitor of the If, or “funny,” current in sinoatrial node pacemaker cells. This current…

ECG Introduction to ECG interpretation Principles of cardiac electrophysiology and electrocardiography (ECG) To ensure effective cardiac pumping function, the atria and the ventricles must be…

…general practice concern the nails, and all three rest on the same foundation: an effective digital block and a tourniquet . Without a bloodless field one…

…®, Rogitine ® Indications Hypertensive crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity…

…including laypeople. As shown in Table 1, BLS is an exceptionally effective treatment, with a very low number needed to treat (NNT), indicating high effectiveness…

…calcium channel blocker. Clevidipine is highly selective for vascular smooth muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces…

…and Clinical Role Invasive coronary angiography (ICA) is a catheter based investigation that visualizes the coronary arterial tree after selective intracoronary contrast injection under fluoroscopy…

…vasovagal syncope is reported to occur in over 40% of females and 30% of males due to a lack of effective reflex response to posture…

…in isolation, distinguishing between them in clinical scenarios may remain challenging. Effective management of tachycardia requires a comprehensive understanding of differential diagnoses, therapeutic strategies, and…

…diagnosing hypertension and the effectiveness of antihypertensive treatments, targeting hypertension is the single most effective public health measure available ( Ezzati et al, Lim et al )…

…in properly selected patients. Tenecteplase 0.25 mg/kg is a safe and effective alternative to alteplase and is simpler to administer, since the whole…

…pH ≥ 7.3 and bicarbonate ≥ 15 mmol/L Hyperosmolality Not required Effective osmolality 300 mosm/kg or total osmolality 320 mosm/kg Typical patient Often…

…implantation. Beta blockers, particularly non selective agents like nadolol and propranolol, are the first line treatment for reducing arrhythmic risk across all LQTS genotypes. These…

…implantation. Beta blockers, particularly non selective agents like nadolol and propranolol, are the first line treatment for reducing arrhythmic risk across all LQTS genotypes. These…

…calcium channel blocker. Clevidipine is highly selective for vascular smooth muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces…

…Antianginal effect. Reduces afterload and preload. Effective in pulmonary edema. Can produce severe hypotension. Time to onset of action 30 seconds to 1 minute Duration…

…term prediction of sudden cardiac arrest. The constraint does not lie in therapy: implantable cardioverter defibrillators (ICDs) are highly effective, terminating well over 99% of…

…is 34,000 as of March 29, 2020 (Figure 1). There are no known effective treatments, although several randomized controlled trials are underway. Figure 1…

…and an LVEF below 40%. Signs may be absent in early disease or after effective treatment. HFrEF is commonly associated with structural and functional ventricular…

…from cardiovascular disease. Pharmacological PCSK9 inhibition increases the effective availability of hepatic LDL receptors and thereby enhances LDL C removal from plasma. Two principal therapeutic…

…stroke compared with fibrinolysis. It is also more effective at opening the occluded coronary artery and is advantageous when fibrinolysis is contraindicated, bleeding risk is…

…ischemia, improve myocardial function and increase resistance to episodes of more severe myocardial ischemia. Collateral circulation may be very effective in reducing ischemia. Indeed, it…

…ACE inhibitors, and ARBs were effective for treating heart failure. The rapid advances in the 1970s and 1980s were followed by almost two decades without…

…ACE inhibitors, and ARBs were effective for treating heart failure. The rapid advances in the 1970s and 1980s were followed by almost two decades without…

…calcium channel blocker. Clevidipine is highly selective for vascular smooth muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces…

…Principles of myocardial excitability and the conduction system Achieving an effective pumping mechanism requires the atria and the ventricles to be activated rapidly and sequentially…

…activity. Advantages of regadenoson over adenosine Regadenoson has advantages over adenosine: Regadenoson is a selective A2A receptor agonist : A2A receptors are responsible for coronary vasodilation…

…ventricle with varying orientation. This organization allows the left ventricle to contract in a highly sophisticated and effective way (Figure 1). Myocardial fibers adjacent to…

…targeted temperature management, etc.) and are much less effective in terms of the number needed to treat (NNT). The Number Needed to Treat (NNT) is…

…entry circuits , causing rapid and chaotic ventricular depolarizations, rendering the left ventricle incapable of generating effective contractions. This results in circulatory collapse, loss of consciousness…

…hearing, cardiac examination, ECG, selective vascular imaging Traumatic or toxic syndrome Onset after trauma, a change in medication or an exposure Concussion, temporal bone injury…

…marked rise in SVR. As for the intermediate dose, together with marked hypertension (caution during non selective beta blockade). Dobutamine Cardiogenic shock. Bradycardia (second line…

…activity is suspected Benzodiazepines are the established first line treatment. Intravenous lorazepam and diazepam are effective, and intramuscular midazolam is particularly useful where there is…

…should be increased to target as tolerated. Higher doses are more effective than lower doses in preventing hospitalization. Abrupt withdrawal of treatment with an ACE…

…Concomitant nonsteroidal anti inflammatory drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be prescribed routinely to…

…Conversely, a rise in creatinine during effective decongestion and overall clinical improvement does not necessarily indicate an adverse outcome. Classification of CKD CKD severity is…

…of coronary artery disease? Does diet affect cholesterol levels? Are statins really effective, or is it all just a "big pharma" sham? These are actually…

…treatment. The presence of ST segment changes or a positive troponin assay identifies patients in whom an invasive strategy is generally preferred over selective angiography…

…be considered. Effective lipid lowering improves survival and reduces cardiovascular mortality in patients with coronary artery disease irrespective of the baseline cholesterol concentration. Intensive statin…

…pressure and rhythm monitoring are mandatory, particularly when utilising dobutamine, to ensure the lowest effective dose is used. When titrating sodium nitroprusside for afterload r

…ischaemia on stress testing. Such developments may convert an initially selective or delayed approach into an indication for angiography and possible revascularization. Initial evaluation and…

…support. More intensive, individualized counselling is more effective than advice alone, although long term success rates remain modest and repeated intervention is often necessary. Patients…

…right shunt, tamponade, or sudden loss of effective cardiac output. Their recognition is essential because treatment often requires urgent surgical or transcatheter intervention, with temporary…

…rhythms) after confirmed cardiac arrest. If it is not feasible to provide effective CPR due to the position of the victim, it is necessary to…

…and light reactivity is lost when cerebral blood flow ceases. In other words, during prolonged cardiac arrest without effective perfusion, one expects fixed, dilated pupils…

…15 to 30° to the left. The supporting surface should be sufficiently rigid to ensure chest compressions remain effective. Although the empirical evidence supporting these…