…throughout life. Lp(a) is elevated in approximately one in five individuals. Pathophysiology Lp(a) is associated with several interrelated pathological processes: accelerated atherogenesis; vascular…

…insulin action promote hepatic triglyceride rich lipoprotein synthesis and reduce triglyceride rich lipoprotein and remnant clearance. The resulting atherogenic dyslipidaemia is characterized by elevated triglycerides…

…combined dyslipidaemia, non HDL C is particularly relevant because it captures triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk…

…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…

…than corresponding LDL C goals. Apolipoprotein B ApoB is the principal structural apolipoprotein of atherogenic lipoproteins. Each atherogenic lipoprotein particle carries one apoB molecule. Consequently…

…or calculator. The relevant BP and non high density lipoprotein cholesterol (non HDL C) values are then entered into the table or application. Estimates should…

…LDL particles from the circulation. Statins also reduce production of apoB 100 containing lipoproteins and exert effects beyond LDL C reduction, including modulation of inflammation…

Cardiology Endocrinology & metabolism Definition and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every…

…Hypertensive emergency is defined as significantly elevated blood pressure (systolic pressure ≥180 mmHg and/or diastolic pressure ≥120 mmHg) with concurrent signs of acute organ…

Cardiology Pharmacology & dosing Definition and pathophysiology Congestion is a central expression of the heart failure syndrome and reflects excessive retention of sodium and water, with…

…or only mildly elevated, particularly early in the disease or after treatment. During exertion, however, the limited diastolic reserve becomes evident, with a rise in…

…functional cardiac abnormalities and/or elevated natriuretic peptides (NPs) [1] [2] . The evolution of HF terminology has been driven by a deeper understanding of myocardial…

…cardiovascular societies, defines HF as a clinical syndrome corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion [3] . Within…

…Hypertensive emergency is defined as significantly elevated blood pressure (systolic pressure ≥180 mmHg and/or diastolic pressure ≥120 mmHg) with concurrent signs of acute organ…

…contingent upon the specific mutation present. For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker…

…contingent upon the specific mutation present. For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker…

…BMI is particularly poor a predictor in South Asians, who have substantially elevated risk of cardiovascular disease and diabetes at BMI levels of 23 kg…

…is a marker of elevated left ventricular filling pressures and is linked to adverse outcomes. Left Ventricular Outflow Tract Gradient (LVOTG) : LVOT obstruction is a…

…findings may occur singly or in combination. Syncope is particularly important as a marker of potentially severe disease. The presence of haemodynamic instability places the…

…distinction supports a risk based approach because cardiovascular benefit from blood pressure reduction may also occur in selected people whose pressure is elevated but below…

…may reveal a normal or low pulse pressure, an elevated jugular venous pressure with a paradoxical rise on inspiration (Kussmaul sign), and a difficult to…

…A fundamental prerequisite for diagnosing any MI is myocardial injury, defined by an elevated cardiac troponin (cTn) value with at least one value above the…

…of ischaemia represents acute myocardial injury rather than MI. Persistent elevation without a significant dynamic change is consistent with chronic myocardial injury. Non ischaemic conditions…

…benefit from a more individualized selection strategy. When to Initiate Pharmacological Treatment Lifestyle intervention is an essential component of care. In adults with elevated blood…

…BNP or NT proBNP may be markedly elevated even when overt congestion is not apparent. Such a discrepancy should prompt consideration of an infiltrative cardiomyopathy…

…or coma in a pregnant woman with preeclampsia. HELLP syndrome—haemolysis, elevated liver enzymes or transaminases, and thrombocytopenia—is generally regarded as a severe preeclamptic…

…central venous, right atrial, and right ventricular end diastolic pressures—are elevated, whereas left ventricular filling pressure is usually normal or only modestly increased. Right…

…the whole community through healthier environmental defaults, whereas individual level prevention focuses more intensively on people with elevated risk. These approaches are not alternatives: both…

…than that of never smokers for a prolonged period. In heavy smokers, cardiovascular risk falls within five years of stopping but may remain elevated thereafter…

…URL). It is considered acute when there is a rise and/or fall in cTn values. An elevated cTn alone does not establish MI, because…

…promote local inflammation and create a highly prothrombotic endothelial surface. Furthermore, AF induces a systemic hypercoagulable state, characterized by elevated biomarkers such as D dimer…

…Elevated lactate is an indicator of tissue hypoperfusion and can guide resuscitative efforts. If the patient presents with hypotension or has a lactate level exceeding…

…Therefore, in the presence of a tamponade, chest compressions have limited efficacy. Furthermore, administering large tidal volumes might inadvertently elevate intrathoracic pressures, additionally compromising venous…

…among different assays (see Table 1), with values between 10 ng/L and 20 ng/L being most common. Elevated troponin : A value above the

…which can be detected by elevated levels of cardiac proteins in the blood. Diagnostic criteria for acute myocardial infarction A diagnosis of myocardial infarction is…

…and elevated catecholamine states. EAT typically has an abrupt onset, although a brief warm up phase lasting approximately 5 to 10 seconds may precede the…

…performed. Note that troponins may be elevated but the elevation is typically discrete and not on a par with the degree of left ventricular impairment…

…Perfusion : MAP is a more reliable indicator of blood flow to vital organs than systolic blood pressure alone. Predictive Value : Elevated MAP has been associated…

…risk of bleeding, especially in patients with known elevated bleeding risk. Discontinuation of Ticagrelor should be avoided. If a dose is missed, only one tablet…

…the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and is also a common tachyarrhythmia requiring treatment in decompensated heart failure (DHF)…

…in later life. These changes contribute to the complexity of defining an appropriate treatment target, particularly when a lower DBP, orthostatic hypotension, or impaired autonomic…

…in patients with elevated TnT levels who had underlying cardiovascular disease, of which 69.4% died. Guo et al also report a significant association between…

…troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin, so biomarker interpretation must be integrated with the…

…is particularly associated with elevated central venous pressure, which is transmitted to the renal veins and can reduce GFR. Conversely, a rise in creatinine during…

…improve cardiovascular outcomes, although opportunistic assessment during clinical encounters improves detection of risk factors such as elevated blood pressure and lipid abnormalities. CAC should therefore…

…LVEF ≥50%. The ejection fraction classification is clinically useful but should not be regarded as a series of completely discrete diseases. Heart failure extends across…

…The diagnostic requirements for LBBB vary by the stringency of the criteria applied: Classic Criteria : These include a QRS duration of $\ge 120$ msec …

…Hypertension, diabetes, and elevated NT proBNP are more frequent in this pattern. Endothelial dysfunction may contribute to both microvascular and epicardial vasomotor disorders. Endothelial activation…

…Myocardial ischemia and infarction Definition and Pathophysiology Myocardial injury Myocardial injury is a biochemical diagnosis defined by at least one cardiac troponin value above the…

…by the detailed article The normal electrocardiogram (ECG). A brief summary of that article is provided below. Summary of lecture The Normal ECG (EKG) waves…

…When preprocedural troponin is elevated but stable or falling, the postprocedural level must demonstrate both the required absolute threshold and a rise of more than…

…traditionally termed Dressler syndrome , which is a manifestation of post cardiac injury syndrome (PCIS). PCIS is an umbrella term that also includes post pericardiotomy syndrome…

…material does not describe a distinctive symptom profile for resistant hypertension. In clinical practice, the condition is identified primarily through persistently elevated blood pressure despite…

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

…short; they typically disappear within minutes after a total occlusion in a coronary artery occurs (then of course, the ST segment will be elevated). T…

…PSAX (parasternal short axis view). Individuals with bicuspid aortic valves have substantially elevated risk of developing aortic stenosis. The prevalence of bicuspid aortic valves is…

…myocardial infarction: a diagnosis based on cardiac troponins A diagnosis of acute myocardial infarction (AMI) is made only after blood analyses confirm elevated levels of…

…ACS exhibit elevated troponin levels, and are thereby diagnosed as ST elevation myocardial infarction (STEMI) . Chronic Coronary Syndromes (CCS) Coronary artery disease is a progressive…

…coronary arteries (Felker et al). Left ventricular dilation entails a markedly elevated risk of ventricular tachycardia and cardiac arrest, regardless of the underlying cause of…

…in the ST segment and the T wave during myocardial ischemia. A thorough discussion of the electrophysiological principles, ECG changes and clinical implications is provided…