…characteristic clinical syndrome consists of: Malaise Fever Pericardial or chest discomfort Leukocytosis Elevated erythrocyte sedimentation rate Pericardial effusion Pericardial pain is often sharp and pleuritic…

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…

…and pathophysiology Familial hypercholesterolaemia (FH) is an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a…

…insulin resistance, dyslipidaemia, elevated blood pressure and impaired glucose regulation. Diagnosis is based on the coexistence of defined clinical and laboratory components; the diagnostic criteria…

…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…

…unless filling pressures are elevated. The syndrome is therefore defined by symptoms and signs of congestion or impaired cardiac performance rather than by ejection fraction…

…normal cardiac function, but rather to a state where stroke volume is maintained only at the expense of pathologically elevated filling pressures. Epidemiology and risk…

…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…

…in South Asians, who have substantially elevated risk of cardiovascular disease and diabetes at BMI levels of 23 kg/m 2 or higher. Body surface…

…risk. Left Atrial Diameter (LA) : Enlargement of the left atrium is a marker of elevated left ventricular filling pressures and is linked to adverse outcomes…

…therefore focus on: Blood pressure and evidence of hypotension Heart rate and tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure…

Cardiology Definition and pathophysiology Blood pressure is a continuous cardiovascular exposure rather than a binary distinction between normotension and hypertension. Its long term relationship with…

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

…an important consideration in older populations. Risk prediction is particularly relevant in adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably…

…myocardial injury, defined by an elevated cardiac troponin (cTn) value with at least one value above the 99th percentile upper reference limit (URL). The injury…

…including myocarditis, rapid ventricular rate atrial fibrillation, marked anaemia, hypertensive emergency, heart failure, and end stage renal disease, may produce elevated troponin concentrations. The probability…

Cardiology Pharmacology & dosing Definition and Therapeutic Rationale Hypertension is a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It…

…hyperdynamic states In cardiac amyloidosis, BNP or NT proBNP may be markedly elevated even when overt congestion is not apparent. Such a discrepancy should prompt…

…groups and generally remain relatively stable throughout life. Lp(a) is elevated in approximately one in five individuals. Pathophysiology Lp(a) is associated with several…

…maternal organ involvement. Proteinuria is defined as urinary protein excretion 300 mg over 24 hours or a protein–creatinine ratio ≥0.3. Preeclampsia may nevertheless…

…common in patients with inferoposterior left ventricular infarction, while infarction confined predominantly to the right ventricle is rare. The clinical spectrum extends from limited 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…

Cardiology Clinical medicine Definition and cardiovascular rationale Smoking cessation is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible…

…These range from diffuse myalgia with a normal CK and no functional impairment to myositis with muscle inflammation and elevated CK. Rhabdomyolysis is a rare…

…is a rise and/or fall in cTn values. An elevated cTn alone does not establish MI, because myocardial injury may occur without myocardial ischaemia…

…endothelial surface. Furthermore, AF induces a systemic hypercoagulable state, characterized by elevated biomarkers such as D dimer, von Willebrand factor, and increased thrombin generation. The…

…the context of sepsis induced cardiac arrest, consider the following recommendations: Administer 100% oxygen at the maximum flow rate . Hypoxia can precipitate cardiac arrest in…

…conventional chest compressions are ineffective. This is explained by the elevated intrapericardial pressure due to the tamponade. The increased pressure causes compression of the atria…

…higher for troponin I (cTnI). Antibody interference is a rare phenomenon that occurs when troponin forms complexes with immunoglobulins, leading to higher levels of troponin…

…becomes ischemic. Ultimately this results in myocardial necrosis (death of myocytes) which can be detected by elevated levels of cardiac proteins in the blood. Diagnostic…

…EAT, or atrial tachycardia) arises when an ectopic focus within the atria generates electrical impulses at a rate exceeding that of the sinoatrial (SA) node…

…apical ballooning syndrome, stress induced cardiomyopathy) Takotsubo cardiomyopathy (broken heart syndrome) is a rather peculiar and certainly acute condition. Much research has been devoted to…

…the heart pumps and the resistance encountered in the systemic circulation. Therefore, alterations in heart rate, stroke volume, or vascular tone can significantly impact MAP…

…nasogastric tube. Warnings and Precautions Increased risk of bleeding, especially in patients with known elevated bleeding risk. Discontinuation of Ticagrelor should be avoided. If a…

…disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory…

…transient rate related conduction abnormalities, pacing related repolarization changes, and inadequate coronary flow relative to myocardial oxygen demand. Consequently, an elevated cardiac troponin concentration and…

…pressure may be harmful in significantly frail patients, especially when baseline blood pressure is not markedly elevated. These apparent J shaped associations are considered unreliable…

…total, 82 patients (19.7%) had elevated high sensitivity troponin I (TnI) levels. The mortality rate among patients with elevated troponin I was 51.2%…

Emergency medicine Myocardial ischemia and infarction Definition and Clinical Framework Chest pain is a broad clinical syndrome rather than a narrowly defined symptom. It includes…

…may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is particularly associated with elevated central venous pressure, which is transmitted to…

…factors such as elevated blood pressure and lipid abnormalities. CAC should therefore be integrated with clinical assessment and established risk estimation systems rather than used…

…requirements or can do so only at the cost of elevated filling pressures. Congestion and elevated filling pressures produce the characteristic clinical syndrome of breathlessness…

…LDL C or non HDL C, particularly in patients with metabolic syndrome or elevated triglycerides despite normal or low LDL C. HDL cholesterol (HDL C…

…V6), while ST segments are elevated and T waves are typically upright in leads with predominantly negative QRS complexes (such as V1 and V2) [7]…

…is increased, potentially reflecting capillary rarefaction, fibrosis, or left ventricular hypertrophy. Hypertension, diabetes, and elevated NT proBNP are more frequent in this pattern. Endothelial dysfunction…

…evidence of ischaemia; an elevated and dynamically changing troponin concentration without evidence of ischaemia should instead be classified as acute myocardial injury. Mechanisms of troponin…

…of the PR segment. ST segment elevation implies that the ST segment is elevated above the level of the PR segment. The magnitude of any…

…This distinction is clinically important because cardiac troponin elevation after revascularization is common and may reflect procedural myocardial injury rather than a clinically significant infarction…

…In clinical practice, the condition is identified primarily through persistently elevated blood pressure despite multidrug treatment rather than through specific symptoms. The clinical importance lies…

…is loss of contractile myocardium, with reduced cardiac output and systemic hypoperfusion. LV failure may produce elevated filling pressures, pulmonary venous hypertension, and pulmonary congestion…

…Figure 18 . Positive T waves Positive T waves are rarely higher than 6 mm in the limb leads (typically highest in lead II). In the…

…term outcomes. Patients with low flow low gradient aortic stenosis (discussed below) have a 3 year survival rate of 50% ( Eleid et al ). The cause…

…elevations are classified as STE ACS . Virtually all cases of STE ACS lead to myocardial infarction (elevated troponin levels), whereafter the condition is classified as…

…which results in ST elevations on the ECG. Virtually all patients with STE ACS exhibit elevated troponin levels, and are thereby diagnosed as ST elevation…

…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…

…aVF : positive T wave, but occasionally flat. Lead V1 : Inverted or flat T wave is rather common, particularly in women. The T wave inversion is…