…obstructive sleep apnoea, social determinants of health, air pollution, family history, ethnicity, and frailty. Primary prevention is complemented by population level interventions. Population strategies aim…

Procedurer The result of a repair is determined before the first needle goes in. A wound that has not been irrigated clean, has not been…

…to bleeding and alcohol use. A high bleeding risk score should prompt correction of modifiable risk factors and closer surveillance; it does not, by itself…

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

…Paper speed 25 mm/s. Calculate the heart rate by dividing 300 by the number of large boxes between R waves. There are approximately 3…

…not their actual trigger. The fact that continuous dizziness becomes worse when the patient moves the head is therefore not evidence of BPPV. Step 2:…

…intubation, and prolonged ICU admissions. Pending the correct level of care, the following actions can be performed. CPR Initiate CPR in adherence to standard guidelines…

…the vast majority of these arrests are caused by ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation), whose occurrence is highly stochastic. This is evident from the…

…there is a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried in with…

ECG Myocardial ischemia and infarction Pathological Q waves are evidence of myocardial infarction Myocardial infarction – particularly if extensive in size – typically manifests with pathological Q…

…I C Blood samples Management Recommendation Level of evidence Serum biomarkers of myocardial infarction (troponin) should be sampled as early as possible without delaying reperfusion…

…evidence of acute myocardial ischaemia, electrocardiographic findings, cardiac biomarkers, imaging, angiography, and, occasionally, pathological examination. Pathologically, infarction represents myocardial cell death caused by prolonged ischaemia…

…certain radiotracers enable direct measurement of coronary blood flow, providing absolute quantification. The resting myocardium rarely reveals evidence of significant coronary artery stenosis unless the…

…occurs within the media without imaging evidence of an intimal tear or flap. AAS is classified anatomically according to involvement of the ascending aorta: Stanford…

…independent cause of ischemia, including with non obstructive epicardial arteries (ANOCA/INOCA); CFR has independent prognostic value. CFR confounded by heart rate/blood pressure/contractility…

…with acute coronary syndrome, randomized evidence has demonstrated lower rates of access site bleeding, surgical repair, and blood transfusion with radial access. Radial access has…

…or partly outside of the conduction system (which is slow). However, WCTs may be supraventricular, if the tachycardia is accompanied by one of the following…

…acute coronary event may be triggered by increased myocardial demand during the infection. Systemic inflammation results in increased levels of circulating pro inflammatory cytokines that…

…cause of brain injuries is anoxic cell death, continued dysfunction in cerebral blood flow (autoregulation) after ROSC and cerebral hypoperfusion. Myocardial dysfunction is defined by…

…atherosclerotic vascular disease or familial hypercholesterolaemia, addition of bempedoic acid to statin therapy reduced LDL C by approximately 16.5%; the reduction in a subgroup…

…was coined in 1858 by Virchow (the same Virchow who unraveled thrombosis). He used te term to describe a reduction of blood flow to tissues…

…or CABG. While the procedure itself provides the clinical context, the diagnosis requires evidence of new myocardial ischaemia, which may manifest through symptoms, ECG changes…

…suggestive of ischaemia, especially intermittent ST segment elevation Patients may initially stabilize and subsequently develop recurrent angina, recurrent ischaemic ECG changes, biomarker evidence of myocardial…

…triggered by ventricular tachycardia (VT) and ventricular fibrillation (VF). Defibrillation is extremely effective during the first few minutes of these arrhythmias. This is evident from…

…up diameter stenosis greater than 50%—occurred in 20–30% of patients, while clinically evident restenosis, manifested by recurrent angina attributable to the treated segment…

…α and β agonist Infusion of 5−20 μg/kg/min T½ 2 min • Avoid boluses. • Effective if bradycardia is caused by beta blockers…

…or other situations with increased myocardial load. Symptoms are exacerbated by increasing the level of exertion ( i.e increasing the myocardial load), and vice versa …

…or other situations with increased myocardial load. Symptoms are exacerbated by increasing the level of exertion ( i.e increasing the myocardial load), and vice versa …

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

…after 20 weeks of gestation. Preeclampsia is characterized by new onset hypertension after 20 weeks, generally accompanied by proteinuria or evidence of maternal organ involvement…

…purpose of antiarrhythmic drugs is to control arrhythmias, these medications may also cause arrhythmias and confusing ECG changes. ECG changes and arrhythmias caused by digoxin…

…INR on day 3. The dose that day is determined by the value: below 1.5 means the full dose is continued, 1.5–2…

Cardiology Clinical medicine Definition and Pathophysiology Dietary patterns are the overall combinations of foods habitually consumed rather than isolated nutrients considered independently. For cardiometabolic health…

…selective inhibitor of the If, or “funny,” current in sinoatrial node pacemaker cells. This current is a mixed inward Na⁺/K⁺ current activated by hyperpolarisation…

…curiosity into a major focus of contemporary cardiac electrophysiology [1] . Recognized as a primary inherited arrhythmia syndrome, BrS is characterized by a distinct electrocardiographic (ECG…

…LVEF) of ≥50%, accompanied by objective evidence of structural and/or functional cardiac abnormalities and/or elevated natriuretic peptides (NPs) [1] [2] . The evolution of…

…levels and/or objective evidence of pulmonary or systemic congestion [3] . Within this spectrum, Heart Failure with Reduced Ejection Fraction (HFrEF) is specifically classified by…

…failure. The rapid advances in the 1970s and 1980s were followed by almost two decades without any major breakthrough in the management of heart failure…

…failure. The rapid advances in the 1970s and 1980s were followed by almost two decades without any major breakthrough in the management of heart failure…

…shock index is calculated as the heart rate divided by the systolic blood pressure. A value of around 0.9 to 1.0 or higher…

…As of 2025, it is recommended to use the CHA₂DS₂ VA score for stroke risk assessment in atrial fibrillation patients. By excluding the sex parameter…

…36% lower risk of premature death than continued smoking After acute coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45…

…Although the empirical evidence supporting these interventions may be limited, they are consistently endorsed by expert panels. In the event of unsuccessful resuscitation within a…

…on the cause of the arrest, other units may be critical (e.g. trauma unit). Careful and evidence based planning at the societal level (e…

…ventricular ejection fraction (LVEF) of 41–49%. It occupies an intermediate position between heart failure with reduced ejection fraction (HFrEF), defined by an LVEF ≤40%…

…in which the patient has symptoms suggestive of acute coronary syndrome (ACS), biochemical evidence of myocardial injury with corroborating evidence of infarction caused by ischaemia…

…and infarction ECG Definition and Pathophysiology Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions characterized by a recent change in symptoms or signs…

…without evidence of acute cardiomyocyte injury or necrosis. It is distinguished from acute myocardial infarction (AMI), in which myocardial ischaemia is accompanied by cardiomyocyte necrosis…

…dose of broad spectrum antibiotics within 60 minutes of triage or arrival. This is supported by international guidelines on neutropenic fever [2]. The direct evidence…

…a hepatic protein that regulates the availability of the low density lipoprotein receptor (LDL receptor) on hepatocytes. By directing the receptor toward intracellular degradation rather…

…completeness of occlusion and on the adequacy of collateral blood flow. Ischaemia initially produces pain and sensory disturbance. With progression, motor dysfunction develops, followed by…

…acute ACS, aspirin should be administered as soon as possible in the absence of contraindications, using a loading dose followed by maintenance treatment. The source…

…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…

…deliver blood at a rate appropriate to tissue requirements unless filling pressures are elevated. The syndrome is therefore defined by symptoms and signs of congestion…

… and Evidence that the injury is caused by myocardial ischaemia. Accordingly, acute troponin elevation without evidence of ischaemia represents acute myocardial injury rather than MI…

…intravascular coagulation, and abrupt deterioration in renal function. By contrast, hypertensive urgency describes severe hypertension without clinical evidence of acute, ongoing target organ damage. Although…

…septal perforator of the left anterior descending artery was associated with lower five year survival than a more distal lesion. Revascularisation improves myocardial blood flow…

…The formal diagnostic construct for MVA incorporates four components: Symptoms suggestive of myocardial ischaemia. Objective evidence of myocardial ischaemia. Absence of obstructive coronary artery disease…

…elevated blood pressure Other cardiovascular risk factors and relevant comorbidities Evidence of hypertension mediated organ damage Existing cardiac, cerebrovascular, or renal disease The possibility of…

…myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand, which is not related to acute coronary atherothrombosis. By definition…