…of patients with metabolic syndrome. A substantial proportion develop metabolic dysfunction associated steatohepatitis, which has a more prominent inflammatory component and may progress to cirrhosis…

…synthetic function of the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become abnormal late. A cirrhotic liver can have…

…that may also reduce myocardial contractility and cause ventricular fibrosis, thereby increasing the risk of ventricular arrhythmias. Clinical Presentation and Symptoms Patients with bradycardia or…

…node and the atrium). All these conditions have been discussed in detail in the previous articles. Hence, sinus node dysfunction may manifest with any of…

…several overlapping processes: Recurrent or extensive MI with necrosis and scar formation Diffuse myocardial fibrosis Reversible ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic…

…delivery and beta hydroxybutyrate oxidation Reduced sodium hydrogen exchanger subtype 3 activity Attenuation of oxidative stress, inflammation and fibrosis Reduction in body weight and haemoglobin…

…and altered cardiomyocyte relaxation. Coronary microvascular rarefaction and myocardial fibrosis have been described in HFpEF, while nitrosative stress and abnormalities of cellular and molecular myocardial…

…it binds the MR, which translocates to the nucleus and induces expression of aldosterone responsive genes. Although the kidney is a major target—where MR…

…BNP and NT proBNP in heart failure (HF). The biologically active natriuretic peptides promote vasodilation, renal sodium and water excretion, and reduction of cardiac fibrosis…

…functional assessment. Coronary microvascular dysfunction (CMD) is characterized invasively by reduced CFR and increased microvascular resistance, measured by the index of microcirculatory resistance (IMR), hyperaemic…

…right sided chest leads and deeper S waves in left sided leads. Left ventricular hypertrophy (LVH) The most common causes of left ventricular hypertrophy are…

…Abnormal renal/liver function, Stroke history, Bleeding history, Labile INRs, Elderly age ( 65), and Drugs/alcohol. A crucial clinical pitfall is the misapplication of this…

…Myocardial remodelling and fibrosis These processes form part of the broader cardiovascular kidney metabolic syndrome, in which adiposity, insulin resistance, diabetes, hypertension, CKD and CVD…

…particular care in: A risk of hypercapnic respiratory failure — COPD, severe obesity with hypoventilation, neuromuscular disease, marked chest wall deformity, severe bronchiectasis and cystic fibrosis…

…infarction : There are numerous causes of LBBB, such as heart failure, structural heart disease, fibrosis of the conduction system and acute myocardial infarction (particularly anterior…

…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

…between treatment benefit and harm. Prevention in the very elderly therefore extends beyond reducing myocardial infarction, stroke, heart failure, or cardiovascular death. Preservation of mobility…

…extent of ventricular fibrosis, LVOT obstruction, age, and left ventricular function. The HCM Risk SCD score aims to identify individuals with a high risk of…

…other causes of wide QRS complex must always be considered. For example, Wolff Parkinson White syndrome (WPW), pacemaker stimulated beats, electrolyte imbalance and medications may…

…of the pulmonary valve and, subsequently, narrowing of the valvular orifice. Carcinoid heart disease may also lead to endocardial fibrosis. Rheumatic heart disease Sinus of…

…and neurohormonal changes that further worsen the hemodynamic situation. Thus, chronic aortic regurgitation gradually leads to impaired contractile function and the development of myocardial fibrosis…

…very good prognosis and may even occur in otherwise healthy individuals. However, if the QRS complexes are wide there is a risk of distal block…

…and P3 (posterior or lateral scallop). Figure 1. Anatomy of the mitral valve The leaflets are connected to the papillary muscles via chordae tendineae (Figure…

…pre excitation (presence of an accessory pathway). This is associated with a delta wave. For further details on the PR interval and the PR segment…

…and a thin fibrous cap. Disruption of the cap exposes the lipid core and extracellular matrix to circulating blood. Tissue factor within the plaque and…

…yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of site…

…mellitus and increases with age. STEMI may present as sudden onset breathlessness. Other less common presentations, with or without pain, include sudden loss of consciousness…

…core and a highly inflamed fibrous cap measuring less than 65 micrometers in thickness. Macrophage derived matrix metalloproteinases (MMPs) degrade the interstitial collagen of the…

…gray scale IVUS. This allows detailed visualization of the lumen surface, fibrous cap thickness, thrombus, stent struts, tissue prolapse, and strut coverage. OCT has limited…

…by an imbalance between matrix synthesis and degradation. Histologically, a vulnerable plaque is defined by a fibrous cap thickness of less than 65 μm…

…abundant foam cells and macrophages; a thin fibrous cap; positive remodelling; neovascularization; intraplaque haemorrhage; adventitial inflammation; spotty calcification. Nevertheless, the presence of these features does…

…tissue [5] . Polymorphic VT (PMVT): Characterized by a continuously changing QRS morphology and axis, indicating a dynamic sequence of ventricular activation. PMVT is frequently associated…

…by the gradual loss of myocardial cells, which are replaced by fat and fibrous tissue. This process begins in the epicardium and gradually moves towards…

…pericarditis, the pericardium becomes fibrotic (rigid) and thickened (about 80% have thickening). The parietal and visceral leaves of the pericardium are most often fused. The…