…cell recruitment, extracellular matrix remodelling, and thrombosis interact to produce focal arterial lesions. Although epicardial coronary arteries are a major site of disease, atherosclerosis is…

…most important dangerous differential diagnosis. Clear focal neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination…

…which needle is chosen, and that the tubes go to the right place. In suspected bacterial meningitis it is the time to antibiotics that saves…

…subclavian artery. Penetrating atherosclerotic ulcer PAU is focal ulceration of an atherosclerotic plaque that penetrates through the internal elastic lamina into the media. The lesion…

…Conversely, certain macroreentrant atrial tachycardias (MRATs) that traverse protected anatomical areas may display a focal atrial tachycardia pattern on the ECG, characterized by discrete P…

…and the broader atherosclerotic burden. Clinical Presentation and Symptoms Asymptomatic disease Many patients with carotid stenosis have no focal neurological symptoms. Asymptomatic disease may be…

…within the broader framework of guideline directed medical therapy and secondary prevention. PCI treats focal stenotic segments, whereas CABG provides a bypass beyond diseased segments…

…on chronic hypercapnic respiratory failure Rapidly falling pH An urgent ventilatory problem Focal chest pain or unilaterally reduced breath sounds Consider pneumothorax New arrhythmia or…

…Seizures later than this, focal seizures or status epilepticus should raise strong suspicion of another or an additional cause [1]. Delirium tremens most often begins…

…risk [3]. Questions that rapidly change management Ask specifically about: Neurological symptoms: confusion, visual loss, focal neurological signs, seizures, severe or sudden headache. Chest pain…

…can cause: difficulty concentrating irritability or abnormal behaviour slurred speech visual disturbance confusion focal neurological signs drowsiness or unconsciousness seizures coma The symptom threshold varies…

…including non obstructive plaque, therefore contributes prognostic information beyond identification of focal severe stenoses. Coronary anomalies Coronary artery anomalies are uncommon among the general population…

…may therefore be discordant. A reduced FFR with preserved CFR suggests a predominantly focal epicardial lesion that may not be strongly flow limiting. In contrast…

…loss of consciousness. Focal neurological findings are uncommon in hypertensive encephalopathy and should prompt consideration of stroke. Acute ischemic or intracerebral haemorrhage may coexist with…

…Acute severe aortic regurgitation with heart failure Cardiac tamponade from haemopericardium Myocardial ischaemia from coronary ostial compromise Focal neurological deficits or non haemorrhagic stroke Renal…

… may be mistaken for vasospasm or diffuse disease Type 3 Focal or tubular stenosis resembling atherosclerosis Often requires intravascular imaging to demonstrate an intramural haematoma…