…PA), also termed primary hyperaldosteronism or Conn syndrome, comprises disorders in which aldosterone secretion is inappropriately increased, relatively autonomous from angiotensin II and plasma potassium…

…effect of acetylsalicylic acid. Use with caution in patients on low dose acetylsalicylic acid for cardioprotection. Pharmacokinetic interactions Methotrexate: NSAIDs inhibit tubular secretion of methotrexate…

…management of arrhythmias, particularly tachyarrhythmias, is often considered challenging, separate chapters are dedicated to their diagnosis and management. The recommendations presented throughout this section align…

…in this section. It is important to follow the recommendations. It increases the quality of the examination, and allows for standardized comparisons of serial examinations…

…use of pacemakers and the trend towards increased use of cardiac devices in general, it is crucial to be familiar with these devices. This section…

…Bilevel NIV IPAP 12–15 and EPAP 4–5 cmH₂O Increase the IPAP in steps of 2–3 cmH₂O every 5–10 min towards 20…

…salicylate poisoning, intubation with an inadequate minute ventilation can rapidly worsen the acidaemia and increase the entry of salicylate into the central nervous system. Discuss…

…a complicated anatomy. In cross section (SAX, short axis view), the the ventricle is rather a crescent shaped appendage of the left ventricle. On longitudinal…

Cardiology Endocrinology & metabolism Definition and pathophysiology Hypertriglyceridaemia (HTG) is defined by an increased concentration of circulating triglycerides. Both fasting and non fasting measurements provide prognostic…

…cannot increase their own cortisol production. Situation Action : : Fever, infection or gastroenteritis at home Double or triple the oral daily dose during the days of…

…a life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular filling. It generally results from accumulation of pericardial fluid…

…heart disease (CHD) has increased dramatically over the past few decades. This has resulted in an increased prevalence of congenital heart disease in the general…

…weak, slow deceleration variable dense, steep deceleration, early termination of diastolic flow Jet width colour Doppler small,, < 10 mm length, narrow origin variable large…

…and impaired ventricular relaxation [10]. There is also an increased risk of intracardiac thrombus and stroke or systemic embolization, even in patients in sinus rhythm…

…quantity of cholesterol delivered to the liver. The resulting hepatic response includes increased expression of low density lipoprotein receptors (LDLRs), which enhances removal of circulating…

…concentrations generally increase with age and are higher in patients with impaired renal function, reflecting both reduced clearance and the high prevalence of structural heart…

…the hepatocyte surface, PCSK9 reduces hepatic clearance of circulating LDL cholesterol (LDL C). Increased PCSK9 activity therefore contributes to higher LDL C concentrations. The genetic…

…impairment, reflected by transaminase concentrations at least twice the normal level Neurological symptoms are particularly important because of the increased risk of cerebrovascular complications. Seizures…

…becomes smaller, the transvalvular resistance increases, making it more difficult to eject blood into the aorta. In the early stages of aortic stenosis, stroke volume…

…appear primarily during exercise or other situations with increased myocardial load. Symptoms are exacerbated by increasing the level of exertion ( i.e increasing the myocardial…

…node. Thus, withdrawal of parasympathetic activity results in increased heart rate and increased impulse transmission across the AV node. Sympathetic fibers innervate the entire heart…

…adults has increased in recent years ( Nabel et al, Savarese et al ). This is a paradoxical and worrisome trend, particularly in light of the improvements…

…adults has increased in recent years ( Nabel et al, Savarese et al ). This is a paradoxical and worrisome trend, particularly in light of the improvements…

…from hypertrophy caused by increased loading conditions. The latter is far more common and the conditions may coexist. A significant percentage of the population has…

Cardiology Interpreting myocardial perfusion SPECT images involves a systematic comparison of rest and stress images to assess myocardial ischemia and infarction. The key steps in…

…increase the gain for all reflected sound waves, making all objects in the image whiter. This may clarify some tissue borders but excessive use of…

…tachyarrhythmia (tachycardia). Sinus tachycardia is the result of an increased rate of depolarization (i.e increased automaticity) in the sinoatrial node. This simply means that…

…appear primarily during exercise or other situations with increased myocardial load. Symptoms are exacerbated by increasing the level of exertion ( i.e increasing the myocardial…

…oedema and mucus plugging. Expiratory flow limitation causes air trapping and dynamic hyperinflation. The consequences are increased work of breathing, exhaustion and, in the most…

…analysis of three phase 3 trials, tenecteplase was non inferior to alteplase with respect to an excellent functional outcome, without an increased risk of symptomatic…

…An ABI ≤ 0.90 is diagnostic of peripheral arterial disease and at the same time indicates a substantially increased risk of myocardial infarction and stroke…

…ratio Waist / height 0.5 = increased risk, irrespective of sex Mid upper arm circumference Midpoint of the upper arm < 23 cm suggests undernutrition…

…Drug Standard dose Reduced dose and criterion : : : Apixaban 5 mg twice daily 2.5 mg twice daily if at least two of: age ≥80 years…

…aspiration, pressure sores, loss of function, longer length of stay, institutional care, readmission, cognitive decline and increased mortality [3,4]. Do this first 1. Assess…

…ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury…

…and increased chronotropy (heart rate). Beta 2 adrenergic receptors: expressed in vascular smooth muscle. Activation results in vasodilatation. D1 and D2 (dopamine receptors): activation of…

…gain of function mutations in SCN5A (LQT3). These genetic anomalies disrupt the cardiac ion channels, leading to delayed repolarization and an increased risk of life…

…gain of function mutations in SCN5A (LQT3). These genetic anomalies disrupt the cardiac ion channels, leading to delayed repolarization and an increased risk of life…

…with higher scores indicating an increased risk of stroke (Table 1). Interpretation of the CHA₂DS₂ VA score CHA₂DS₂ VA Score Risk Category Annual Stroke Risk…

…Withdraw slowly. • Simultaneous use of tricyclic antidepressants reduces the effect of clonidine. • Clonidine increases the CNS depressive effects of alcohol and sedatives. Clonidine doses and…

…agonists lower systemic blood pressure and increase renal perfusion. Time to onset of action 50 to 10 minutes Duration of action 30 to 60 minutes…

…For instance, an increase in left atrial size or the development of NSVT may warrant closer surveillance or a reassessment of treatment strategies. References O…

…lactic acidosis). Fatal outcomes are rare. Renal failure increases risk of cyanide toxicity. Cyanide toxicity requires doses 2 μg/kg/minute. Use the lowest…

…mg once daily. Rationale: Patients in this age group have higher bleeding risk and increased exposure to the active metabolite of prasugrel. Patients weighing <…

… 18:7). Short QT interval A shortened QT interval is also associated with an increased risk of ventricular arrhythmias. Corrected QT Interval (QTc interval) The…

…Denmark, Netherlands and United Kingdom reported a novel ECG syndrome characterized by widespread ST segment depressions and an increased risk of sudden cardiac arrest. They…

…the recovery of time dependent inward currents. This process creates early afterdepolarisations (EADs) that generate premature ventricular contractions (PVCs) and increases transmural dispersion of repolarisation…

…by rhabdomyolysis, with potential renal failure and increased mortality. Clinical presentation and symptoms Symptoms commonly develop rapidly, often within an hour of arterial occlusion. The…

…Thus, non HDL C provides a broader estimate of atherogenic cholesterol than LDL C alone. It is particularly informative when triglyceride rich lipoproteins are increased…

…conventional hypertension threshold. The traditional diagnostic threshold of 140/90 mmHg derives from epidemiological observations associating pressures above this level with increased mortality. Contemporary management…

…itself. It may cause symptoms and impaired quality of life, contribute to heart failure, and increase the risk of stroke and other thromboembolic events. Subclinical…

…low DBP and increased mortality. Older adults have a higher absolute cardiovascular risk than younger adults. Thus, although a smaller number of older patients may…

…family history of premature coronary disease, hypertension and hypercholesterolaemia did not fully explain the excess coronary risk. Rheumatoid arthritis RA is associated with increased carotid…

…increased venous and intra abdominal pressures, impaired renal venous outflow and persistent right sided congestion may be important mechanisms. Diuretics relieve the hemodynamic consequences of…

…events but increases bleeding. Standard DAPT duration after ACS Default strategy The standard treatment after ACS is DAPT for 12 months , irrespective of stent type…

…Reduced cellular uptake and clearance of LDL leads to increased circulating LDL C. The principal genetic mechanisms involve: Loss of function variants in the LDL…

…Evidence such as increased left atrial size, left ventricular hypertrophy or abnormal LV filling supports the diagnosis Unlike HFpEF, objective evidence of structural or functional…

…dysfunction or increased filling pressures, including raised natriuretic peptides. HF with mildly reduced ejection fraction (HFmrEF) is defined by symptoms and/or signs of HF…

…greater risk of embolic events in patients with LV thrombus than in matched patients without thrombus. Factors associated with embolization Echocardiographic features suggesting increased embolic…

…syndrome is therefore both a clinical risk factor cluster and a marker of broader metabolic dysfunction. Associated abnormalities may include increased apoB and apoC III…