…to limit ordinary activities and substantially impair quality of life. The clinical impact should be assessed in terms of: Symptom frequency and duration. Functional limitation…

…severity of symptoms should be described by their effect on walking distance, daily activities, work and independence. Exercise testing can quantify both the time to…

…Where functional impairment is accompanied by inability to perform activities of daily living, treatment goals should be individualized and discontinuation of medication may become appropriate…

…limitation of infarct size. The extent of myocardial injury is strongly influenced by total ischaemic time. This interval includes: The time from symptom onset to…

…substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting in delayed treatment. In response to these limitations…

Myocardial ischemia and infarction Definition and Pathophysiology Left main coronary artery disease (LMCAD) refers to atherosclerotic narrowing of the left main coronary artery, which supplies…

…before starting treatment. Clinical assessment History that affects the level of risk Ask briefly and to the point: When did the deterioration begin, suddenly or…

…94–1.0. The physiological basis of FFR is that, during maximal vasodilation, distal coronary pressure is proportional to maximum achievable myocardial perfusion. A pressure…

…not produce physiologically significant flow limitation. The mechanisms are incompletely defined. Proposed contributors include hypercontractility or hypersensitivity of coronary vascular smooth muscle to vasoconstrictor stimuli…

…the patient has persistent or progressive disease suggestive of an advanced phenotype. Particular attention should be paid to potentially reversible causes and associated cardiovascular conditions…

…before every ear syringing. Removal of cerumen: Hearing loss, a blocked sensation, itching, earache or dizziness attributable to a wax plug. The tympanic membrane cannot…

…incidentally identified on a chest CT performed for another indication can also contribute to risk assessment. Visual reporting of coronary calcification using four categories—none…

…ventricular function is therefore an important therapeutic objective. Exercise intolerance Exercise limitation is multifactorial. In addition to elevated exercise induced filling pressures, patients may have:

…PET. Evaluate myocardial viability, particularly when combined with metabolic imaging. Contribute to assessment of cardiac inflammation, infective endocarditis, and cardiac amyloidosis using appropriate radiopharmaceuticals. Functional…

…main disease. Clinical presentation and symptoms The clinical presentation of multivessel CAD varies from stable angina or exertional limitation to acute coronary syndrome (ACS), ventricular…

…with better discrimination. The missing ingredient has been a training set large enough to link raw waveforms to reliable cause of death data. The current…

…of drug toxicity, such as digitalis excess. Biomarkers and Laboratory Findings The source material does not provide information on biomarkers or laboratory findings specific to…

…Limitations Key evidence Fractional Flow Reserve (FFR) Ratio of distal coronary pressure (Pd) to aortic pressure (Pa) at maximal pharmacologic hyperemia (adenosine); approximates fraction of…

…of flow limiting disease, myocardial ischaemia may develop. The electrical manifestation may be horizontal or downsloping ST segment depression, reflecting an abnormal repolarization response to…

…the concept has important limitations. Although thin capped fibroatheromas may have imaging characteristics associated with rupture, fewer than 5% of such lesions caused a clinical…

…invasive and costly direct measurements of GFR. Limitations of MDRD eGFR Accuracy at Higher GFR Levels: The MDRD equation tends to underestimate GFR in individuals…

…family history of dissection, severe aortic regurgitation or mitral regurgitation, planning pregnancy, uncontrolled hypertension or annual growth 3 mm. Limitations Formulas assume normal body habitus…

…18.5 to 24.9 Overweight : 25 to 29.9 Obese : 30 and above Limitations of BMI Despite its widespread use, BMI has several limitations:…

…II? The SYNTAX Score II is an advanced version of the original SYNTAX Score, designed to improve the prediction of long term outcomes after revascularization…

…to markedly impaired renal function [3]. Urine output can change before creatinine but is not a pure marker of filtration. Oliguria may be due to…

…to image the myocardium, assess wall motions and myocardial perfusion. However, due to varying strengths, limitations and clinical applications of these modalities, the definitions of…

Cardiology Indications for pharmacologic agents Pharmacologic stress tests are indicated in the following scenarios: Inability to exercise due to physical limitations. Contraindications to exercise, such…

…non cardiac causes of symptoms like dyspnea or failure to thrive. Limitations and Considerations Technical Challenges : Poor acoustic windows or suboptimal Doppler alignment may skew…

…CABG treated patients, as surgery can bypass complex lesions irrespective of their angiographic complexity. Evolution: SYNTAX Score II To address these limitations, the SYNTAX Score…

…bulges into the artery lumen and causes stenosis (reduction of the artery lumen). The reduction of the artery lumen causes limitations to the blood flow…

…information about the artery. The clinical value of these techniques rests on their ability to characterize the anatomy responsible for a stenosis, define plaque morphology…

…been associated with an increased risk of cardiovascular diseases, such as stroke, and mortality. Stability : MAP readings tend to be more accurate than systolic blood…