…B recommendation. Combination therapy is preferred when feasible because it may provide greater benefit than either drug alone. Long term efficacy data remain limited, and…

…is more effective than advice alone, although long term success rates remain modest and repeated intervention is often necessary. Patients with acute coronary syndrome should…

…renal perfusion, particularly in patients with long standing hypertension and a rightward shifted autoregulation [1,3]. The term hypertensive urgency is best avoided. It implies…

…wave. Because of the long duration of the plateau phase most contractile cells are in this phase at the same time (more or less). Moreover…

…a new drug class, the ARNI (Angiotensin–Neprilysin Inhibitors), a long awaited breakthrough. Heart failure is a serious condition with a poor long term prognosis…

…a new drug class, the ARNI (Angiotensin–Neprilysin Inhibitors), a long awaited breakthrough. Heart failure is a serious condition with a poor long term prognosis…

…if the initial rhythm is asystole or PEA. Most current protocols for ECMO exclude patients presenting with asystole or PEA. Duration of cardiac arrest : In…

…develop strategies and tools for long term prevention of cardiac arrest. Unfortunately, these efforts have not borne fruit. Our current ability to predict cardiac arrest…

…and unstable presentations, the critical entity of electrical storm, and the long term management strategies informed by recent sub group analyses, registry data, and ongoing…

…no reliable model currently exists for the long term prediction of sudden cardiac arrest. The constraint does not lie in therapy: implantable cardioverter defibrillators (ICDs…

…guideline directed medical therapy are integrated. Rationale and Pathophysiological Basis Survivors of STEMI remain at substantial risk of recurrent cardiovascular events. Long term prognosis is…

…not reverse coronary atherosclerosis. Long term benefit therefore depends on the integration of revascularisation with guideline directed medical therapy and secondary prevention. Clinical Presentation and…

…SP, Frankel T, Cohn LH, Adams DH. Long term outcomes of tricuspid valve replacement in the current era. Ann Thorac Surg 2005;80:845–850.

Procedurer The donation process begins long before any retrieval: it begins when someone in the intensive care unit identifies a possible donor and the deceased…

…cells which respond by contracting. The action potential generates electrical currents that give rise to the classical ECG waveforms presented here. Activation of the atria…

…long QT syndrome (LQTS) Metabolic disorders Hypokalemia Hypomagnesemia Hypocalcemia Starvation Anorexia nervosa Liquid protein diets Hypothyroidism Bradyarrhythmia Sinus bradycardia Sinus node dysfunction AV blocks Drugs…

…intervention while limiting major and clinically relevant bleeding. Long term antiplatelet therapy after STEMI is associated with approximately a 25% reduction in recurrent infarction, stroke…

…than a binary distinction between normotension and hypertension. Its long term relationship with cardiovascular risk is therefore graded, although practical clinical care requires diagnostic and…

…an advanced version of the original SYNTAX Score, designed to improve the prediction of long term outcomes after revascularization. It incorporates both anatomical (from the…

…both lifestyle and antihypertensive drug therapy. For grade 1 hypertension, pharmacological treatment has demonstrated cardiovascular benefit, although in younger individuals with low short term risk…

…while simultaneously affecting systemic perfusion. Aortic stenosis is a serious condition with poor long term outcomes. Patients with low flow low gradient aortic stenosis (discussed…

…may also develop tachycardia induced cardiomyopathy (Gopinnathair et al). Long term prognosis is excellent, with the vast majority of patients recovering completely after restoration of…

…cardiomyopathy Takotsubo cardiomyopathy Tachycardia induced cardiomyopathy Non compaction cardiomyopathy Peripartum cardiomyopathy Cardiomyopathy secondary to valvular heart disease Long term prognosis varies markedly across these conditions…

…patient with primary adrenal insufficiency (Addison's disease), secondary adrenal insufficiency or long term corticosteroid treatment cannot increase their own cortisol production. Situation Action : : Fever…

…after pituitary surgery or radiotherapy, or with suspected suppression of the HPA axis after long term glucocorticoid treatment. A basal morning cortisol in the grey…

…bursa The effect is chiefly short term Lateral epicondylitis At the extensor origin Consider withholding it; the long term outcome is worse Medial epicondylitis At…

…scores (≥33) are typically advised to undergo CABG due to better long term outcomes. Intermediate scores (23–32) require careful consideration by a heart team…

…antianginal drugs have not been shown to improve long term cardiovascular outcomes in CCS. General strategy For most patients, initial therapy consists of a beta…

…complications than patients without AF; both short and long term prognosis are worse than in patients who remain in sinus rhythm. Several mechanisms may account…

…heart failure with reduced ejection fraction (HFrEF) in developed countries. New ischemic events are major determinants of subsequent LV deterioration and long term survival. Viable…

…protocols. Note that while cardioversion restores sinus rhythm in up to 95% of patients, long term maintenance (particularly in persistent AF) remains the greater challenge.

…of mortality and long term disability compared to non cardioembolic ischemic strokes. Consequently, the cornerstone of AF management remains the meticulous application of anticoagulant therapies…

…Both methods may be used in the acute setting, whereas long term management only includes pacemaker therapy. Treatment of AV block in the acute setting…

…Two dimensional echocardiogram. This view is called parasternal long axis view (PLAX). Structures that are closest to the transducer are placed at the top of…

…is intensified [1,2]. The evidence that any particular intravenous drug improves mortality or long term functional outcome is limited. A Cochrane review found insufficient…

…Atrioventricular nodal reentrant tachycardia Atrioventricular nodal reentry tachycardia Atrioventricular nodal reentrant tachyarrhythmia Atrioventricular nodal reentry tachyarrhythmia Some textbooks use the term "node" instead of "nodal"…

…Figure 1 A ). The plateau phase has a long duration which enables the majority of the ventricular myocardium to contract simultaneously. Since the membrane potential…

…in some instances, persist for extended durations. As for any long standing tachycardia, there is a risk of developing tachycardia induced cardiomyopathy. In pediatric populations…

…in myocardial oxygen consumption associated with exercise. Chronic myocardial injury Long term heavy consumption can produce a cardiomyopathy, although the exact exposure threshold and duration…

…are rarely useful, as myocardial concentration—which correlates best with total cumulative dose—may be a better predictor of long term tolerability. Hemodynamic Effects Amiodarone…

…disruption. Fewer than 5% of thin capped fibroatheromas have been identified as the source of an acute myocardial infarction during long term follow up. Moreover…

…the sinus rate, there are generally no reliable and safe drugs available for long term heart rate augmentation without undesirable side effects. Drugs, With Doses…

…the type of revascularization; stent related risk; whether long term oral anticoagulation is required; tolerance of treatment during the initial months. Patients with HBR are…

…Cardiovascular Outcomes Associated With Dietary Patterns Cardiovascular disease and mortality The strongest long term evidence supports Mediterranean or DASH style patterns that emphasize minimally processed…

…managed with PCI or without revascularization, although the exact antithrombotic strategy may differ when long term OAC is also indicated. Possible shortening of DAPT A…

…outcomes: Mortality in STEMI : Patients presenting with ST elevation myocardial infarction (STEMI) and bundle branch blocks exhibit higher long term and in hospital mortality rates…

…repeated hospital presentations and angiography, and increased short and long term adverse cardiovascular outcomes. Clinical Presentation and Symptoms Symptoms may resemble those of obstructive epicardial…

…absence of a major residual epicardial obstruction. No reflow is associated with serious short and long term outcomes. Its occurrence is associated with an approximately…

…thrombotic material is an important proposed mechanism. No reflow may produce major short and long term adverse consequences, including a substantially increased risk of periprocedural…

…a patient with an impaired cough reflex, and the first feed then becomes a direct instillation into the lung. No tube may be used before…

…pericardiotomy syndrome. Acute transmural myocardial infarction. Rupture of the free ventricular wall. Neoplasms (particularly breast and lung cancer). Inflammatory conditions, such as rheumatoid arthritis, systemic…

…cardiac injury syndrome (PCIS). PCIS is an umbrella term that also includes post pericardiotomy syndrome and post traumatic pericarditis, including cases related to cardiovascular interventions…

…failure, lung disease (e.g COPD), fever, infections, anemia, myocardial ischemia/infarction, pulmonary embolism, pheochromocytoma, hyperthyroidism, hypovolemia, pharmacological substances (alcohol, amphetamine, coffee, anticholinergic drugs, beta…

…peak plasma concentrations of that drug. The QT interval should be adjusted for heart rate. Long QT interval causes long QT syndrome An abnormally prolonged…

ECG Please refer to the previous chapter: LQTS (Long QT Syndrome)

…M. R. (2017). Beta blocker therapy for long QT syndrome and catecholaminergic polymorphic ventricular tachycardia: Are all beta blockers equivalent? Heart Rhythm, 14(1), e41…

Echocardiography Pericardial diseases: effusion and tamponade A long series of conditions can affect the pericardium (pericardium). The most common of these are acute pericarditis (perimyocarditis…

…M. R. (2017). Beta blocker therapy for long QT syndrome and catecholaminergic polymorphic ventricular tachycardia: Are all beta blockers equivalent? Heart Rhythm , 14(1), e41…

Kardiologi Lathundar Three questions determine the management: is the patient unstable, how long has the fibrillation lasted, and does the patient need an anticoagulant? The…

Arrhythmias and arrhythmology Drugs and electrolyte imbalance ECG Definition and Pathophysiology Acquired long QT syndrome (LQTS) is characterised by an abnormal prolongation of the QT…