…Gonzalo; Baumgartner, Helmut et al. (2012): Guidelines on the management of valvular heart disease (version 2012). In European heart journal 33 (19), pp. 2451–2496…

…on Echocardiography of the European Society of Cardiology 11 (3), pp. 223–244. DOI: 10.1093/ejechocard/jeq030. Pulmonary valve stenosis Mild stenosis Moderate stenosis…

…regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of…

…triglycerides exceed 500 mg/dL to reduce this risk. The ASCVD implications of chylomicronaemia itself remain uncertain, whereas moderate HTG, approximately 150–500 mg/dL…

…with low to moderate risk of CAD. In patients with a high to very high risk of CAD, invasive coronary angiography is the first line…

…to moderate Can usually be stopped without a prolonged taper 3 weeks, prednisolone ≥ 5 mg/day Substantial A stepwise taper. More quickly down to the…

…withdrawal carries a risk of rebound. The referring physician should have made this decision; document which applies. Nitroglycerin is continued; note it in the report…

…A low risk of hypoglycaemia; it can usually be continued Red flags and pitfalls Stopping basal insulin in type 1 diabetes. The single most dangerous…

…toe pressure < 30 mmHg. Decompensated heart failure — compression of both legs acutely increases preload. Untreated deep vein thrombosis in the acute phase. Septic phlebitis…

…a bloodless field one works by feel, and by feel nail spicules are left behind — which is the commonest cause of recurrence. Indications Condition Procedure : …

…Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon…

…NOACs is considered for female patients with scores of 2 or more. Patient preference and the balance of risk and benefit determine whether treatment is…

DICTrank: The Largest Reference List of 1318 Human Drugs Ranked by Risk of Drug Induced Cardiotoxicity Using FDA Labeling . Drug Discovery Today. 2023. DICT =…

…management of modifiable risk factors. The HAS BLED score has demonstrated moderate predictive abilities for bleeding risks in AF patients, regardless of the type of…

…regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of…

…10 year risk of fatal or non fatal CVD Low <2% Moderate ≥2% to <10% High ≥10% to <20% Very high ≥20% The risk categories…

…practical principle is that the visual severity of a stenosis does not reliably establish its haemodynamic importance. A lesion that appears moderate may be functionally…

…encompasses several physiological states. Brief coronary occlusion or relatively prolonged moderate ischemia may produce post ischemic stunning. In the absence of infarction, contractile recovery can…

…the principal preventive target is: 150–300 minutes per week of moderate intensity aerobic activity; or 75–150 minutes per week of vigorous intensity aerobic…

…Contraindications Asthma and COPD. Adenosine has caused mild to moderate exacerbation of asthma symptoms. Adenosine should be used with caution in patients with obstructive lung…

…the European Society for Cardiology, 2800 adults per 1 million individuals have congenital heart defects, and half of them have moderate or complicated defects; the…

…LVH) and right ventricular hypertrophy (RVH). The electrical vector of the left ventricle is enhanced in LVH, which results in large R waves in left…

…or raised Other Moderate work of breathing Accessory muscle use Cyanosis, exhaustion, hypotension or collapse The classification is based on a combination of clinical findings…

…claudication, the ankle pressure is measured immediately after treadmill walking or after repeated heel raises. A fall of ≥ 20 % after exercise confirms peripheral arterial disease…

…eGFR 30 mL/min. At an eGFR of 15–30 mL/min the documentation is inadequate and closer monitoring is required. Dabigatran is contraindicated at…

…leg raising with an increase in stroke volume 10%, or inferior vena cava variability . In the absence of responsiveness, fluid does more harm than good.

…coma may occur Mixed picture of DKA and HHS Overlap is common. Treat as mixed DKA and HHS if the patient has marked hyperosmolality together…

…early diastolic early diastolic holodiastolic Quantification of jet Mild regurgitation Moderate regurgitation Severe regurgitation Jet width / LVOT width < 0.25 0.25 0.64…

…address the cause, assess renal function and the rate of rise. Often outpatient or brief inpatient follow up depending on the clinical picture Moderate 6…

…or impending herniation Moderately severe symptoms New confusion Severe headache Persistent nausea Moderately reduced consciousness Marked gait instability The specificity of the symptoms is limited…

…The three are distinguished by the history and the speed of the course. An AST/ALT ratio 2 with moderately raised values suggests alcohol related…

…which requires body plethysmography DLCO Diffusing capacity for carbon monoxide An obstructive pattern: FEV₁/FVC below the lower limit of normal (traditionally < 0.70)…

…of the ear canal , past the plug — not straight at it. The water should get behind the wax and push it out. 6. Use moderate…

…early diastolic early diastolic holodiastolic Quantification of regurgitant jet Mild regurgitation Moderate regurgitation Severe regurgitation Jet width / LVOT width < 0,25 0,25 0…

…Proietti M, Lane DA, Lip GYH. Evaluation of the HAS BLED, ATRIA, and ORBIT bleeding risk scores in atrial fibrillation patients on warfarin. Am J…

…combination with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic events in adult patients with acute coronary syndromes (ACS), including: Unstable angina (UA…

…and are at high risk of a new event. Treatment can be started without interruption as continuation treatment after the initial one year treatment with…

…from sudden cardiac death. Atrial fibrillation and ventricular arrhythmias were observed in the fifth decade of life in several family members. Imaging studies did not…

…claudication, accompanied by moderate pain or paresthesia, while sensory and motor function remain preserved. The duration and progression of symptoms should be documented carefully. Longer…

…and atherosclerotic coronary disease In patients with heavy alcohol use, left ventricular dilation may precede the development of increased left ventricular hypertrophy and mass. Initially…

…used as a filtration marker. CKD is one of the strongest independent risk factors for cardiovascular disease (CVD) and cardiovascular mortality. Cardiovascular risk rises progressively…

…treatment. The presence of ST segment changes or a positive troponin assay identifies patients in whom an invasive strategy is generally preferred over selective angiography…

…liver disease. Interpretation of the Agatston Score The score should be interpreted both by its absolute value and in relation to age and sex. A…

…evaluate for the presence of worsening renal function, advanced age, hypokalemia, chronic lung disease, hypothyroidism, and amyloidosis. Furthermore, ongoing ischemia, hypomagnesemia, and moderate to severe…

…exercise induced arrhythmias Evaluating the blood pressure response Refining risk stratification and prognosis For patients with low or moderate pre test likelihood of obstructive CAD…

…be initiated concurrently. In patients with a confirmed indication for treatment but blood pressure in the range of 120–139/70–89 mmHg, concomitant indications…

…or moderate intensity statins should have treatment intensified. The 2025 ACS guideline recommendations include: High intensity statin therapy for all patients with ACS. Addition of…

…or unit of cholesterol than LDL cholesterol. Clinical implications High Lp(a) is independently associated with first and recurrent atherosclerotic cardiovascular disease events. The strongest…

…moderate or high pre test likelihood of obstructive coronary artery disease, defined in the cited guidance as greater than 15% and up to 85%. The…

…likelihood of disease and can justify further investigation or treatment. Testing is therefore not an automatic response to chest pain. It is appropriate when the…

…likelihood of obstructive CAD is moderate or high, generally greater than 15% and less than 85% Baseline ECG abnormalities make exercise ECG interpretation unreliable The…

…diameter suggests moderate aortic regurgitation. A jet diameter 65% of the LVOT diameter suggests severe aortic regurgitation (Figure 1). Figure 1. Diameter of the regurgitant…

…total of 4 6 mEq/L in 24 hours may be targeted. Chronic Hyponatremia ( 48 hours duration): Due to cellular adaptations, rapid correction carries the…

…bedside. Heating is optimally achieved using extracorporeal membrane oxygenation (ECMO). In the absence of ECMO, both non invasive and invasive rewarming techniques should be pursued…

…ECG in moderate hyperkalaemia Previously mentioned ECG changes becomes more pronounced. P waves become wider. P wave amplitude decreases. The P wave may be difficult…

…due to the fact that systolic blood pressure increases during exercise. The increase in cardiac output during moderate exercise is the result of increased stroke…

…and subject preparations. We will also discuss the relevance of withholding specific cardioactive medications during exercise testing (exercise ECG). Indications for exercise stress test Indications…

…pronounced during stress. RR is characterized by normal or near normal perfusion observed during stress, followed by the appearance of a perfusion defect in rest

…predictor of survival and for elevated left ventricular filling pressures (Lam et al). PASP is elevated in pulmonary arterial hypertension (PAH). Valve area The continuity…

…correlate well with the severity and extent of ischemia. In the setting of moderate ischemia, the myocardium becomes hypokinetic, meaning that the ischemic segments contract…