…stenosis exceeds 70%. Patients being assessed before non cardiac surgery should be questioned specifically about neurological symptoms during the preceding 6 months. Those with symptoms…

…Consequently, current guidelines recommend a 3 generation family history and consideration of genetic testing for all patients with non ischemic HFrEF. Toxic and infiltrative causes…

…acidosis , that is, a pH below 7.35 and a PaCO₂ above 6.0 kPa despite optimal medical treatment with bronchodilators, steroids and controlled oxygen…

…coronary microvascular dysfunction or vasospasm. A normal or non obstructive coronary anatomy does not necessarily exclude an ischaemic mechanism. Clinical assessment and estimation of pre…

Continous medical discussion: the ECG blog ECG A deep learning ECG biomarker for sudden cardiac death: what the new Nature study shows Low risk (blue…

Continous medical discussion: the ECG blog Myocardial ischemia and infarction Myocardial ischemia The definition of ischemia may appear trivial but it is actually a very…

…should influence the urgency of management: Recurrent or ongoing chest pain despite medical treatment Acute heart failure presumed to result from ongoing myocardial ischaemia Haemodynamic…

…g. trauma unit). Careful and evidence based planning at the societal level (e.g. CPR education programs) and local level (e.g. EMS protocols, in…

…non specific complaints. The choice of recording is governed by the frequency of symptoms: Symptom interval Method : : Daily 24 hour Holter A few times per…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…work systematically through the possible causes, apply several non pharmacological measures at the same time, and use drugs only in severe agitation or marked distress…

…events after coronary angiography, percutaneous coronary intervention (PCI), or medical management. The standard post ACS regimen is DAPT for 12 months, generally consisting of low…

…to established reversible myocardial ischaemia in either of two settings: Obstructive coronary artery disease (CAD) that cannot be controlled despite escalation of antianginal medical therapy…

…Initial diagnosis of STEMI ECG Management Recommendation Level of evidence A 12 lead ECG should be interpreted immediately (within 10 minutes) at first medical contact…

…exclusively at the infarct related artery (IRA), or it may extend to additional non infarct related lesions. Culprit only revascularization treats the artery responsible for…

…approximately 20–25% of secondary hypertension cases. Coarctation of the aorta and renovascular disease are important non endocrine causes, particularly in patients with resistant hypertension…

…troponin elevation, ACS are classified into unstable angina (UA), non ST segment elevation myocardial infarction (NSTEMI), and ST segment elevation myocardial infarction (STEMI). While the…

…chest pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or other symptoms that may be caused…

…to a hospital with 24/7 PCI capability, bypassing non PCI hospitals. A regional network should link emergency medical services, non PCI hospitals, PCI centres…

…Dofetilide, Ibutilide, Sotalol Class IV Non dihydropyridine L type Ca 2+ channel blockers Diltiazem, Verapamil Singh–Vaughan Williams classification of antiarrhythmic drugs. Bold text indicates…

…injury rather than MI. Persistent elevation without a significant dynamic change is consistent with chronic myocardial injury. Non ischaemic conditions, including myocarditis, rapid ventricular rate…

…Dofetilide, Ibutilide, Sotalol Class IV Non dihydropyridine L type Ca 2+ channel blockers Diltiazem, Verapamil Singh–Vaughan Williams classification of antiarrhythmic drugs. Bold text indicates…

…In out of hospital cardiac arrest (OHCA) the initial rhythm is recorded by the EMS (emergency medical service) team upon their arrival at the scene…

…3] . By Duration: Non sustained VT (NSVT): Defined as three or more consecutive ventricular beats at a rate exceeding 100 beats per minute (bpm), which…

…5 minutes seated or supine. White coat hypertension: office pressure above the hypertension threshold but non hypertensive home or ambulatory pressure. Masked hypertension: office pressure…

…despite guideline directed medical therapy (GDMT), prompting consideration of revascularization. The likelihood that symptoms are attributable to the CTO is increased when non invasive testing…

…precipitants include vigorous physical activity, emotional stress, and an intercurrent medical or surgical illness. Events may occur at any time, although clustering in the morning…

…be defined before revascularization Residual ischaemia must be assessed after initiation of medical treatment LV function requires evaluation in the setting of suspected ischaemia or…

…or at risk of developing symptoms. The most common non reversible causes of sinus bradycardia are sinus node dysfunction, side effects of medications and acute…

…rest pain in the foot or leg, or a non healing distal ulcer. Before compression treatment of a leg ulcer — compression in arterial insufficiency can…

…a non adherent dressing, gauze. The digital block Anaesthetise from the dorsal aspect, one injection medial and one lateral to the base of the phalanx…

…typically platelet rich and less occlusive, often presenting clinically as Non ST Elevation Myocardial Infarction (NSTEMI) rather than STEMI [4] . Calcified Nodules: A less common…

ECG Myocardial ischemia and infarction Non ST Elevation Acute Coronary Syndromes (NSTE ACS): Non ST Elevation Myocardial Infarction (NSTEMI) and Unstable Angina (UA) The focus…

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

Myocardial ischemia and infarction Definition and clinical concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has…

…coronary syndromes (ACS) into ST segment elevation myocardial infarction (STEMI), non STEMI (NSTEMI), and unstable angina (UA) has guided clinical decision making for decades but…

Cardiology Pharmacology & dosing Definition and pharmacological basis Ezetimibe is a non statin lipid lowering agent that inhibits the Niemann–Pick C1 like 1 (NPC1L1) transporter…

…patterns. Patients may present with: exertional angina or angina like chest discomfort; symptoms suggestive of myocardial ischaemia despite normal or non obstructive coronary arteries; dyspnoea…

…total plaque burden or stenosis severity directly. A patient may have little or no calcium despite clinically relevant non calcified plaque, particularly in middle age…

Echocardiography Ultrasound artifacts The following artifacts are common in ultrasound imaging: The ultrasound image displays non existing structures. The ultrasound image does not display existing…

Cardiology Principles of myocardial perfusion imaging Myocardial perfusion imaging (MPI) is a non invasive technique for detecting and quantifying coronary artery disease (CAD). It offers…

…®, Rogitine ® Indications Hypertensive crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity…

…Myocardial ischemia and infarction Definition and Clinical Role Coronary computed tomographic angiography (CCTA) is a non invasive anatomical examination that depicts the coronary arterial lumen…

…focuses principally on ASCVD prevention and reduction of LDL C, non HDL C and apolipoprotein B. Causes and secondary contributors A search for secondary contributors…

…applies where you work. They assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick…

…history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or…

…including: Unstable angina (UA) Non ST elevation myocardial infarction (NSTEMI) ST elevation myocardial infarction (STEMI) This applies to patients undergoing either primary or delayed percutaneous…

…onset atrial fibrillation to sinus rhythm. Vernakalant is used in the following settings: Non surgery patients: atrial fibrillation ≤7 days duration. Post cardiac surgery: atrial…

…used in adults aged ≥70 years. SCORE2 OP accounts for the competing risk of death from non cardiovascular causes, an important consideration in older populations…

…the most favourable patterns generally contain more minimally processed, fibre rich and bioactive foods, including fruits, non starchy vegetables, beans, whole grains, nuts and seeds…

…an intraluminal thrombus. The clinical spectrum includes unstable angina, non ST segment elevation myocardial infarction (NSTEMI), and ST segment elevation myocardial infarction (STEMI). The traditional…

…natural course in acute myocardial infarction (AMI) The traditional distinction between NSTE ACS (NSTEMI, Non STEMI) and STE ACS (STEMI) is slightly simplified. In reality…

…visual angiographic guidance in selecting lesions for percutaneous coronary intervention (PCI). Non hyperemic pressure ratios (instantaneous wave free ratio [iFR], resting full cycle ratio [RFR]…

…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…

…circulatory compromise severe gastrointestinal symptoms, particularly after exposure to a drug, insect venom or another non food allergen 2. Acute airway, respiratory or circulatory compromise…

…metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia…

…with the same risk as manifest hypertension. Non dipping: a nocturnal fall in pressure of < 10% of the daytime value; an independent risk marker…

…Transfusion thresholds in the stable, non bleeding patient Patient category Transfusion threshold (Hb) : : Most stable adult inpatients, including intensive care 70 g/L Known cardiovascular…

…reflexes, vomiting with a risk of aspiration. Inadequate oxygenation despite maximal oxygen or non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis…