…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…

…ACS): Non ST Elevation Myocardial Infarction (NSTEMI) and Unstable Angina (UA) The focus of this chapter is the diagnosis and management of patients with Non…

…are two different treatments with different physiology, and the commonest source of error is confusing them. CPAP delivers a constant pressure that recruits alveoli and…

…or non HDL C, cardiovascular risk may be misestimated if cholesterol measures alone are used. Risk in these circumstances appears to track more closely with…

…with the pressure that would be available in the absence of that stenosis. The complete physiological formulation considers coronary venous pressure: Distal coronary driving pressure…

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

…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…

…myocardial ischaemia despite normal or non obstructive coronary arteries; dyspnoea; fatigue; and recurrent symptoms causing impaired quality of life. Women with suspected angina are more…

…the spectrum of non ST elevation acute coronary syndrome (NSTE ACS). The clinical spectrum includes patients with a confirmed NSTEMI, patients with a working diagnosis…

…detection of risk factors such as elevated blood pressure and lipid abnormalities. CAC should therefore be integrated with clinical assessment and established risk estimation systems…

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…

…Indications Hypertensive crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes…

…invasive coronary angiography (ICA) for excluding non ST segment elevation acute coronary syndrome (NSTE ACS) in patients with a low to intermediate likelihood of CAD…

…examination findings. Diagnostics and laboratory findings Lipid assessment Triglyceride concentrations should be interpreted in conjunction with LDL C, non HDL C and apolipoprotein B, particula

…after hip fracture, major surgery and intensive care [1,2]. The condition is associated with falls, aspiration, pressure sores, loss of function, longer length of…

…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…

…reactivity: Do not administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs …

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

…adjustments are necessary. Contraindications to vernakalant Severe aortic stenosis Systolic blood pressure < 100 mm Hg. Heart failure with NYHA class III–IV. Prolonged QT…

…risk of death from non cardiovascular causes, an important consideration in older populations. Risk prediction is particularly relevant in adults with elevated blood pressure (BP)…

…ACS) with multivessel coronary artery disease (MVD), revascularization may be directed exclusively at the infarct related artery (IRA), or it may extend to additional non…

…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 unexplained drop in arterial pressure. Silent or unrecognized infarction occurs more often in patients without antecedent angina and in those with diabetes and hypertension…

…activation and coagulation, with formation of an intraluminal thrombus. The clinical spectrum includes unstable angina, non ST segment elevation myocardial infarction (NSTEMI), and ST segment…

…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…

…ischemia, including with non obstructive epicardial arteries (ANOCA/INOCA); CFR has independent prognostic value. CFR confounded by heart rate/blood pressure/contractility (less reproducible, less…

…troponin. If clinical suspicion persists despite an initially non diagnostic ECG, the ECG must be repeated, particularly with ongoing or recurrent pain [1,3,4]…

…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…

…Measure the blood pressure in both arms when fitting the device. Use the arm with the higher pressure, or the non dominant arm if the…

…adrenaline never replace intramuscular adrenaline [1,2]. Delayed administration of adrenaline is associated with more severe and more protracted reactions, biphasic courses and fatal outcome…

…low pressures. No smoking or coffee in the preceding hour. Remove socks and any compression stockings. Avoid measuring the arm pressure on the side with…

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

…but raised outside it — associated with the same risk as manifest hypertension. Non dipping: a nocturnal fall in pressure of < 10% of the daytime…

…platelets: in ongoing bleeding with coagulopathy, or as part of balanced transfusion in massive haemorrhage. Transfusion thresholds in the stable, non bleeding patient Patient category…

…in kg Always have one size smaller to hand. The cuff is inflated to 20–30 cmH₂O measured with a manometer — a higher pressure ca

…completely. Relative contraindications: A high risk of aspiration: a non fasted patient, ileus, third trimester pregnancy, marked reflux. A need for high airway pressures, for…

…must never delay it. Indications Suspected meningitis or encephalitis. Suspected subarachnoid haemorrhage with a normal or non diagnostic CT. Suspected neuroborreliosis, neurosyphilis or another CNS…

…1]. Strong indications for activation Ongoing bleeding with haemodynamic instability, for example a systolic blood pressure below 90 mmHg, a narrow pulse pressure, peripheral vasoconstriction…

…for pain). An opioid is rarely the right choice in nociplastic or neuropathic pain, in chronic non cancer pain, or in headache. A failure to…

…to 32–36 °C. The HYPERION result means that active hypothermia is still used in some units with a non shockable rhythm; this is the…

…the first instance. Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse, peripheral perfusion, mental state and…

…implantation. Beta blockers, particularly non selective agents like nadolol and propranolol, are the first line treatment for reducing arrhythmic risk across all LQTS genotypes. These…

…implantation. Beta blockers, particularly non selective agents like nadolol and propranolol, are the first line treatment for reducing arrhythmic risk across all LQTS genotypes. These…

…by therapy. Non sustained VT (NSVT) : VT with ≥3 beats and spontaneous termination. Classification according to morphology: Monomorphic VT : VT with constant QRS morphology. Polymorphic…

…ventricular septal defects (VSD), and patent ductus arteriosus (PDA). Echocardiography provides a non invasive, accessible method to calculate this ratio, guiding clinical decisions about intervention…

…stroke risk in patients with non valvular atrial fibrillation (AF). It is a modification of the widely used CHA₂DS₂ VASc score, with the primary distinction…

…enhancing consistency in patient care. Non Invasiveness: The calculation relies on readily available clinical parameters, eliminating the need for more invasive and costly direct measurements…

…of patients should undergo angiography within 24 hours, but high risk patients should be evaluated with angiography earlier. Guidelines recommend the use of validated risk…

…2031 7. The TIMI risk score for unstable angina/non ST elevation MI: A method for prognostication and therapeutic decision making E M Antman, M…

…typically present with near syncope, syncope, or cardiac arrest. Before the onset of sustained VT, patients frequently experience PVCs and runs of non sustained VT…

…particularly among women with stroke risk factors, but this benefit was accompanied by increased serious gastrointestinal bleeding and a non significant increase in cerebral haemorrhage…

…ACL reduces hepatic cholesterol synthesis and produces reductions in LDL C, non high density lipoprotein cholesterol, apolipoprotein B and high sensitivity C reactive protein (hsCRP…

…remains consequential, and historically 2–6% of patients discharged with presumed non ischaemic chest pain were subsequently found to have had an infarction. Pathophysiological Considerations…

…over time, including transitions between stable angina, angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), post ACS or post revascularization states, and heart…

…rest or with minimal exertion; symptoms lasting at least 10 minutes unless treated immediately; severe chest pain, pressure, or discomfort; an accelerating pattern, with increasing…

…systematic differential diagnosis, as the syndrome associated with ischemic heart disease is broader than chest pain itself, encompassing symptoms like tightness, pressure, and discomfort in…

…brief as 4–6 weeks. This made BMS attractive in patients requiring urgent non cardiac surgery, those with high bleeding risk, or those considered unlikely…