…compromise and does not protect the airway completely. Relative contraindications: A high risk of aspiration: a non fasted patient, ileus, third trimester pregnancy, marked reflux…

…airway produces no reliable symptoms in a patient with an impaired cough reflex, and the first feed then becomes a direct instillation into the lung…

…and no obstructive stenosis in a major epicardial coronary artery. Non obstructive disease is generally defined as the absence of a stenosis of 50% or…

…chest discomfort; symptoms suggestive of myocardial ischaemia despite normal or non obstructive coronary arteries; dyspnoea; fatigue; and recurrent symptoms causing impaired quality of life. Women…

…or normal ↓↓ ↓ or normal ↑ or normal Obstructive (tamponade, PE) ↓ ↑ ↑ ↓ Vital signs and measures of perfusion Parameter Normal Comment :…

…predictor of future myocardial infarction or sudden death. Lesions causing only mild obstruction may rupture, thrombose and occlude. Many acute myocardial infarctions arise from lesions…

…likelihood of atherosclerotic obstructive CAD. CAC is therefore not merely an incidental imaging finding; it can refine the decision to test and may identify patients…

…age, height and ethnicity — not against absolute figures. Since 2022 the z score with a lower limit of normal at z = −1.64 (the…

…local availability, and cost. The pathophysiological substrate of angina may differ between patients. Myocardial ischaemia may result predominantly from obstructive epicardial coronary disease, coronary vasospasm…

…restenosis and stent thrombosis. Intravascular imaging may also clarify the mechanism of an acute coronary syndrome (ACS), particularly when angiography shows no significant obstructive disease…

…factor and as a driver of hypertension, diabetes, dyslipidaemia and systemic inflammation. It is also associated with respiratory disorders, notably obstructive sleep apnoea (OSA) and…

…Deasy et al ). A complete airway obstruction results in PEA and cardiac arrest within 8 minutes. Cardiac arrest as a result of asphyxia or hypoxia…

…pericarditis Acute aortic dissection Physical disability that precludes safe and adequate testing Relative contraindications Known obstructive left main coronary artery stenosis Moderate to severe aortic…

…obstructive. Atherosclerotic plaque accumulation in the epicardial arteries is a major pathological substrate, but ischaemia may also result from epicardial vasomotor abnormalities or structural and…

…mmHg for 15 minutes, or a need for a vasopressor), obstructive shock or cardiac arrest with suspected pulmonary embolism. Urgent bedside echocardiography, looking for right…

…no previous diagnosis of CAD, and a low clinical likelihood of obstructive disease when good image quality is expected. It is also an alternative to…

…prominent as a primary diagnostic test for obstructive coronary artery disease (CAD), because coronary computed tomography angiography (CCTA) and functional imaging have higher diagnostic performance…

…ICA is based on the clinical likelihood of obstructive CAD, symptoms, findings from non invasive testing and the anticipated effect of the result on management…

…and cardiac amyloidosis using appropriate radiopharmaceuticals. Functional perfusion imaging primarily identifies haemodynamically important disease. Non obstructive coronary atherosclerosis not associated with demonstrable ischaemia may therefore…

…and cardiac arrest after presentation are markers of very high risk. They require immediate escalation because the priority is to identify and treat an obstructive…

…Epicardial and microvascular angina can coexist, and this combination is associated with a worse prognosis. VA may occur in the presence of obstructive coronary artery…

…to the reduced area of the valvular orifice. Both aortic stenosis and hypertension result in increased ventricular load, which the ventricle counteracts by developing hypertrophy…

…then relative contraindications may be disregarded. Absolute contraindications for exercise ECG Aortic dissection – due to risk of progression and rupture. Acute myocardial infarction (AMI) within…

…chronic obstructive pulmonary disease, renal insufficiency, systemic hypertension, and concomitant abdominal aortic aneurysm. Clinical Presentation and Symptoms Acute chest and/or back pain is the…

…appropriate when: The pre test likelihood of obstructive CAD is moderate or high, generally greater than 15% and less than 85% Baseline ECG abnormalities make…

…the hemodynamic significance of a coronary lesion, with anatomic and functional assessment discordant in a substantial minority of intermediate lesions. Over the past three decades…

…conditions like osteoarthritis and obstructive sleep apnea primarily reflect the extent of weight loss, the reductions in hard cardiovascular outcomes (MI, stroke) and metabolic liver…

…failure, congenital heart disease, diabetes mellitus (both type 1 and type 2), obesity, smoking, obstructive sleep apnea and chronic obstructive pulmonary disease (COPD). Moreover, certain…

…disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. EAT typically has an abrupt onset, although…

…attention. The ventricular rate is typically very high (100–250 beats per minute) and cardiac output is affected (i.e reduced) in virtually all cases…

…Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has identified the relevant endotype and its treatment options have been addressed…

Procedurer Spirometry is the only investigation that distinguishes obstructive from restrictive impairment of lung function, and COPD cannot be diagnosed without it . The quality of…

…This type of cardiomyopathy is characterized by pronounced hypertrophy of the myocardium. It may also lead to obstruction of the LVOT (Hypertrophic Obstructive Cardiomyopathy, HOCM)…

…physical inactivity, and alcohol consumption. Additional considerations include psychosocial stress, obstructive sleep apnoea, social determinants of health, air pollution, family history, ethnicity, and frailty. Primary…

…necessary to establish a transcutaneous pacemaker, which is the only treatment with class I recommendation according to European (ESC) and North American (AHA, ACC) guidelines…

…failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given for the pain, but the effect on the…

…and in obstructive airways disease Verapamil or diltiazem When a beta blocker is contraindicated, for example in asthma Contraindicated in impaired left ventricular function and…

…Mechanical obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other…

…administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for…

…Unprotected Left Main Disease : Increases complexity and risk. Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive Pulmonary Disease (COPD) : Associated with higher perioperative risk…

…patients with obstructive coronary disease. It is also the most prevalent antecedent of heart failure—particularly heart failure with preserved ejection fraction—and chronic kidney…

…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…

…airway obstruction: inhalation injury, anaphylaxis, deep neck infection, an expanding haematoma, facial trauma. An anticipated course requiring a secured airway — transfer, heavy sedation, surgery — and…

…liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease, hay fever…

…1). Myocardial ischemia affecting the papillary muscles or the connected myocardium may cause mitral prolapse, and thus regurgitation. Ischemia manifests with myocardial akinesia or dyskinesia…

Myocardial ischemia and infarction Definition and pathophysiology A chronic total occlusion (CTO) is a complete or nearly complete coronary arterial obstruction that has persisted for…

…or immediately after PCI. The clinical presentation depends on the extent of microvascular obstruction and the territory supplied by the treated vessel. Possible manifestations include…

…according to tolerance and pCO₂ SpO₂ 88–92% Obesity hypoventilation Bilevel NIV IPAP 14–16 and EPAP 6–8 cmH₂O Increase the EPAP against obstruction…

…and possible reperfusion. The principal pathophysiological determinant of early adverse outcome is acute RV failure. In acute PE, obstruction of pulmonary blood flow increases RV…

…artery bypass grafting (CABG), and is classified within the universal MI framework as follows: Type 4a MI: MI related to PCI. Type 4b MI: MI…

…obstruction, or a range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the patient’s clinical context and…

…contributes to the extension and severity of ischemic injury. In its most severe form, known as no reflow, structural and functional impairments sustain vascular obstruction…

…to atheromatous plaque producing progressive narrowing or obstruction of epicardial coronary arteries. Endothelial dysfunction, coronary microvascular disease and vasospasm may coexist with atherosclerosis or may…

…which prompt recognition, specialist assessment and restoration of perfusion are essential. The abrupt arterial obstruction may result from progression of peripheral arterial disease, cardiac or…

…alkali) — it makes endoscopic assessment more difficult and causes vomiting Medicinal charcoal Petroleum products — vomiting with chemical pneumonitis as a consequence Medicinal charcoal Bowel obstruction…

…likewise affected by inflammation and other systemic influences. The severity of myocardial injury is determined not only by the epicardial obstruction but also by the…

…Some acute coronary events occur without an identifiable culprit thrombus. NSTE ACS generally reflects an imbalance between myocardial oxygen supply and demand. In many cases…

…vena cava and the descending aorta. During a cardiac arrest, the venous and arterial pressures are substantially reduced, potentially leading to complete obstruction of venous…

Cardiology Clinical medicine Definition and pathophysiology Peripheral artery disease (PAD) is a clinical disorder caused by stenosis or occlusion of the aorta or arteries supplying…

…a large myocardial territory through the left anterior descending (LAD) and left circumflex (LCx) arteries (Figure 1). Acute obstruction can lead to rapid hemodynamic deterioration…