…for the intensive care patient and totals 12 points: Mallampati III–IV (5 points), obstructive sleep apnoea syndrome (2 points), reduced neck mobility (1 point)…

…sleep ( Dickinson et al ). Pronounced sinus bradycardia is frequently associated with hypoxic episodes caused by obstructive sleep apnea. The following bradyarrhythmias are considered normal findings…

…Etiologies of hypoxic cardiac arrest : Trauma and injuries : Direct trauma can cause airway injuries, resulting in obstruction. Central nervous system (CNS) injuries might cause apnea…

…patients with asthma/chronic obstructive pulmonary disease (COPD). Dyspnea has been reported in patients treated with ticagrelor. Patients with a history of ischemic stroke can…

…2), obesity, smoking, obstructive sleep apnea and chronic obstructive pulmonary disease (COPD). Moreover, certain other tachyarrhythmias predispose to developing atrial fibrillation: atrial flutter, AVNRT and…

…tissues. 15 Recent evidence clarifies that while the benefits in conditions like osteoarthritis and obstructive sleep apnea primarily reflect the extent of weight loss, the…

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

…depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given for the pain…

…notably obstructive sleep apnoea (OSA) and obesity hypoventilation syndrome, which further increase cardiovascular burden. Obesity may be a particularly important cause of HF with preserved…

…despite the absence of an angiographically obstructive lesion Coronary embolism or thrombus Epicardial coronary vasospasm Coronary microvascular dysfunction Spontaneous coronary artery dissection (SCAD) Standard angiography…

…is increased resistance in the aortic valve itself, due to the reduced area of the valvular orifice. Both aortic stenosis and hypertension result in increased…

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

…with non obstructive coronary arteries (INOCA) denotes the subgroup in whom objective myocardial ischaemia is demonstrated. ANOCA may occur in up to 70% of patients…

…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…

…the expected information is likely to change management. In patients with a very low probability of obstructive CAD, testing may generate false positive results and…

…without an obstructive epicardial lesion. Once conventional anti ischaemic targets have been exhausted, proposed therapeutic approaches act through several broad mechanisms: Promotion of coronary collateral…

…without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and…

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

…EMG about 95 %). Contraindications Known hypersensitivity to edrophonium. Mechanical obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade…

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

…risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease, hay fever, or nasal polyps (increased risk of hypersensitivity…

…II Anatomical SYNTAX Score : Derived from the original SYNTAX Score, which evaluates the complexity of coronary lesions. Clinical Variables : Age : Older patients have a higher…

…substrate of angina may differ between patients. Myocardial ischaemia may result predominantly from obstructive epicardial coronary disease, coronary vasospasm, microvascular dysfunction, or combinations of these…

…angina, angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), post ACS or post revascularization states, and heart failure of ischaemic or cardiometabolic origin…

…plaque and future events Angiographic stenosis severity is an imperfect predictor of future myocardial infarction or sudden death. Lesions causing only mild obstruction may rupture…

…a lower suspicion of obstructive disease. Patients with no plaque or stenosis on CCTA should be reassured, and non atherosclerotic causes of symptoms should be…

…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…

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

…available, PET MPI is recommended in individuals with suspected chronic coronary syndrome and a moderate or high pre test likelihood of obstructive coronary artery disease…

…ST segment elevation caused by spasm. The absence of obstructive disease generally indicates a more favourable course than VA accompanied by severe fixed lesions. Nevertheless…

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

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

…without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. EAT typically has an…

…causes immense strain on the ventricular myocardium, simultaneously as the cause of the arrhythmia already affects cellular function. This results in electrical instability which explains…

…hypertension coexists in approximately 70% of patients with aortic dissection. PAU is particularly associated with advanced age, smoking, coronary artery disease, chronic obstructive pulmonary disease…

…and may worsen ischemia in patients with obstructive coronary disease. It is also the most prevalent antecedent of heart failure—particularly heart failure with preserved…

…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…

…treat an obstructive coronary lesion without avoidable delay. In contrast, haemodynamically stable patients without ST segment elevation after successful resuscitation from out of hospital cardiac…

…severity, or location of inducible ischaemia. It is particularly appropriate when: The pre test likelihood of obstructive CAD is moderate or high, generally greater than…

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

…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…

…of mitral regurgitation Degeneration, prolapse DCM (dilated cardiomyopathy) Ischemic heart disease (coronary heart disease) Rheumatic valve disease Endocarditis Congenital mitral regurgitation Amyloidosis SLE Hypertrophic obstructive…

…isolates microvascular resistance. Only indices that detect microvascular disease as an independent cause of ischemia, including with non obstructive epicardial arteries (ANOCA/INOCA); CFR has…

…Definition and pathophysiology A chronic total occlusion (CTO) is a complete or nearly complete coronary arterial obstruction that has persisted for at least 30 days…

…are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of acute PE comprises four clinically…

…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…

…sided cardiac disease, chronic lung disease or hypoxia, chronic thromboembolic obstruction, or a range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis and classification…

ECG Left main coronary artery occlusion Left main coronary artery (LMCA) occlusion is a rare but catastrophic manifestation of acute coronary syndromes. The LMCA supplies…

…output can change before creatinine but is not a pure marker of filtration. Oliguria may be due to hypovolaemia, shock, obstruction or advanced renal injury…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…kills because the tube would not pass, but because the team keeps trying to intubate instead of changing the plan. The aim is always oxygenation…

…nasal fracture or unilateral nasal obstruction. 2. Measure the depth of insertion by laying the tube from the tip of the nose to the earlobe…

…is a marker of elevated left ventricular filling pressures and is linked to adverse outcomes. Left Ventricular Outflow Tract Gradient (LVOTG) : LVOT obstruction is a…

…venous filling Pulses proximal and distal to the suspected obstruction Arterial and venous Doppler signals Evidence of systemic disease or a potential embolic source Neurological…

…measure of luminal obstruction. Calcified plaque is generally less likely to rupture than non calcified, lipid rich plaque. CAC nevertheless serves as a marker of…

…obstruction. Intensive lipid lowering improves endothelial function, lowers circulating high sensitivity C reactive protein, reduces thrombogenicity, and favourably modifies inflammatory and collagen related components of…

…dissection with obstruction of the true lumen Occlusion of a major epicardial artery or bypass graft Side branch occlusion or thrombus Disruption of collateral flow…

…obstruction. Furthermore, cardiomyocyte swelling, interstitial edema, and tissue inflammation promote extravascular compression, exacerbating myocardial injury. Clinical Presentation and Symptoms In up to one half of…

…myocardial infarction as the final diagnosis. The underlying process usually involves acute thrombotic obstruction of an epicardial coronary artery. A vulnerable atherosclerotic plaque and thrombogenic…

…microvascular disease and vasospasm may coexist with atherosclerosis or may be the dominant cause of ischaemia. Other mechanisms capable of obstructing coronary arteries include embolism…