…left ventricular hypertrophy or abnormal LV filling supports the diagnosis Unlike HFpEF, objective evidence of structural or functional cardiac abnormality or raised natriuretic peptides is…

…the sinoatrial node) is a common finding in athletes and during sleep; in these scenarios, it should not be considered abnormal. On the other hand…

…Patients without haemodynamic instability require more detailed prognostic evaluation using two complementary domains: Indicators of acute PE severity , including clinical findings, RV dysfunction on imaging…

…ECG finding is the ST segment depressions. In STE ACS, on the other hand, the ST segment depressions are secondary findings and the primary findings…

…assessment of myocardial regions in myocardial perfusion imaging (MPI) is based on principles similar to those used in echocardiography. The 17 segment model of the…

…infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings, cardiac biomarkers, imaging…

…pulmonary oedema, or evidence of coronary ischaemia. These findings determine the urgency and type of intervention. The assessment should also clarify: Whether AF is pre…

…result, pupils often dilate widely within 30–120 seconds of cardiac arrest and light reactivity is lost when cerebral blood flow ceases. In other words…

…This is also a normal finding. Abnormal (pathological) causes of sinus bradycardia In all other situations, sinus bradycardia should be regarded as a pathological finding…

…waves were present on previous recording, the amplitude must be increased in order to suggest ischemia. Inverted U waves are even more typical of ischemia …

…formerly termed Prinzmetal or variant angina, is myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible…

…Rhythm control, on the other hand, attempts to restore sinus rhythm by use of antiarrhythmic drugs. Randomized controlled trials have not demonstrated any clear difference…

…A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance…

…Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic…

…6% High risk 5 or more 5.8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist…

…and imaging technique. Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous origin of…

…the diagnosis is straightforward, as sinus P waves are never negative in this lead. When P waves are positive in lead II, comparison of P…

…the presence of an abnormal amount of fluid in the pericardial space. It can be caused by numerous local and systemic disorders. Accumulation of fluid…

…a premature ventricular contraction. Classification of premature ventricular contractions When every other beat on the ECG is a premature ventricular complex (PVC), the rhythm is…

…physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient…

…m² Abnormal urinalysis or renal imaging Risk of progression rises with proteinuria and depends on cause 2 60 mL/min/1.73 m² Abnormal urinalysis…

…a definitive disease diagnosis. It is a descriptive and provisional classification that should trigger further investigation. The underlying mechanism may be coronary, myocardial, or systemic…

…focuses on practical diagnostic and therapeutic considerations, with recommendations aligned with current guidelines from both the American Heart Association (AHA) and American College of Cardiology…

…is based on the following three components: Cardiac troponins – Elevation of cardiac troponins in peripheral blood is mandatory to establish a diagnosis of myocardial infarction…

…all other situations, sinus arrest/pause should be considered abnormal, and the following differential diagnoses are at hand: Sinus node dysfunction. Side effects of drugs…

…rhythm. Recognizing these arrhythmias on the electrocardiogram (ECG) is of clinical importance. Diagnosis and management of ventricular tachycardia will be addressed in a separate chapter…

…is which change can explain the pH, and whether the other variable lies within the expected range of compensation. Sample type and baseline values An…

…older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work systematically through the possible causes…

…in the myocardium. The electrical potential difference exists between ischemic and normal myocardium and it results in displacement of the ST segment. The ST segment…

…men and women, respectively, should be considered abnormal. A common cause of abnormally large T waves is hyperkalemia, which results in high, pointed and asymmetric…

…acute stressor superimposed on the patient's baseline cardiovascular state. For instance, a patient with stable CAD may present with clinical manifestations of myocardial ischaemia…

…OAC) hinges on a rigorous assessment of both thromboembolic and hemorrhagic risks. The diagnostic prerequisite for clinical AF remains the documentation of the arrhythmia via…

…to the QRS morphology during LBBB. Stimulation in other regions of the ventricle may result in a different QRS morphology. If the lead tip is…

…emphasis on ECG diagnosis, definitions, management, and clinical characteristics. Ventricular tachycardia is a highly nuanced arrhythmia that originates in the ventricles. A wide range of…

…Components of the HAS BLED Score The HAS BLED score is an acronym that stands for: H ypertension A bnormal renal/liver function S troke…

ECG Introduction to ECG interpretation The QRS complex (ventricular complex): normal and abnormal configurations and intervals A complete QRS complex consists of a Q , R…

…Hypocalcemia Causes of hypocalcemia Acute pancreatitis, pancreas surgery, alkalosis (hyperventilation), rhabdomyolysis, septicemia (sepsis), osteolytic cancer metastases, abnormal calcium absorption (gastrointestinal) and resorption (from primary urine…

…whereas others have brief or asymptomatic episodes that are not detected during routine clinical assessment. The clinical burden of AF does not reliably predict stroke…

…a systemic corticosteroid if the exacerbation is more than mild. 6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal…

…interpreting platelet function tests for HIT. Other cosiderations Based on a relationship observed in the PLATO study between the maintenance dose of ASA and the

…scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular…

…LDL C, regardless of the drug used to achieve it. Absolute benefit depends on baseline cardiovascular risk and the magnitude of LDL C reduction. Thus…

…and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine…

…if the total expected time is 120 minutes or less If PCI cannot be performed within 120 minutes Fibrinolysis within 10 minutes of the diagnosis…

…without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning…

…NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or duodenal ulcers. Liver cirrhosis. Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy…

…and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and…

…C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression. As the burden of retained…

…aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

…The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome (ACS). Other cardiopulmonary causes…

…three main questions discussed in media, blogs and on social plattforms: Is high cholesterol a true cause of coronary artery disease? Does diet affect cholesterol…

…depends on symptoms, serial electrocardiography, and cardiac troponin findings. The default treatment after ACS, whether or not PCI is performed, is 12 months of DAPT…

…impair autoregulation and cause ischemia Acute rapid reduction may cause harm without prognostic benefit Clinical Presentation and Symptoms Symptoms depend on the organ system involved…

…of revascularization Expected effects on death, myocardial infarction and stroke Likelihood of repeat revascularization Symptom burden and treatment goals Diabetes, left ventricular function and other…

…Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather…

…and cardiovascular rationale Smoking cessation is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible, other inhaled nicotine products…

…a notch on the apex. Please note that for most clinicians it is not necessary to be able to determine the direction of the re…

…cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In case the ECG or other examinations suggest…

…myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of upper abdominal pain. An…