…sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI. QTc prolongation The QT…

…myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia…

…abnormal tachyarrhythmia (only sinus tachycardia is more common). The prevalence of atrial fibrillation correlates strongly with age. Approximately 10% of individuals aged 80 years and…

…the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become abnormal late. A cirrhotic liver can have entirely normal transaminases…

…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…

…score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist for patients with AF, including HAS BLED, HEMORR2HAGES, and ORBIT scores. Each…

…in the presence of abnormal clinical risk assessment. Low risk PE is characterized by clinical low risk features, negative cardiac biomarkers, and no imaging evidence…

…source material include cardiac memory after abnormal ventricular activation, transient rate related conduction abnormalities, pacing related repolarization changes, and inadequate coronary flow relative to myocardial…

…differences in ascertainment and imaging technique. Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include…

…Management of all other cases aligns with the approach used for atrial fibrillation and atrial flutter. Beta blockers, digoxin, and calcium channel blockers may be…

…and the condition is classified as cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other frequent…

…discussion. A premature ventricular complex is recognized on the ECG as an abnormal and wide QRS complex occurring earlier than expected in the cardiac cycle…

…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…

…Sampling and measurement error A capillary glucose is sufficient to start emergency treatment, but abnormal or unexpected values should be confirmed with a laboratory analysed…

…heart failure, atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The…

…or abnormal arteriolar vasoconstriction. More than one mechanism may coexist. Supply–demand mismatch MINOCA may result from a mismatch between myocardial oxygen supply and demand…

…except in type 2 and type 3 MI. A diagnosis of MI should not be made solely from an abnormal cTn concentration in the absence…

…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…

…bundle of His, and hence it originates in the atria. In other words: tachycardias with narrow QRS complexes originate in the atria. the term supraventricular…

…an upper reference limit . Any value above the upper reference limit is considered elevated (abnormal) and thus indicates myocardial necrosis. The upper reference limit is…

…and during sleep; in these scenarios, it should not be considered abnormal. On the other hand, sinus bradycardia developing during physical exercise is considered abnormal…

…acute pain or other stimuli that increases vagal tone. In all other situations, sinus arrest/pause should be considered abnormal, and the following differential diagnoses…

…In STE ACS, on the other hand, the ST segment depressions are secondary findings and the primary findings are the ST segment elevations. As explained…

…Causes of ventricular rhythm and idioventricular rhythm The usual mechanisms are responsible for all ventricular rhythms. Increased automaticity (in His Purkinje fibers), abnormal automaticity (in…

…Normal Abnormal Abnormal A compensated simple disorder, or two opposing primary disorders It is therefore not enough to ask which of the pCO₂ and the…

…however, and an abnormal result is not specific to delirium. Symptoms are often worse in the evening and at night, but diurnal variation is not…

…depression). As mentioned above there are numerous other conditions that affect the ST T segment and it is fundamental to be able to differentiate these…

…after periods of ischemia, after infarction and after successful reperfusion (PCI). Post ischemic T wave inversion is caused by abnormal repolarization. These T wave inversions…

…though abnormal cardiac troponin (cTn) values in the setting of acute or chronic heart failure are often better categorised as myocardial injury. Clinical Presentation and…

…It evaluates Hypertension, Abnormal renal/liver function, Stroke history, Bleeding history, Labile INRs, Elderly age ( 65), and Drugs/alcohol. A crucial clinical pitfall is the…

…sex and age, to identify deviations from normal values. This enhances the ability to detect subtle perfusion defects and differentiate between normal and abnormal patterns…

…pacing results in abnormal depolarization, repolarization will also be abnormal, resulting in discordant ST T segments (i.e the QRS complex and T wave display…

…favorable prognosis, as compared with other forms of ventricular tachycardia. Mechanisms of ventricular tachycardia Ventricular tachycardia (VT) may emerge due to increased/abnormal automaticity, re…

…used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES, ATRIA, ORBIT, and GARFIELD AF scores…

…waves may not be visible and there is always variation between the leads. Some leads may display all waves, whereas others might only display one…

…and torsade de pointes. Hypocalcemia Causes of hypocalcemia Acute pancreatitis, pancreas surgery, alkalosis (hyperventilation), rhabdomyolysis, septicemia (sepsis), osteolytic cancer metastases, abnormal calcium absorption (gastrointestinal) and…

…fatigue and oedema. The underlying mechanisms are not uniform across the HFmrEF population. Some patients have a pathophysiological profile closer to HFrEF, whereas others have…

…abnormal renal or liver function, prior stroke, bleeding tendency or previous bleeding, labile international normalized ratio (INR), older age, drugs predisposing to bleeding and alcohol…

…6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV…

…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…

…However, other inheritance patterns, de novo variants, incomplete penetrance and variable phenotypic expression complicate risk prediction. Familial clustering may also reflect shared environmental or behavioural…

…Non HDL C and apoB are secondary targets or risk refining measures, particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance…

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

…assess the circulation and the bleeding risk, and exclude dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time…

…drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre…

…Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing bleeding risk. Monitor coagulation. Cyclosporine…

…atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term antiplatelet therapy after STEMI…

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

…effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to…

…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…

…Other life threatening cardiopulmonary conditions account for approximately 5% of presentations in some populations. Despite this relatively low prevalence, missed myocardial infarction remains consequential, and…

…Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction…

…intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies designed mainly around bleeding outcomes may not…

…and cerebral involvement. Catecholamine excess and drug related presentations Severe hypertension may result from phaeochromocytoma, monoamine oxidase inhibitor crisis, cocaine intoxication, or other sympathomimetic exposure…

…ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures. Both…

…atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation…

…other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption but to achieve complete abstinence from tobacco and ultimately…

…with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2:1 block will be difficult…

…has low sensitivity with respect to detecting biventricular hypertrophy. This is because the strong and oppositely directed forces tend to cancel each other out. However…

…segment elevations that are not caused by ischemia and a significant proportion have ST T changes caused by other pathological conditions (such as bundle branch…