…contrast media are injected selectively into the epicardial coronary arteries through a catheter advanced from a peripheral artery to the aortic root and coronary ostia…

…blood pressure of 20 mm Hg systolic or 10 mm Hg diastolic leads to a doubling of the risk of stroke and acute myocardial infarction…

…oxygen demand) in order to provoke ischemia in myocardium supplied by atherosclerotic arteries. This engenders the typical ECG changes as well. In acute coronary syndromes…

…due to high vagal tone. These individuals have developed a highly efficient left ventricle, capable of generating sufficient cardiac output at low heart rates. During…

…administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other contraindications…

…deposition and retention of LDL C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression…

…adequate. For example, a patient with acute graft occlusion may report an abrupt reduction in walking distance before claudication, accompanied by moderate pain or paresthesia…

…confined to a single lesion. Consequently, local revascularization must be accompanied by systemic treatment aimed at stabilizing the broader atherosclerotic disease. Pathophysiology Mechanisms of acute…

…The patient will experience severe chest pain due to the abrupt reduction of coronary blood flow. Acute coronary syndromes are subdivided into STE ACS and…

…circulating LDL particles. Its principal clinical effect is therefore reduction of LDL cholesterol (LDL C), through a mechanism complementary to that of statins. Statins reduce…

…risk plaques may coexist within one coronary tree, and inflammatory activity may be widespread rather than confined to a single lesion. Plaque composition is heterogeneous…

…the benefit of ischemic preconditioning, while other studies have failed to establish such a relation. The most cited study to date, Botker et al62001 8…

…establish a mortality benefit. Consequently, the decision to prescribe colchicine requires attention to the balance between reduction in ischaemic events and possible infectious or other…

…in a reduction of coronary blood flow and this causes subendocardial ischemia (i.e ischemia that only affects the subendocardium). STEMI, on the other hand…

…other acute organ damage can often be treated more cautiously with oral drugs under careful observation [3,4]. A markedly raised blood pressure without acute…

…or electrical instability in advanced or acute presentations Left main disease may be clinically silent, and revascularisation recommendations are not restricted to patients with symptoms…

…is a marker of several crucial events and factors: Cause of cardiac arrest : Shockable rhythms (ventricular fibrillation, pulseless ventricular tachycardia) are mostly due to acute…

…vascular autoregulation during a rapid or severe rise in BP. This may produce acute injury in the brain, retina, heart, aorta, kidneys, or other vascular…

…oedema but makes the brain sensitive to a rapid increase in extracellular tonicity. This explains why acute hyponatraemia chiefly carries a risk of cerebral oedema…

…is associated with approximately a 25% reduction in recurrent infarction, stroke, or cardiovascular death. In the cited evidence, this corresponded to 36 fewer events per…

…therapy added when necessary to achieve the recommended LDL C target. Inclisiran: pharmacology and lipid effects Inclisiran produces a dose dependent reduction in PCSK9 and…

…A brief, structured intervention should be used whenever smoking is identified. During encounters with smokers, “very brief advice” can initiate discussion and promote referral to…

…reduction as in the table above for rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible according to…

…Acute cardiovascular effects Acute ethanol exposure has a negative inotropic effect and promotes peripheral vasodilation through reduced systemic vascular resistance. The resulting mild reduction in…

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

…a sinoatrial pause. Refer to Figure 1 . Figure 1. Sinoatrial arrest. Also note the ST segment elevations (which in this case have no relation to…

…among other reasons because it has the least renally dependent elimination. Agent Standard dose in atrial fibrillation Criteria for dose reduction according to FASS : : : Apixaban…

…interventricular septum, or mitral valve apparatus. These lesions can cause acute severe regurgitation, a left to right shunt, tamponade, or sudden loss of effective cardiac…

…mechanisms have been proposed to precipitate acute coronary events during infections: An acute coronary event may be triggered by increased myocardial demand during the infection…

…Because NT proBNP is not a neprilysin substrate, it remains more closely related to the clinical state during treatment with an angiotensin receptor–neprilysin inhibitor…

…stress generally indicates previous infarction. Extensive ischaemia may produce a reduction in global LVEF and transient LV cavity dilatation during stress. Stress echocardiography can also…

…including chronic coronary syndromes and acute coronary syndromes HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD…

…to a complex fibroatheroma. Smooth muscle cells (SMCs) migrate from the tunica media into the intima, driven by platelet derived growth factor (PDGF) and other…

…CPR, and a prognostic indicator for survival. In the nationwide Swedish Cardiopulmonary Resuscitation Registry, 30 days survival in OHCA, in relation to initial rhythm, is…

… photograph it with a ruler in the image. A reduction in size of 40% within four weeks predicts healing — failure to shrink should prompt reconsideration…

…or bacterial pericarditis Trauma Cardiac surgery and other iatrogenic cardiovascular procedures Acute aortic disease, particularly ascending or type A aortic dissection Myocardial free wall rupture…

…Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…posterolateral) acute myocardial infarction (STEMI) The heart is rotated 30° to the left in the thorax. This positions the basal portion of the left lateral…

…order to suggest ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic…

…represents acute tubular necrosis arising from the combined effects of contrast exposure and other ischaemic or nephrotoxic stresses. The kidney is particularly vulnerable to toxic…

…refers to cardiac troponin release that does not fulfil the criteria for ischaemic myocardial infarction. It may be acute, when serial troponin values show a…

…and other conditions incorporated into validated clinical risk tools Acute RV failure is a rapidly progressive syndrome characterized by systemic congestion resulting from impaired RV…

…segment strongly suggest acute transmural ischemia ( Figure 1 A ). Concave ST segment elevations, on the other hand, are much less likely to be caused by…

…for dialysis? AKI occurs in about one fifth of adults during a hospital episode in international studies and is linked to substantial mortality, even though…

…Moderate attack Acute severe attack Life threatening attack : : : : Speech Full sentences Cannot complete a sentence in one breath Single words or unable to speak Position…

…investigation in acute stroke to identify large vessel occlusion, dissection or other vascular pathology CT perfusion Used with an unclear time of onset, a late…

…Spontaneous attacks without a clear trigger: consider vestibular migraine, Ménière's disease, TIA and arrhythmia, among others. Acute severe balance disturbance without nystagmus: HINTS does…

…is stated that it is extremely uncommon to have a non ischemic ECG (absence of ST T changes) during chest pain caused by myocardial ischemia…

…Diagnostic criteria for acute myocardial infarction A diagnosis of myocardial infarction is based on the following three components: Cardiac troponins – Elevation of cardiac troponins in…

…among others, can raise the blood pressure. Serotonin syndrome can also cause autonomic instability and hypertension [4]. Step 2: look systematically for acute organ damage…

…it may extend to additional non infarct related lesions. Culprit only revascularization treats the artery responsible for the acute clinical event during the index procedure…

…patients with unknown etiology for acute severe heart failure. A recent echocardiographic examination should be available or performed urgently to evaluate ventricular and valvular function…

…LBBB) in acute myocardial infarction (AMI): clinical implications & Sgarbossa criteria Contrary to right bundle branch block, left bundle branch block is always a pathological finding…

…with acute coronary syndrome (ACS) or a prior heart attack and a high risk of developing an atherothrombotic event. Contraindications Hypersensitivity to the active substance…

…with patient denial, often leads to a mistaken impression of indigestion. STEMI pain can simulate pain from acute pericarditis, pulmonary embolism, acute aortic dissection, costochondritis…

…provoked by less exertion. Angina occurring after a recent myocardial infarction. UA belongs to the broader spectrum of acute coronary syndromes, which may present with…

…and infarction ST segment depression due to acute myocardial ischemia ST segment depressions caused by ischemia are characterized by a horizontal or downsloping ST segment…

…result of a perfect storm scenario , where ischemia, hemodynamics, the autonomous nervous system, electrolyte concentrations, and other factors (potentially also genetic predisposition) interact to trigger…

…4 to 6 days after acute myocardial infarction. Moreover, early exercise tests should not be maximal, which means that the clinician must set a lower…