…condition. It is associated with a two to four fold increase in lifetime cardiovascular disease (CVD) risk and approximately doubles cardiovascular risk on average. Its…

…and death. The clinical consequences are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of…

…the adverse effects and the important precautions. A hypertensive emergency is defined by a markedly raised blood pressure in combination with new or progressive acute…

…is thought to involve the sensitization of sensory nerve endings due to the accumulation of bradykinin. ACE is responsible for metabolizing bradykinin and other tachykinins…

…Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory…

…or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular dysfunction and/or MVD…

…more recent analyses question whether this reflects true biological protection. Potentially favourable associations with myocardial infarction may coexist with adverse effects on stroke, heart failure…

…increased vulnerability to adverse outcomes. It is dynamic and may improve or worsen with illness, treatment, or other interventions. Frailty commonly overlaps with multimorbidity and…

…relief of angina in some patients and a greater likelihood of repeat PCI. Multivessel disease in ACS is associated with an adverse prognosis. In STEMI…

…with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption…

…blocks or other conduction defects. However, in rare instances, it may be due to pre excited atrial fibrillation (i.e. atrial fibrillation with impulses conducted…

…to lack a pupillary reflex upon their initial presentation. An absent pupillary reflex upon presentation was associated with a threefold increased risk of an adverse…

…Consequently, the decision to prescribe colchicine requires attention to the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes…

…3. Give atropine 0.5 mg intravenously (alternatively glycopyrronium 0.2 mg) to reduce the risk of a cholinergic vagal reaction with bradycardia. Wait 5…

…and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The association is mediated by…

…Vascular complications 0.43 Contrast agent reaction 0.37 Haemodynamic complications 0.26 Cardiac chamber perforation 0.03 Other complications 0.28 Total major complications…

…Virtual histology IVUS has also been used to identify thin cap fibroatheroma, a plaque phenotype associated with subsequent major adverse cardiovascular events in observational studies…

…Estimate major adverse cardiovascular event risk. Quantify myocardial blood flow when PET is used. SPECT is recommended in suspected chronic coronary syndrome with moderate or…

…individuals, screening with ECG may reveal atrial fibrillation. Unfortunately, atrial fibrillation is too often discovered first at hospital admission due to its complications (stroke, thromboembolism…

…other imaging methods, namely exercise capacity (and VO2 max , see below). In addition to exercise capacity, stress testing also provides information on electrocardiographic (ECG) reaction…

…urgently to evaluate ventricular and valvular function. Levosimendan drug is generally well tolerated. Severe adverse effects are less common. Levosimendan may be administered simultaneously with…

…addition of bempedoic acid to statin therapy reduced LDL C by approximately 16.5%; the reduction in a subgroup with diabetes was approximately 19.1…

…depression. Sinus tachycardia. Refer to Figure 1 . Figure 1. Electrical alternans in patient with cardiac tamponade. The ECG shows varying QRS and T wave amplitudes.

…attributable to chronic LV systolic dysfunction and HF Angina, although its absence does not exclude ischemic cardiomyopathy Symptoms related to recurrent ischemia Symptoms associated with…

…of the R waves. This is believed to be due to delayed (and thus electrically unopposed) depolarization in the ischemic area. Fragmented QRS complex The…

…and circulation. 2. Give controlled oxygen with a target of 88 to 92 percent until the risk of hypercapnia has been assessed. 3. Take an…

…at high risk of developing a new event. Administration Ticagrelor can be administered with or without food. For patients who cannot swallow the tablets whole…

…dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting the relevant variant to each child. However, other inheritance patterns, de…

…in addition to LDL and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years without diabetes and with LDL…

…because of the severe reduction of coronary flow caused by acute atherothrombosis. Table 1: Myocardial and ECG reaction in various settings with ischemia or increased…

…is indicated in persisting STEMI. 12 to 48 hours: primary PCI should be considered even if symptoms have subsided, particularly with continuing ischaemia, heart failure…

…by an inexperienced examiner it is unreliable. A single central feature is enough to proceed with urgent investigation , and a normal CT of the brain…

…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…

…term interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular…

…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…

…relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without…

…In diabetes, carotid plaque prevalence correlates linearly with diabetes and carotid atherosclerosis tends to be more advanced than in people without diabetes. Carotid disease is…

…not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin, so biomarker interpretation must be integrated with the clinical history, ECG…

…at 20 to 30 years of age. People with familial hypercholesterolemia have no other metabolic aberration, besides high LDL cholesterol. Treating these individuals with LDL…

…a potent P2Y12 inhibitor to clopidogrel; reducing the dose of prasugrel; extending DAPT beyond 12 months in carefully selected patients with high ischemic risk and…

…The European definition uses BP ≥180/110 mmHg with acute HMOD, although other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence…

…coronary, cerebrovascular or other peripheral arterial disease, and management should therefore address the entire arterial circulation. PAD is associated with increased cardiovascular morbidity and mortality…

…as compared with atrial fibrillation, atrial flutter is not capable of persisting for longer periods of time. This is due to the fact that atrial…

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

…medical attention due to chest discomfort or other symptoms that may be caused by myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left…

…two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves. The cardinal difference between continuous wave…

…administration. Radiotracers with higher levels of redistribution can move from areas of higher concentration to regions with lower concentration, for reasons other than perfusion differences…

…The injury currents are not strong enough to be detected on leads with opposite angle of observation. Other vectors may interfere with the injury currents…

…have constant PP interval and ride straight through the strip, without any relation to QRS complexes. P waves may occur on the ST T segment…

…expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90…

…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…

…4. Make a small skin incision with the scalpel. 5. Aspiration: advance the needle with the stylet in place perpendicular to the bone surface, angled…

…with a high frequency linear probe, a sterile probe cover and sterile gel. Chlorhexidine in alcohol 5 mg/mL for skin disinfection. Allow it to…

…where indicated according to the table above. 9. Check that the whole lesion, including the margin, has turned white. Contact technique with a cryoprobe gives…

…severe piperacillin–tazobactam 4 g × 4 IV Exacerbation of COPD with an indication for antibiotics amoxicillin 750 mg × 3 PO 5–7 days or doxycycline…

…meal or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating…

…neurological symptoms that may be due to the hyponatraemia? 2. Is the hyponatraemia acute or chronic? Severe symptoms require immediate treatment with hypertonic sodium chloride…

…A normal GGT shifts the suspicion to bone, pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction…

…count with a differential, CRP, creatinine, electrolytes, liver function tests, glucose and lactate. Add a blood gas, coagulation tests and other investigations according to the…

…the prognosis. The patient must go to cardiothoracic surgery. In profound shock, very limited decompression may be considered in consultation with a cardiothoracic surgeon. Myocardial…