…typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and…

…and the severity and manifestations of disease may differ substantially among carriers. Consequently, a normal examination or cardiac investigation at one point in time does…

…C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB…

…beats per minute. Note that with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2…

…attention to the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes. Mechanisms of action Colchicine Colchicine appears to…

…In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography…

…Caffeine and other methylxanthines, which antagonize adenosine receptors, should be avoided for at least 12 hours before testing. Dobutamine : Contraindicated in patients with severe hypertension…

…without current symptoms, alternating bundle branch block in acute anterior infarction, and before drugs or procedures with a known risk of bradycardia. Transvenous pacing is…

…hypertension and atherosclerotic coronary disease In patients with heavy alcohol use, left ventricular dilation may precede the development of increased left ventricular hypertrophy and mass…

…or respiratory distress. In patients with HFpEF, acute hypertension is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive…

…with reported reductions of up to 50–55% in guideline summaries. It also lowers non HDL C by up to approximately 50% and apolipoprotein B…

…strong and oppositely directed forces tend to cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In…

…is generally performed in order to evaluate ventricular function, since it may affect the choice of device therapy and also suggest whether other interventions (e…

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…

…and allows for standardized comparisons of serial examinations. If pathology is discovered during the standard examination, other examinations (which are not included in the standard…

…wave is positive in limb lead II. Normal (physiological) causes of sinus bradycardia Sinus bradycardia (SB) is considered a normal finding in the following circumstances…

…hypoxemia and ischemia all aggravate the risk of developing ventricular fibrillation, in any situation. ECG features of ventricular fibrillation The ECG shows irregular waves with…

… diabetes and other cardiovascular risk factors; smoking, hypertension, hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral arterial and aortic disease…

…of multiple modest dietary changes. Mediterranean type diets provide polyphenols from extra virgin olive oil, fruits, vegetables, nuts and legumes; unsaturated fatty acids and other…

…measurements permit assessment of the physiological significance of selected stenoses using fractional flow reserve (FFR) and instantaneous wave free ratio (iFR). Other invasive techniques can…

…and in these cases, the likelihood of ROSC is higher as compared to other etiologies and presentations. Asystole and pulseless electrical activity (PEA) often have…

…sedentary behaviour and loss of independence. Identification of PAD also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention…

…be small — a few tenths of a millilitre, at most about 0.5 mL. A larger volume draws in peripheral blood and dilutes the specimen…

…spot, in three minutes, without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The…

…GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur…

…the sinus and atrioventricular (AV) nodes. In addition to these direct effects, adenosine antagonizes catecholamine stimulated adenylate cyclase. This inhibition decreases the accumulation of cyclic…

…and hyperkalemia. For recurrent symptomatic bradycardia, temporary or permanent pacing may be required. However, transcutaneous pacing in the setting of cardiac arrest has not demonstrated…

…In apparently healthy individuals, SCORE2 and SCORE2 OP estimates can be used to classify 10 year risk as follows: Risk category 10 year risk of…

…in patient selection, procedural definitions, and institutional practice. Complications are more frequent during PCI than during purely diagnostic angiography. Elective PCI has reported mortality of…

…report rates of approximately 5–10%, while fewer than 5% of otherwise normal angiograms demonstrate bridging. The wide range reflects differences in ascertainment and imaging…

…recognition of edge dissection, tissue prolapse, thrombus, or other acute complications; investigation of restenosis and stent thrombosis. Intravascular imaging may also clarify the mechanism of…

…10% of patients presenting with myocardial infarction in other reports. It is more frequent in women and in patients presenting with NSTEMI than in those…

…occur in association with other procedural complications, including distal embolization, coronary dissection, perforation, and abrupt closure. The clinical consequences depend heavily on the amount of…

…or detection of prescribed drugs in blood or urine. The terms “controlled resistant hypertension,” referring to blood pressure controlled with four or more medications, and …

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

…deterioration in a previously stable pattern. Angina that occurs after a recent MI is also characteristic. The duration, frequency, precipitating threshold and recent trajectory of…

…and asystole can all occur in one patient. The typical depiction of sudden cardiac death as a gradual transition from sinus rhythm to ventricular tachycardia…

…feature was the characteristic ST segment elevations in leads V1–V3. Prevalence and genetics of Brugada syndrome The prevalence of Brugada syndrome remains largely unknown…

…5% of all hangings exhibit VF on the initial ECG recording ( Kitamura et al, Deasy et al ). A complete airway obstruction results in PEA and…

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

…These ST segment depressions are mirror images of the ST segment elevations, and they are seen in leads with a roughly opposite angle to the…

…effect of drugs, hypoxia, myocarditis and electrolyte disorders. Because the rate (60–100 beats per minute) is on a par with the rate in sinus…

…diagnosis. With a longer expected delay and a symptom duration of less than 12 hours, immediate fibrinolysis is recommended in the absence of contraindications, followed…

…reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration, particularly in patients with…

…metabolizing bradykinin and other tachykinins, such as substance P. When ACE is inhibited, the resulting accumulation of these peptides irritates afferent neural pathways in the…

…Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease, active cancer, and other conditions…

…anaemia and other nephrotoxic exposures may contribute to tubular injury, making attribution to contrast alone difficult. In patients with normal renal function, the occurrence of…

…resolution does not consistently permit identification of foamy macrophages. The occurrence of neoatherosclerosis helps explain why ISR and other stent related events may arise well…

…in this population. Obesity is associated with lower than expected BNP and NT proBNP concentrations despite comparable or greater ventricular wall stress, probably because of…

…and other familial forms associated with adrenal adenoma or bilateral adrenal hyperplasia. A family history is therefore important, particularly in patients with early onset hypertension…

…frequent in people with diabetes and becomes more common with advancing age. Presentations without pain may include: Sudden breathlessness Syncope or sudden loss of consciousness…

…effect on cardiovascular complications in T2DM. Cardiovascular benefit depends substantially on comprehensive risk factor management and, in appropriate patients, selection of glucose lowering therapies with…

…symptoms, and ECG changes. Although the risk of cardiac arrest is very small, personnel must be well trained in resuscitation. Subject preparations The procedure must…

…Use of synchronized electric shock (i.e. a shock synchronized to the QRS complex). Typically used to treat atrial fibrillation, ventricular tachycardia, and other tachyarrhythmias…

…instead of injecting into it, and expect the procedure to hurt even so. Offer nitrous oxide, oral or intravenous analgesia, or procedural sedation in advance…

…as soon as haemorrhage and contraindications have been excluded. CT angiography or transport planning must not delay treatment unnecessarily. 10. In unknown time of onset…

…the concentration, the dilution instructions and the local protocol before prescribing. Basic principles of treatment The patient should be managed in an emergency department, an…

…definition of MI. Type 1 MI is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and…

…consequences in frail patients. Clinical Assessment Frailty and Functional Status Treatment decisions should not be based on age alone. Assessment should include: Degree of frailty…

…FH results from pathogenic variants affecting proteins in the hepatic LDL receptor pathway. Reduced cellular uptake and clearance of LDL leads to increased circulating LDL…