…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…

…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…

…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…

…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…

…and colchicine has been studied as an additional therapy alongside standard treatment. Interleukin 1β inhibition Canakinumab reduced inflammatory biomarkers without affecting lipids or other…

…syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI), or medical…

…severe hypotension, or high degree AV block. Caffeine and other methylxanthines, which antagonize adenosine receptors, should be avoided for at least 12 hours before testing…

…spike is followed by a wide QRS complex and a pulse that can be felt. The other predictable error is forgetting that pacing hurts a…

…myocardial infarction may coexist with adverse effects on stroke, heart failure, cardiovascular mortality and atrial fibrillation. Consequently, alcohol should not be initiated as a cardiovascular…

…disseminated intravascular coagulation, and abrupt deterioration in renal function. By contrast, hypertensive urgency describes severe hypertension without clinical evidence of acute, ongoing target organ damage…

…biweekly injections. Inclisiran is used as an adjunct to dietary measures and maximally tolerated statin therapy, with or without other LDL C lowering drugs, when…

…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…

…order to evaluate ventricular function, since it may affect the choice of device therapy and also suggest whether other interventions (e.g. heart failure management…

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…

Arrhythmias and arrhythmology ECG Sinus bradycardia: ECG, causes & management Definition of sinus bradycardia Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate…

…Other common causes are cardiomyopathy (hypertrophic or dilated), arrhythmogenic right ventricular cardiomyopathy, Brugada syndrome, early repolarization. Electrolyte disorders, acidosis, hypoxemia and ischemia all aggravate 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…

…risk factors within 6–8 weeks even without weight loss. Cardiovascular Outcomes Associated With Dietary Patterns Cardiovascular disease and mortality The strongest long term evidence…

…thrombus and other structural features that may not be evident on angiography alone. It is particularly useful when ACS occurs without significant obstructive CAD or…

CPR Neurons are exceptionally vulnerable to hypoxia and anoxia ( Casas et al ). In cardiac arrest without chest compressions (i.e. if cerebral perfusion ceases), irreversible…

…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…

…Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather…

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

…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…

…A1 receptors located on the extracellular surface of cardiac cells. Through the guanine nucleotide regulatory proteins Gi and Go, adenosine activates potassium channels (IK.Ach…

…theophylline and terbutaline can increase the sinus rate, there are generally no reliable and safe drugs available for long term heart rate augmentation without undesirable…

…according to age and the presence of concomitant risk factors. In contrast, patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification…

…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…

…in approximately 0.5–12% of angiographic series and up to 5–75% of CT series; other angiographic descriptions report rates of approximately 5–10…

…and distal reference segments; assessment of stent expansion and apposition; recognition of edge dissection, tissue prolapse, thrombus, or other acute complications; investigation of restenosis and…

…younger and more often female than patients with atherosclerotic mediated myocardial infarction. A history of cigarette smoking may be present despite relatively few other conventional…

…for routine use. No reflow may also occur in association with other procedural complications, including distal embolization, coronary dissection, perforation, and abrupt closure. The clinical…

Cardiology Definition and Pathophysiology Resistant hypertension is a clinical indicator rather than a distinct disease. It identifies patients whose blood pressure remains uncontrolled despite intensive…

…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…

…recent changes in symptoms or signs, with or without ECG abnormalities and with or without an elevation in cardiac troponin. The underlying pathological mechanism is…

…regardless of all other circumstances. The initial rhythm is an indicator of the underlying etiology, duration of cardiac arrest, quality of CPR, and a prognostic…

…There are however other disorders that may bring about similar ECG changes, and these are as follows: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVC/ARVD) – ARVC…

CPR Hypoxia and asphyxiation Hypoxia refers to a reduced partial pressure of oxygen in the blood. Asphyxia is characterized by insufficient ventilation, leading to hypoxia…

…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…

…on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted in both North American and European…

…discordant ST T segment and the rhythm is regular (in most cases). Idioventricular rhythm starts and terminates gradually. It occurs in other situations than does…

…STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based on symptoms, the ECG and…

…alpha 2 agonists and antipsychotics, which mainly affect individual symptoms. Initial management ABCDE and immediate tests Assess the withdrawal and other life threatening conditions at…

…the sensitization of sensory nerve endings due to the accumulation of bradykinin. ACE is responsible for metabolizing bradykinin and other tachykinins, such as substance P…

…determines whether the patient has high risk PE and therefore requires an emergency management pathway. Patients without haemodynamic instability require more detailed prognostic evaluation using…

…cardiac dysfunction, haemodynamic instability, anaemia and other nephrotoxic exposures may contribute to tubular injury, making attribution to contrast alone difficult. In patients with normal renal…

…of foamy macrophages. The occurrence of neoatherosclerosis helps explain why ISR and other stent related events may arise well after the initial intervention. Mechanical mechanisms…

…dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies, particularly cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac amyloidosis, BNP or NT proBNP may be markedly…

…1, formerly termed glucocorticoid remediable aldosteronism, and other familial forms associated with adrenal adenoma or bilateral adrenal hyperplasia. A family history is therefore important, particularly…

…other systemic influences. The severity of myocardial injury is determined not only by the epicardial obstruction but also by the vulnerability of the myocardium and…

…T2DM, although management follows the same principles as in patients without diabetes. Clinical Presentation and Symptoms T2DM may be clinically silent while vascular disease progresses…

…or other professionals. A physician is always formally responsible for conducting the test. All personnel must be appropriately trained and the laboratory must be equipped…

…fibrillation, ventricular tachycardia, and other tachyarrhythmias with discernible QRS complexes. Shockable rhythm : Tachyarrhythmias that can be treated with defibrillation (ventricular fibrillation) or cardioversion (ventricular tachycardia)…

…Contraindications and when to involve a surgeon The following locations must not be handled routinely in primary care or in the emergency department without contacting…

…the NIHSS and document which symptoms are disabling. 6. Measure the blood pressure, initially in both arms if this can be done without losing time…

…without acute target organ damage should not normally be lowered rapidly with intravenous drugs. Such treatment has not been shown to improve the prognosis and…

…whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or…

…It is dynamic and may improve or worsen with illness, treatment, or other interventions. Frailty commonly overlaps with multimorbidity and is frequent in patients with…

…premature CAD or other vascular disease. A history of myocardial infarction or raised cholesterol among relatives. The presence of tendon xanthomas, corneal arcus and xanthelasma…