…Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather…

…applies where you work. They assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick…

…and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around…

…early phases of ischemia). To conclude, concave ST segment elevation is atypical of ischemia, but they do not rule out ischemia. Other features of ischemic…

…Cystatin C based eGFR With an atypical muscle mass, or to confirm a creatinine based value The mean of creatinine and cystatin C The most…

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

…atypical chest pain (30%) and dyspnea (10%). The major ECG findings in ARVC are T wave inversion in V1–V3 (in the absence of right…

…traditional aggravating and relieving characteristics of angina; many patients report less characteristic symptoms, while others present primarily with exertional dyspnoea. Symptoms should be characterized systematically…

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

…is an emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint or absent. Take cultures immediately, but never let…

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

…occur in one patient. The typical depiction of sudden cardiac death as a gradual transition from sinus rhythm to ventricular tachycardia (VT), to ventricular fibrillation…

…that for most clinicians it is not necessary to be able to determine the direction of the re entry loop. Figure 1. Typical atrial flutter…

…ECG changes and symptoms. Troponins and other biomarkers of myocardial necrosis (infarction) Myocardium can endure 20 to 30 minutes of complete ischemia. After this period…

…brainstem infarction, intoxication, Wernicke's encephalopathy, other central disease Neurological examination, gait and truncal stability, often MRI Episodic triggered vestibular syndrome Brief attacks, usually lasting…

…from sleep. Initial symptoms of NSTEMI and UA may be similar. NSTEMI is diagnosed when typical ischaemic symptoms occur without persistent ST segment elevation, accompanied…

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

…often indicative of a noncardiac source [4]. 3. Pneumonia with Pleurisy Pain Characteristics: Pleuritic pain is a common presentation [2]. 4. Other Systemic/Local Causes…

…and lesion haziness raise suspicion of thrombus, although haziness is not specific. Intravascular imaging can identify plaque disruption, thrombus and other structural features that may…

…local revascularization must be accompanied by systemic treatment aimed at stabilizing the broader atherosclerotic disease. Pathophysiology Mechanisms of acute coronary syndrome The major mechanisms producing…

…Infections are difficult to heal because the heart valves are not vascularized and therefore it is difficult for the immune system to reach the bacteria…

…and 5 apical segments, constituting 30% of myocardial mass. The 17 segment model provides the best agreement with anatomic data, as compared with other segmentation…

…is discharged in the ventricles it will spread partly or entirely outside of the conduction system and thus produce a wide QRS complex (QRS duration …

…with regards to measuring ventricular dimensions, trabeculae and papillary muscles are considered part of the left ventricular cavity. Other dimensions– including atrial dimensions, mitral annulus…

…and the same assumption can be made for the other valves. The area is calculated by measuring the diameter of the valve ( area = π …

…the other arm. 2. Ankle pressure. Place the cuff just above the malleoli, with its lower edge about 2 cm above the tip of the…

…subtypes Subtype Typical picture Clinical significance : : : Hyperactive Agitation, motor restlessness, picking, calling out, irritability, hallucinations More easily detected, but accounts for a minority of cases…

…Chronic: more than 90 days. The central clinical danger is progressive aortic wall disruption, rupture and compromise of branch vessels. Type A disease may cause…

…S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization…

Cardiology Interpreting myocardial perfusion SPECT images involves a systematic comparison of rest and stress images to assess myocardial ischemia and infarction. The key steps in…

…to the QRS morphology during LBBB. Stimulation in other regions of the ventricle may result in a different QRS morphology. If the lead tip is…

…in diastole in apical four chamber view. VTI is obtained in the same view with the sample volume placed in the center of the mitral…

…seconds). The QRS complex is wide simply because the ectopic impulses that cause these rhythms spread partially or entirely outside of the ventricular conduction system…

…Always follow the local protocol for exact infusion rates, electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises…

…a systemic corticosteroid if the exacerbation is more than mild. 6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal…

…and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for the prevention of…

…scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular…

…C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…A single central feature is enough to proceed with urgent investigation , and a normal CT of the brain does not exclude an infarction in the…

…NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or duodenal ulcers. Liver cirrhosis. Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy…

…and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and…

…C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression. As the burden of retained…

…aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. 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…

…with homozygous FH typically die from acute myocardial infarction at 20 to 30 years of age. People with familial hypercholesterolemia have no other metabolic aberration…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the…

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

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

…cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In case the ECG or other examinations suggest…

…myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of upper abdominal pain. An…

…1). This is possible by using two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves…

…tomographic images of the left ventricle. In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron, they annihilate each other…

…atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular…

…at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist…

…the bleeding risk of the procedure and by renal function. In markedly reduced renal function (dabigatran at eGFR <30 mL/min, the other DOACs at…

…marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of site The posterior superior…

…plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous…

…margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is…