…bacteria. Endocarditis can lead to the destruction of the valvular apparatus, as well as to embolization in the systemic circulation. The complications can be fatal…

…with fewer vascular and bleeding complications than femoral access. In patients with acute coronary syndrome, randomized evidence has demonstrated lower rates of access site bleeding…

…intake, body weight, male sex and salt intake. Population blood pressure increases in parallel with economic development and industrialization. The increasing prevalence of obesity, diabetes…

…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…

…hours ( Soar et al ). The causes of death among these patients are complications related to PACS: 60% die from neurological injuries. 30% die from hemodynamic…

…from out of hospital cardiac arrest should not routinely undergo immediate angiography. A selective or delayed approach is recommended in this setting unless other findings…

…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…

…CHA₂DS₂ VASc score. As of 2025, it is recommended to use the CHA₂DS₂ VA score for stroke risk assessment in atrial fibrillation patients. By excluding…

…this score aids clinicians in estimating the risk of bleeding complications due to anticoagulants. Components of the ATRIA Score The ATRIA score assigns points based…

…Prophylaxis against recurrence of cerebrovascular disease: 75–80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…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…

…shock most commonly reflects severe left ventricular (LV) dysfunction, accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect…

…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…

…years of age. Hypertension related left ventricular hypertrophy, concentric remodelling, reduced longitudinal strain and heart failure with preserved ejection fraction are more frequent in women…

…necrosis of small arteries in the kidneys, retina, and brain. Its clinical retinal signature includes flame haemorrhages, cotton wool spots, and papilloedema. Associated complications may…

…risk of recurrence. Atrial fibrillation in other circumstances (particularly those listed above) is usually a progressive disease. Complications of atrial fibrillation and available treatments In…

…affect organs other than the brain. Patients with AF in the setting of ACS have more comorbidities and a higher risk of complications than patients…

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

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

…risk of complications calls for careful consideration of contraindications. Contraindications may be absolute or relative. Briefly, exercise stress testing must not be performed in the…

…HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD with associated cardiovascular complications Symptoms are determined by…

…induces expression of aldosterone responsive genes. Although the kidney is a major target—where MR activation promotes sodium transport—MRs are also present in cardiac…

…vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia. The resulting abnormalities in left ventricular…

…nucleus that often exhibits cavities, which consist of hemorrhages in the tumor. Polypoid myxoma usually causes haemodynamic complications due to obstruction. Papillary myxomas are small…

…anatomy is suitable. In cardiogenic shock, the principal precipitating mechanisms include ischaemia related heart failure, acute severe mitral regurgitation, and other mechanical complications. Shock occurs…

…first year after stenting, although the risk is higher after treatment of ST segment elevation myocardial infarction (STEMI) and following complex PCI. Stent thrombosis remains…

…if there is suspicion of cervical spine injury, in which scenario head tilt chin lift should only be used if other methods fail to open…

…myocardial infarction A diagnosis of myocardial infarction is based on the following three components: Cardiac troponins – Elevation of cardiac troponins in peripheral blood is mandatory…

…determined solely by the apparent frequency or duration of documented episodes. The central therapeutic objective is prevention of thromboembolic complications, particularly stroke. In untreated AF…

…bleeding risks in AF patients, regardless of the type of oral anticoagulant used. Studies have shown that it performs similarly or superiorly to other bleeding…

…In many cases, the renal injury probably represents acute tubular necrosis arising from the combined effects of contrast exposure and other ischaemic or nephrotoxic stresses…

…hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick reference for dosing in impaired renal function. Respiratory tract…

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

…on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic…

…a summary of the indications, contraindications, dosage, administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination…

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

…particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance or metabolic syndrome Elevated triglycerides Low or apparently well controlled LDL C…

…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…

…heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast not recommended [1,5]. STEMI…

…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…

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

…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…

…the clinical importance of non fatal gastrointestinal and intracranial haemorrhage is substantial, particularly because the absolute cardiovascular benefit is small in many primary prevention populations…

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

…although some series report 10–20%. Other life threatening cardiopulmonary conditions account for approximately 5% of presentations in some populations. Despite this relatively low prevalence…

…1960s. In 1948 the NHLBI initiated the Framingham Heart Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were…

…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…

…multivessel disease is present in approximately 80% of patients. Evaluation and clinical assessment Clinical factors influencing treatment selection The following characteristics favour CABG when clinically…

…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…

…ECG In case the ECG or other examinations suggest left ventricular hypertrophy (LVH), one should suspect concomitant right ventricular hypertrophy (RVH) if the following ECG…

…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…

…transducer during systole (systole starts at the peak of the R wave on the electrocardiogram). This Doppler signal represents a pronounced mitral regurgitation. In summary…

…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…

…atypical of ischemia, but they do not rule out ischemia. Other features of ischemic ST segment elevations In STE ACS (STEMI) the level of the…

…and AV block 3 In case the distinction between second degree AV block and third degree AV block is difficult, the following rules may be…

…of the upper arm < 23 cm suggests undernutrition in adults Calf circumference Largest circumference < 31 cm is a screening marker for sarcopenia Body…

…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…

…of the specimen — an aspirate that clots before the smears are made is unusable, no matter how well the puncture went. Indications Unexplained cytopenia in…

…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…