…Definition and clinical concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of acute…

…Assessing the haemodynamic significance of lesions whose angiographic severity is uncertain. Supporting decisions regarding revascularization and, in selected patients, identifying microvascular or vasomotor coronary disorders…

…stopping statins. There are three main questions discussed in media, blogs and on social plattforms: Is high cholesterol a true cause of coronary artery disease?…

…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…

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…

…and whether the other variable lies within the expected range of compensation. Sample type and baseline values An arterial blood gas is the reference method…

…selected congenital heart diseases, pulmonary arterial hypertension and thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected heterozygous individual…

…lipid, or BP disorders Pregnancy Established ASCVD includes previous acute coronary syndrome, chronic coronary syndromes, coronary revascularization, stroke, transient ischaemic attack, and peripheral arterial disease…

…costochondritis, and gastrointestinal disorders. Radiation of discomfort to the trapezius ridge is not seen in STEMI and suggests pericarditis instead. Pain is not uniformly present…

…lithium, thiazide administration, and over supplementation of calcium and vitamin D. ECG in hypercalcemia Typical ECG changes: Shortened QT interval. Attenuated T wave amplitude. Prolonged…

…patterns in detail. Physical manifestations Tendinous xanthomas, particularly over extensor tendons, are characteristic clinical manifestations of untreated FH and may develop when the disorder is…

…with the electronics in the pulse generator or dislodgement or fracture of the leads. External causes are less common and include electrolyte disorders, metabolic disorders…

…CABG) Types 4b and 4c fulfil the criteria for type 1 MI because they represent coronary atherothrombotic events in the setting of a stent thrombosis…

…local and systemic disorders. Accumulation of fluid in the pericardial space may lead to increased intrapericardial pressure, which in turn affects ventricular relaxation (and thus…

…Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing bleeding risk. Monitor coagulation…

Cardiology Endocrinology & metabolism Definition and pathophysiology Primary aldosteronism (PA), also termed primary hyperaldosteronism or Conn syndrome, comprises disorders in which aldosterone secretion is inappropriately increased…

…diseases, including systemic lupus erythematosus and rheumatoid arthritis, are important risk enhancing conditions and are more prevalent in women. Chronic kidney disease and several other…

… rather, it is an indicator of increased cardiovascular risk and a setting in which secondary hypertension is relatively common. Patients presumed to have resistant hypertension…

…Other life threatening cardiopulmonary conditions account for approximately 5% of presentations in some populations. Despite this relatively low prevalence, missed myocardial infarction remains consequential, and…

…Electrolyte disorders, acidosis, hypoxemia and ischemia all aggravate the risk of developing ventricular fibrillation, in any situation. ECG features of ventricular fibrillation The ECG shows…

…2010 ). At the time of J 60 and J 80, there is minimal chance that there are any electrical potential differences in the myocardium. Current…

…may also present in individuals without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine…

…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…

…be classified as idiopathic if no cause can be identified. Idiopathic ventricular tachycardia has a more favorable prognosis, as compared with other forms of ventricular…

…those in Brugada syndrome. This disorder is easy to diagnose with a simple blood test and the ST segment elevations resolve after normalization of potassium…

…and herpes zoster pain are other considerations when assessing chest pain [2]. Autoimmune/Malignancy: A history suggesting an autoimmune disorder or known malignancy may suggest…

…is often used in combination with meprobamate for the treatment of sleep disorders. <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Aceprometazine+AND+(%22QT…

…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…

…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…

…use disorder and planned follow up , not merely detoxification. Benzodiazepines reduce the severity of withdrawal and the risk of seizures and delirium [1,2]. In…

…physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient…

…to electrolyte imbalance (electrolyte disorder) The normal cardiac action potential may be altered by electrolyte imbalance, owing to changes in intra and extracellular electrolyte concentrations…

…a disorder of water balance. The plasma sodium reflects the ratio between the body's exchangeable sodium and potassium and the total body water. In…

…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…

…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…

…on baseline cardiovascular risk and the magnitude of LDL C reduction. Thus, even a modest absolute reduction may be clinically important in individuals at high…

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…

…NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical…

…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…

…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…

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

…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…

… 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…

…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…

…Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the kidneys, retina, and brain…

…epicardial coronary arteries. It frequently coexists with left main coronary artery disease, diabetes mellitus, left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse…

…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…

…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…

ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

Echocardiography Continuous Wave Doppler In continuous wave Doppler (CW Doppler), ultrasound waves are continuously emitted from the transducer and the reflections of these waves are…

…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…

…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…

…more reliable (the risk of cardiac arrest is considerably lower). Moreover, ventricular escape rhythms are slow, resulting in reduced cardiac output and risk of hypoperfusion…

…from a BMI of 23 and obesity from 27.5, because cardiometabolic risk appears at a lower BMI. BMI is misleading in athletes with a…

…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…

…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…

…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…

…front , and this is why the margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis…

…obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked…