…does not by itself identify the cause. The result must always be weighed together with the clinical picture, medication, fluid balance, renal function, electrolytes and…

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

…fracture of the leads. External causes are less common and include electrolyte disorders, metabolic disorders, hypoxemia, antiarrhythmic drugs, or electromagnetic disturbance caused by other machines…

…managed as chronic hyponatremia. Degree of hyponatremia P/S Na + Common effects Mild 130 125 mmol/l Cognitive disorders, vertigo, balance disorder. Moderate 115 125…

…resistance. Hypokalaemia should not be permitted when assessing dietary electrolyte intake, because it can increase blood pressure and may affect interpretation of the clinical picture…

…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…

…after reperfusion in an occluded coronary artery. It also occurs as side effect of drugs, hypoxia, myocarditis and electrolyte disorders. Because the rate (60–100…

…electrolyte disorders , congenital heart disease and catecholamine induced ventricular tachycardia . The vast majority of patients with ventricular tachycardia either have coronary artery disease (ischemic heart…

…primary and secondary. Primary and secondary ST T changes Primary ST T changes are caused by abnormal repolarization . This is seen in ischemia, electrolyte disorders…

…the severity of electrolyte imbalance and the visible ECG changes. Specific electrolyte disorders 1. Sodium Increased (hypernatremia) and decreased (hyponatremia) sodium levels do not have…

…cTn alone does not establish MI, because myocardial injury may occur without myocardial ischaemia. Non ischaemic myocardial injury may accompany numerous cardiac and systemic disorders…

…hypertension and thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting…

…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…

…risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease, hay fever, or nasal polyps (increased risk of hypersensitivity…

…adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast…

…macrophages, neurons and other tissues. This distribution helps explain why PA produces cardiovascular injury beyond its effects on blood pressure and potassium balance. The principal…

…reproductive and pregnancy related history. Female specific or female predominant factors associated with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of…

…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…

…injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin…

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

…These disorders require distinction from true MINOCA because their management is different. Takotsubo syndrome and myocarditis should not be classified as MINOCA when they are…

…without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. EAT typically has an…

…highly malignant disorder that must be recognized by any health care provider. A family history of any of the above listed symptoms and manifestations must…

…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…

…of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial disease, and…

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

…discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective is not merely…

…vasoconstriction, adhesion of circulating cells, inflammatory cell entry into the intima, and thrombus formation. Atherosclerosis is therefore not simply a disorder of lipid storage. Its…

…of dissection and impaired distal flow. These alternative causes must be distinguished from isolated no reflow because their treatment may require immediate stenting or other…

…are characteristic clinical manifestations of untreated FH and may develop when the disorder is not recognized early in life. Corneal arcus and xanthelasma can also…

…at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not merely detoxification…

…is therefore always part of the initial stroke assessment [1]. Treat immediately when there are symptoms and a low glucose. Do not wait for the…

…and media reach out to billions of individuals worldwide. They exert enormous influence over their visitors daily lives. However, media outlets and bloggers are not…

…Q waves and guidelines do not state any ECG criteria specific to R wave progression. Figure 1. Pathological R wave progression is indicative of previous…

…other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive ventilation is not…

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

…reflects the concentration of circulating atherogenic particles because each apoB containing particle carries one apoB molecule. LDL C, non HDL C and apoB are usually…

…Thus, supply and demand are balanced and no ischemia occurs. (Some individuals display a benign form of ischemia located in the subendocardium during exercise; this…

…risk of arrhythmia. 4. Take a full blood count, electrolytes, creatinine, glucose, high sensitivity troponin and, where needed, coagulation tests. Blood sampling must not delay…

…history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks of vertigo, seconds…

…the absence of contraindications, using a loading dose followed by maintenance treatment. The source material does not specify the loading dose. Efficacy and harms In…

…low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non HDL C provides a broader estimate of atherogenic cholesterol than LDL C alone…

…one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary…

…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…

…ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies designed mainly around bleeding outcomes may not reliably…

…and drug related presentations Severe hypertension may result from phaeochromocytoma, monoamine oxidase inhibitor crisis, cocaine intoxication, or other sympathomimetic exposure, including methamphetamine. Abrupt withdrawal of…

…do not prevent the development of new proximal atherosclerosis. The choice between procedures therefore depends on the balance between: Anatomical completeness and complexity of revascularization…

…between 250 and 350 beats per minute (which is slower than the atrial rate in atrial fibrillation). The atrioventricular node is not capable of conducting…

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

…80% of men display ST segment elevations that are not caused by ischemia and a significant proportion have ST T changes caused by other pathological…

…sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves. The cardinal difference between continuous wave Doppler and…

…annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect these gamma rays to construct images with high spatial and temporal…

…currents are not strong enough to be detected on leads with opposite angle of observation. Other vectors may interfere with the injury currents, and inhibit…

…AV block because atrial and ventricular rates are most often not equal (which makes the PR interval appear as varying). Management of third degree AV…

…at the level of the individual: it does not distinguish muscle from fat and takes no account of fat distribution. Waist circumference and the waist…

…call coagulation service Always in parallel: mechanical control of bleeding, tranexamic acid where it is not contraindicated, and contact with the on call coagulation service…

…cytometry and genetics, while the biopsy shows marrow architecture and cellularity. What usually ruins the examination is not the technique but the handling of the…

…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…