…first sign of skin rash, mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance…

…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…

…ask which of the pCO₂ and the HCO₃ deviates most. What matters is which change can explain the pH, and whether the other variable lies…

…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…

…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…

…In apparently healthy individuals, SCORE2 and SCORE2 OP estimates can be used to classify 10 year risk as follows: Risk category 10 year risk of…

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…

…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…

…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…

…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…

…10% of patients presenting with myocardial infarction in other reports. It is more frequent in women and in patients presenting with NSTEMI than in those…

…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…

…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…

…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…

…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…

…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…

…by the accumulation of lipid and inflammatory cells within the arterial intima. Monocytes enter the intima, differentiate into macrophages and participate in a sustained inflammatory…

…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…

…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…

…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…

…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?…

…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…

…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…

… 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…

…or respiratory distress. In patients with HFpEF, acute hypertension is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive…

…recovery and lower initial morbidity than CABG, with lower stroke rates, but it is associated with less complete revascularization, less durable relief of angina in…

…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…

…lowest rib and the iliac crest, at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement…

…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…

…Clean the skin and apply the drape. Anaesthetise skin, subcutaneous tissue and then the periosteum at several points around the puncture site , and wait a…

…a high frequency linear probe, a sterile probe cover and sterile gel. Chlorhexidine in alcohol 5 mg/mL for skin disinfection. Allow it to air…

…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…