…Ultrasound also shows the depth of the cavity and its distance to vessels. Contraindications and when to involve a surgeon The following locations must not…

…may be described as ripping, tearing, sharp or stabbing. Its location and radiation may reflect the segment of aorta involved, although the source material does…

…morphology and location, comorbidities, environmental factors and genetic background. Thrombotic susceptibility is likewise affected by inflammation and other systemic influences. The severity of myocardial injury…

…coronary microvascular dysfunction, also contributes to the extension and severity of ischemic injury. In its most severe form, known as no reflow, structural and functional…

…or another form of physiological stress, but it may also occur at rest or remain clinically silent. The underlying coronary disease may be obstructive or…

…overdose. Tumour lysis syndrome appears as an indication in older protocols but is no longer routinely recommended — alkaline urine increases the precipitation of calcium phosphate…

…ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source…

…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…

…It is the most common form of secondary hypertension. Aldosterone acts principally through the mineralocorticoid receptor (MR). After entering target cells, it binds the MR…

…pillow to place under the shoulders as an alternative to a hanging head. Frenzel goggles or video Frenzel if available — small beats of nystagmus can…

…permit identification of foamy macrophages. The occurrence of neoatherosclerosis helps explain why ISR and other stent related events may arise well after the initial intervention…

…that many visitors are interested in other books and online resources, we have plowed through more than 30 of the most popular ECG books (according…

…this form of hypertension was a physiological reaction that was necessary to maintain normal hemodynamics, hence the term essential . However, a growing body of science…

…22 above 70 years, and reduced food intake together form the basis of most screening instruments and should prompt a nutritional assessment. See also unintentional…

…Syncope is particularly important as a marker of potentially severe disease. The presence of haemodynamic instability places the patient in the high risk category and…

…dysfunction Promotion of vascular calcification Albuminuria and proteinuria Neurohormonal activation Plasma volume expansion Myocardial remodelling and fibrosis These processes form part of the broader cardiovascular…

…Those of us who have read guidelines may agree with those viewpoints. Going through some guidelines the other day I realized that they are indeed…

…although the clinical importance of improved adherence remains dependent on sustained follow up and administration. Clinical indications and place in therapy Inclisiran has been approved…

…contraction) of the ventricles. Although it may not always include a Q wave, R wave and S wave, it is still referred to as a…

…of the stent, stent diameter less than 3 mm, long stent length Large thrombotic burdens increase procedural risk because thrombus can fragment, embolize to other…

…emerged as the preferred biomarkers because they are extremely sensitive and specific for myocardial injury. Elevated levels of cardiac troponins is firm evidence of myocardial…

…In the majority of cases, the arrhythmia is self limiting; however, it may recur and, in some instances, persist for extended durations. As for any…

…It manifests in the form of sudden prolongations in the P P interval (without relation to respiration). Approximately half of all newborns exhibit sinus pauses…

…mm and it resolves rapidly once the exercise is stopped. Some experts believe that these ST segment depressions represent a benign form of subendocardial ischemia…

…the spectral curve and indicates how far blood travels during the flow period. VTI can be used for various volume calculations, such as calculation of…

…kidney disease and several other comorbidities also contribute to the disproportionate cardiovascular burden in women. Depression and anxiety are approximately twice as prevalent in women…

…factors. Plaque erosion Plaque erosion is increasingly recognized and is present in at least one third of acute coronary syndromes in the cited material. Eroded…

…airway) should be established as early as possible. Airway management should not interrupt compressions for more than 5 seconds. The effect of cricoid pressure and…

…treatment of VT is considered one of the greatest advances in cardiology. Until 1961, patients with acute myocardial infarction were placed in beds located far…

…the form of a sound wave. If the sound waves encounter a new medium, some sound waves will be reflected while others will transfer the…

…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…

…and other sedating drugs. Thromboembolic risk, for example immobilisation, cancer and previous venous thromboembolism. A documented decision on the ceiling of care. Signs of a…

…and are at high risk of a new event. Treatment can be started without interruption as continuation treatment after the initial one year treatment with…

…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…

…a therapeutic objective. LDL C as the primary treatment target Current lipid management frameworks place LDL C at the centre of treatment. Lifestyle intervention is…

…diagnosis at a non PCI hospital to wire crossing As quickly as possible, primary PCI if the total expected time is 120 minutes or less…

…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…

…administered as soon as possible in the absence of contraindications, using a loading dose followed by maintenance treatment. The source material does not specify the…

…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…

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

…operative assessment, or evaluation of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of severe asymptomatic stenosis is low, screening has…

…Relevant predispositions, such as connective tissue disease. No single pain descriptor is diagnostic. The severity of pain also has limited discriminatory value. Features suggesting myocardial…

…cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However, association is not the same as causation . A…

…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…

…other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator or institutional experience Assessment of coronary complexity The…

…The haemodynamic consequences depend on lesion location, severity, length, the presence of multilevel disease and collateral circulation. Flow limitation may be clinically silent, manifest as…

…is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective…

…as compared with atrial fibrillation, atrial flutter is not capable of persisting for longer periods of time. This is due to the fact that atrial…

…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…

…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…

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

…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…

…three explanations as to why reciprocal ST segment depressions may be absent: There is no ECG lead with the opposite angle of observation. The injury…

…most often not equal (which makes the PR interval appear as varying). Management of third degree AV block Please refer to Management of AV Blocks.

…50 Dose reduction as in the table above for rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible…

…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…

…of infection. Indications Infusion of vesicant solutions: vasopressors, concentrated potassium, cytotoxic drugs, parenteral nutrition. The need for several simultaneous, incompatible infusions. Haemodialysis, plasmapheresis or other…

…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…

…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…