…coffee ground vomiting or melaena. Haematochezia can occur in massive upper bleeding with rapid intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis…

Echocardiography Myocardial ischemia and infarction Definition and Pathophysiology Stress echocardiography is a functional cardiac imaging technique used primarily to identify inducible myocardial ischaemia and to…

…biological age, frailty, multimorbidity, cognitive status, functional capacity, orthostatic symptoms, and treatment burden. Although older adults are often defined chronologically, age thresholds are intrinsically arbitrary…

…ostia. It remains the reference standard for defining the extent of coronary artery disease because it provides anatomical information while permitting functional assessment and, when…

…epicardial lesion rather than its anatomical appearance alone. Coronary angiography provides only an imperfect estimate of functional severity. Angiographic interpretation is affected by interobserver variability…

…Cigarette smoking is a prominent association, whereas other conventional coronary risk factors may be absent. The condition is more prevalent in Japan and South Korea…

…recurrent symptoms, myocardial infarction, or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular…

…the physiological significance of selected stenoses using fractional flow reserve (FFR) and instantaneous wave free ratio (iFR). Other invasive techniques can quantify coronary flow reserve…

…Coexisting multivessel disease The extent of jeopardized myocardium Left ventricular systolic function Diabetes and other comorbidities Anatomical complexity and completeness of possible revascularization A proximal…

…also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention. Clinical assessment should include functional status and walking capacity…

…environmental factors and genetic background. Thrombotic susceptibility is likewise affected by inflammation and other systemic influences. The severity of myocardial injury is determined not only…

…to the posterior and inferior walls of the left ventricle. Anatomical or functional block in the anterior fascicle leads to left anterior fascicular block. Similarly…

…there is a discrepancy or uncertainty. Intravenous thrombolysis within 4.5 hours improves functional outcome in properly selected patients. Tenecteplase 0.25 mg/kg is…

…organ damage. Isolated malignant retinopathy without other acute organ damage can often be treated more cautiously with oral drugs under careful observation [3,4]. A…

…is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial…

…and up to 5–75% of CT series; other angiographic descriptions report rates of approximately 5–10%, while fewer than 5% of otherwise normal angiograms…

…Coronary vasomotor disorders may involve epicardial spasm or abnormalities of the coronary microcirculation. Microvascular angina reflects myocardial ischaemia caused by structural or functional microvascular abnormalities…

…tomography (PET) is a radionuclide based method for assessing regional myocardial blood flow, inducible ischaemia, myocardial scar, ventricular function, and, in selected circumstances, myocardial viability…

…its most severe form, known as no reflow, structural and functional impairments sustain vascular obstruction. Endothelial dysfunction triggers leukocyte and platelet activation, while thrombotic debris…

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

…devoid of CO 2 . Phase II (Rapid Expiration) : Represents the transition of air from anatomical dead space to functional alveolar space. Phase III (Alveolar Plateau…

…test, exercise stress ECG) Exercise stress testing has been used routinely for over 60 years to evaluate cardiopulmonary function and to diagnose cardiovascular disease. The…

…graft; in such cases, clinical manifestations may be less dramatic despite a sudden deterioration in function. The severity of tissue injury depends on the site…

…insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational diabetes Small for gestational age delivery Placental abruption Pregnancy loss Polycystic ovary syndrome Functional hypothalamic amenorrhoea…

…Chronic coronary syndromes (CCS) comprise the clinical manifestations of chronic structural and/or functional disease involving the epicardial coronary arteries and/or the coronary microcirculation…

…from a previous value of at least 50%. A patient with persistently mildly reduced systolic function. This dynamic nature makes prior imaging particularly important when…

…Historically, revascularization was considered capable of improving LV systolic function and prognosis by restoring perfusion to viable dysfunctional myocardium while preventing further ischemic events. However…

…In order to analyze myocardial motion, the ultrasound system must filter out all sound waves reflected by other structures, notably sound waves reflected by blood…

…with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance. Synthetic function and prognosis…

ECG Interpreting pacemaker ECGs Assessing pacemaker function requires knowledge of the mode of pacing, and careful analysis of ECG tracings. Most modern devices are capable…

…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…

…Information about concurrent ticagrelor treatment is required for interpreting platelet function tests for HIT. Other cosiderations Based on a relationship observed in the PLATO study…

…pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months and have health implications…

…haemodynamic instability, anaemia and other nephrotoxic exposures may contribute to tubular injury, making attribution to contrast alone difficult. In patients with normal renal function, the…

…and treatment goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…kidney injury, AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine value alone but by the course, urine…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…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…

…acute HMOD, although other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence of ongoing acute organ injury is decisive. The pathophysiology…

…of one or both ventricles. Dilation of the left ventricle is virtually always accompanied by impaired left ventricular systolic function. It should be noted that…

…radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect…

…become cheaper, more portable, more powerful, equipped with an increasing number of methods to interrogate organ structure and function. Ultrasound imaging, including echocardiography, has become…

…foundation for understanding subsequent chapters. SCA (Sudden Cardiac Arrest) : Sudden and unexpected cardiac arrest with loss of mechanical cardiac function. Results in loss of consciousness…

…of the procedure and by renal function. In markedly reduced renal function (dabigatran at eGFR <30 mL/min, the other DOACs at eGFR <15 mL…

…h, or anuria ≥ 12 h Other kidney related values The fractional excretion of sodium (FENa) = (urine Na × plasma creatinine) / (plasma Na × urine creatinine) × 100…

…8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist for patients with AF, including HAS BLED…

…is an acronym that stands for: H ypertension A bnormal renal/liver function S troke B leeding history or predisposition L abile INR (International Normalized…

…1 point) M alignancy (1 point) O lder age ( 75 years) (1 point) R educed platelet count or function (1 point) R e bleeding risk…

…Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory…

…vegetables, nuts and legumes; unsaturated fatty acids and other bioactive compounds from nuts; and antioxidant and antithrombotic constituents from whole grains. These combined effects may…

…although radiofrequency procedures, nerve stimulators, and other electronic equipment may also interfere with device function. The clinical consequences depend on the device, the patient's…

…Other guideline formulations similarly define resistant hypertension as blood pressure above goal despite three or more antihypertensive drugs from different classes at maximally tolerated doses…

…which may originate from other branches of the same coronary artery or another coronary artery, will alleviate the ischemia, improve myocardial function and increase resistance…

…generally performed in order to evaluate ventricular function, since it may affect the choice of device therapy and also suggest whether other interventions (e.g…

…structures (discussed in detail in Chapter 1): Specific clusters of atrial myocardium : There are clusters of atrial myocardium that possess automaticity and thus pacemaker function…

…This is also a normal finding. Abnormal (pathological) causes of sinus bradycardia In all other situations, sinus bradycardia should be regarded as a pathological finding…

…excellent, with the vast majority of patients recovering completely after restoration of sinus rhythm (or any other rhythm with normal ventricular rate and activation). Recovery…

…atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular…

…fingers, tendon sheaths Deep compartments and tendon sheaths, loss of function Orthopaedic or hand surgeon, urgently Perianal and perirectal Often larger than it appears; risk…