…the result of a perfect storm scenario , where ischemia, hemodynamics, the autonomous nervous system, electrolyte concentrations, and other factors (potentially also genetic predisposition) interact to…

…Irradiation. Trauma. The most common cause of pericardial effusion is pericarditis. Because it is difficult to determine if there is also myocarditis (which is frequent)…

…each other, the term perimyocarditis is often used. Image by Bruce Blausen, Blausen Gallery 2014. Causes of acute pericarditis/myocarditis The most frequent cause of…

…circulating LDL C. The principal genetic mechanisms involve: Loss of function variants in the LDL receptor gene, LDLR, which account for most cases. Variants in…

…not distinguish different types of dilated cardiomyopathy. Other causes of ventricular dilation ( e.g ischemic cardiomyopathy) must be excluded before establishing a diagnosis of DCM…

…used in adults aged ≥70 years. SCORE2 OP accounts for the competing risk of death from non cardiovascular causes, an important consideration in older populations…

…is the most common cause). Genetic mutations in ARVC At least 13 genes have been implicated in ARVC. The majority of these are genes encoding…

…and be detected randomly when investigating other conditions. More dramatic onset of symptoms can be seen in arrhythmogenic tumors of the myocardium; in these cases…

…that cause pronounced symptoms and other therapies have failed. Patients with structural heart disease or reduced left ventricular function are not eligible. Effects of propafenone…

…of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease. It combines a structured family history, clinical evaluation, cardiac investigations, genetic…

Cardiology Genetic and miscellaneous conditions Definition and classification Coronary anomalies are congenital abnormalities involving the origin, course, distribution, or termination of the coronary arteries. They…

…segment elevations in leads V1–V3. Prevalence and genetics of Brugada syndrome The prevalence of Brugada syndrome remains largely unknown. Available data suggest that it…

…management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease (ASCVD). This causal relationship is supported by genetic…

…current ($I {Na}$) and are identified in 20% to 30% of probands [7] . Historically, expanded genetic panels implicated over 20 other genes (e.g.…

…a true cause of coronary artery disease. What is the evidence? The evidence is vast. Some examples follow. Consider people with the genetic disorder familial…

…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…

…with better discrimination. The missing ingredient has been a training set large enough to link raw waveforms to reliable cause of death data. The current…

…is only of relevance to researchers in electrophysiology and arrhythmology. Regarding the risk of ventricular fibrillation, it is believed that early repolarization is caused by…

…drinking in either sex. Other definitions of unhealthy drinking include at least two drinks daily in women or three in men, or at least four…

…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…

…G enetic factors (e.g., CYP2C9 variants) (1 point) E xcessive fall risk (1 point) S troke (1 point) HEMORR₂HAGES Score Risk category Incidence of…

…It may be broken, as in Figure 1 . Any type of infarction may cause pathological R wave progression. However, the specificity for pathological R wave…

…Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood…

…and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for the prevention of…

…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…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

Procedurer Benign paroxysmal positional vertigo is the commonest cause of vertigo in primary care and one of the few diagnoses that can be cured on…

…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…

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…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…

…reduce cardiovascular or all cause mortality. Reported relative effects include: Approximately 11% reduction in cardiovascular events in a meta analysis of primary prevention trials involving…

…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…

…The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome (ACS). Other cardiopulmonary causes …

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…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…

…left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures…

…the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic…

…and cardiovascular rationale Smoking cessation is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible, other inhaled nicotine products…

…or days. In the vast majority of cases, the re entry circuit in atrial flutter is located in the right atrium and it typically loops…

…cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In case the ECG or other examinations suggest…

…be caused by myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of upper…

…1). This is possible by using two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves…

…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…

…However, one must be careful. There are plenty of cases of transmural ischemia presenting with concave ST elevations. Moreover, the ST segment may have a…

…unreliable, such that they may cease and thus cause cardiac arrest. Junctional escape rhythm is more reliable (the risk of cardiac arrest is considerably lower)…

…at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist…

…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…

…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…

…margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is…

…high grade AV block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability…

…diverticulitis and pancreatitis, antibiotics are given only in certain more severe cases. CNS and other Diagnosis Agent Dose Duration : : : : Bacterial meningitis, initial therapy (after corticosteroid…

…a normalisation can therefore cause cerebral, coronary or renal ischaemia. Neurological status, urine output, creatinine, acid–base status and signs of myocardial ischaemia must be…

…palpitations hunger anxiety pallor paraesthesiae Neuroglycopenic symptoms An inadequate supply of glucose to the brain can cause: difficulty concentrating irritability or abnormal behaviour slurred speech…

…1. Assess airway, breathing and circulation. 2. Assess the neurological symptoms and at the same time exclude other acute causes, for example hypoglycaemia, poisoning, stroke…

…commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome, haemolysis The R value = (ALT / upper limit of normal) / (ALP / upper limit of…

…pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response…

…tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which…

…Kenacort T) has been out of stock for a long period — check local availability. Betamethasone (Betapred 4 mg/mL) is water soluble and short acting…

…small cuts cause burning pain. 2. Position the pads, preferably anteroposteriorly : one anteriorly over the praecordium to the left of the sternum, the other on…

…Heart failure, pulmonary oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic…