…myocardial injury , demonstrated by a rise and/or fall in cTn with at least one value above the 99th percentile URL; and Clinical evidence of…

…anatomically according to involvement of the ascending aorta: Stanford type A: involves the ascending aorta, with or without extension into the arch or descending aorta…

…as compared with 4.5% among patients without evidence of myocardial injury (normal troponin I levels). Hence, troponin I was a strong predictor of survival…

…failure, and heart failure have been identified as important risk factors. Severe atherosclerosis of the axillary or subclavian arteries may increase the risk of embolization…

…requiring dialysis is uncommon except in the presence of substantial pre existing CKD, particularly when congestive heart failure or other causes of ischaemic AKI coexist…

…in three minutes, without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment…

…there are generally no reliable and safe drugs available for long term heart rate augmentation without undesirable side effects. Drugs, With Doses and Practical Co

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

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

…heart, aorta, kidneys, or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small…

…Subclinical cerebral injury may contribute to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS…

…when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of acute PE comprises four clinically useful groups: High…

…for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral regurgitation…

…of acute or chronic heart failure are often better categorised as myocardial injury. Clinical Presentation and Symptoms Patients with Type 2 MI frequently present with…

…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…

…Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis…

…UA) is an acute coronary syndrome characterized by myocardial ischaemia occurring at rest or with minimal exertion, without evidence of acute cardiomyocyte injury or necrosis…

…sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy. The cardiovascular implications of lower alcohol intake remain…

…of those with resistant hypertension. It is also more frequent with increasing blood pressure severity. Hypokalaemia is highly suggestive when present, particularly if spontaneous or…

…the abnormality through increased myocardial contractility and heart rate. Coronary compression and a Venturi or “suction” effect have been proposed as mechanisms of inducible ischaemia…

…patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with vasculitis Individual assessment…

…platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes thrombogenic material, promoting platelet activation…

…elevations on ECG. ST elevations are the hallmark of STEMI. However, there are situations with transmural ischemia that do not yield ST elevations. It is…

…output can change before creatinine but is not a pure marker of filtration. Oliguria may be due to hypovolaemia, shock, obstruction or advanced renal injury…

…ROSC or initiation of ECMO. The syndrome was first described by Negovsky , who identified four processes that defined the victim's outcome: Neurological injury Myocardial…

…and atypical disease Fewer than half of patients with PAD have typical symptoms. Many have impaired walking or a slow gait without describing classic claudication…

…acute aortic dissection, thrombosis of a graft or aneurysm, popliteal artery entrapment, trauma, phlegmasia cerulea dolens, ergotism, hypercoagulable states or iatrogenic vascular injury. Acute occlusion…

…in which the patient has symptoms suggestive of acute coronary syndrome (ACS), biochemical evidence of myocardial injury with corroborating evidence of infarction caused by ischaemia…

…mellitus and increases with age. STEMI may present as sudden onset breathlessness. Other less common presentations, with or without pain, include sudden loss of consciousness…

…pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of…

…specifically at reperfusion injury have not generally demonstrated sufficient clinical benefit for routine use. No reflow may also occur in association with other procedural complications…

…either symptoms or ECG changes consistent with myocardial infarction/ischemia. Most patients, however, display both ECG changes and symptoms. Troponins and other biomarkers of myocardial…

…cotton wool spots or papilloedema. Intravenous treatment is required if there is concomitant acute life threatening organ damage. Isolated malignant retinopathy without other acute organ…

…minority of patients presenting with acute chest pain ultimately have ACS; reported rates are generally 5–10%, although some series report 10–20%. Other life…

…electrocardiographic sign of acute pericarditis, reflecting pericardial involvement overlying the atria [4, 5]. Other Differential Diagnoses ST segment elevations simulating acute ischemia or infarction may…

…of inert cholesterol debris, modern vascular biology has redefined atherosclerosis as a dynamic, immune mediated fibroproliferative response to endothelial injury [2] . The process initiates with…

…in people with diabetes and becomes more common with advancing age. Presentations without pain may include: Sudden breathlessness Syncope or sudden loss of consciousness Confusion…

…part of the target range. Paraquat poisoning — oxygen worsens the lung injury. Discuss with your national or regional poison control centre. An open flame or…

…adults Cystatin C based eGFR With an atypical muscle mass, or to confirm a creatinine based value The mean of creatinine and cystatin C The…

…of neoatherosclerosis helps explain why ISR and other stent related events may arise well after the initial intervention. Mechanical mechanisms Mechanical abnormalities may initiate or…

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

…A patient with BPPV is usually relatively free of symptoms between the brief attacks. Lying down, turning over in bed or looking up triggers a…

…of the abscess or at least half its diameter. Too small an incision is the commonest technical error. 4. Cut straight into the cavity with…

…if there is suspicion of cervical spine injury, in which scenario head tilt chin lift should only be used if other methods fail to open…

…course (no more than 7 days) may be given to selected patients with an eGFR of 30 40 mL/min for lower urinary tract infection…

…ileus or suspected perforation Gastric lavage An unprotected or unsecured airway in a patient with a reduced level of consciousness Gastric lavage Corrosive injury or…

…of fragmented QRS complexes ( Figure 2 ) are as follows: QRS complex with more than 1 R wave and/or notch in the descending limb of…

…antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent…

…for patients who had coronary syndrome and are at high risk of developing a new event. Administration Ticagrelor can be administered with or without food…

…from: Incomplete penetrance of a variant inherited from a parent. A de novo variant. Less commonly, autosomal recessive inheritance. X linked or other non autosomal…

…years without diabetes and with LDL C between 70 and 189 mg/dL, 10 year risk of a first hard ASCVD event—fatal or nonfatal…

…because of the severe reduction of coronary flow caused by acute atherothrombosis. Table 1: Myocardial and ECG reaction in various settings with ischemia or increased…

…particularly with continuing ischaemia, heart failure, electrical instability or a large area of myocardium at risk. Over 48 hours: urgent PCI is still indicated with…

…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…

…more closely associated with cardiovascular risk than LDL C in many studies, although the relative advantage of apoB over non HDL C or standard lipid…

…drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be prescribed routinely to individuals without established ASCVD…

…with carotid stenosis have no focal neurological symptoms. Asymptomatic disease may be discovered during targeted duplex ultrasound (DUS), pre operative assessment, or evaluation of other…

…initiated the Framingham Heart Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery…

…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…

…arteries. It frequently coexists with left main coronary artery disease, diabetes mellitus, left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous…