…risk factor [2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities, does not significantly increase stroke risk. Conversely…

…interstitial oedema and tissue inflammation produce extravascular compression. In the most severe form, termed no reflow, structural and functional microvascular impairment persists despite restoration of…

…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…

…interstitial edema, and inflammatory extravascular compression. This impaired tissue perfusion can extend injury beyond the initial ischemic zone and contributes to ventricular failure. Mechanisms of…

…swelling, interstitial edema, and tissue inflammation promote extravascular compression, exacerbating myocardial injury. Clinical Presentation and Symptoms In up to one half of STEMI cases, a…

…progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental pathophysiological substrate for acute coronary syndromes (ACS), including…

…chronic kidney disease, particularly diabetic kidney disease and advanced CKD. The clinical course is often more rapidly reversible than that of other forms of acute…

…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…

…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…

…Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease…

…is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease (ASCVD)…

…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…

…history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks of vertigo, seconds…

…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…

…encompasses long term interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other…

…Their clinical importance arises from the causal role of low density lipoprotein cholesterol (LDL C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD)…

…that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic cardiovascular disease (ASCVD…

…components of assessment. The history should include: previous TIA or stroke; symptoms suggesting current or recent cerebral ischaemia; known CAD, PAD, or other atherosclerotic disease…

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

…three main questions discussed in media, blogs and on social plattforms: Is high cholesterol a true cause of coronary artery disease? Does diet affect cholesterol…

…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…

…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…

…over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma…

…coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to chronic limb threat

…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…

…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…

…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…

…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…

…significant coronary artery disease, potentially resulting in false negative findings. Radiotracers in myocardial perfusion imaging Radiotracers are designed to identify ischemic areas of the myocardium…

…old, healthy and diseased individuals. For example, roughly 90% of males aged <30 years display concave ST segment elevations in leads V2–V3. This explains…

…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…

…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…

…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…

…departments — follow local protocol. Severe lung disease or a contralateral pneumothorax: avoid the subclavian and jugular routes on the healthy side, since a pneumothorax there…

…Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is needed for management. Cryoglobulinaemia, cold agglutinin disease…

…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…

…3 IV Pneumonia, in chronic lung disease amoxicillin 750 mg × 3 PO 5–7 days or benzylpenicillin 3 g × 4 IV Pneumonia, suspected atypical pathogen…

…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…

…rise can cause osmotic demyelination syndrome [1,2]. Hyponatraemia is primarily a disorder of water balance. The plasma sodium reflects the ratio between the body…

…A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance…

…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…

…and where no liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and…

Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…

…preferably anteroposteriorly : one anteriorly over the praecordium to the left of the sternum, the other on the back between the left scapula and the spine…

…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…

…SOVd} = 1.92 + 0.74 \times \text{BSA} ) Definition of aortic aneurysm Sinus of Valsalva 45 mm. Any other segment 40 mm in diameter…

…6% High risk 5 or more 5.8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist…

…chadsva] The CHA₂DS₂ VA score has superseded the CHA₂DS₂ VASc score. As of 2025, it is recommended to use the CHA₂DS₂ VA score for stroke…

…patients, regardless of the type of oral anticoagulant used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such…

…balancing estimating the risks of bleeding. Components of the HEMORR₂HAGES Score The acronym HEMORR₂HAGES represents the following parameters: H epatic or renal disease (1 point…

…ACE) inhibitors are foundational therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction …

…Manifestations include angina, other chest discomfort, dyspnoea, or no symptoms. Although chronic coronary disease may remain stable for prolonged periods, it can progress or destabilize…

…and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease, active cancer, and other conditions incorporated into…

…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…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…arise during the course of treatment. Even transient, self terminating AF during ST elevation myocardial infarction may indicate an increased long term risk of stroke…