…low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non HDL C provides a broader estimate of atherogenic cholesterol than LDL C alone…

…pathophysiology of NSTEMI and unstable angina is very similar: both are due to partial (incomplete) coronary artery occlusions , which implies that there remains residual blood…

…troponin elevation but are non ischaemic mimics rather than MINOCA when identified as the final diagnosis. Reported prevalence varies according to the population and diagnostic…

…precisely, FFR compares the pressure driving flow distal to a stenosis with the pressure that would be available in the absence of that stenosis. The…

…failure presumed to result from ongoing myocardial ischaemia Haemodynamic instability or cardiogenic shock Life threatening arrhythmias or cardiac arrest after presentation Mechanical complications of myocardial…

…settings, while the broader lipid lowering recommendation refers to a recurrent event without requiring that it be of the same type as the initial event…

…administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other contraindications…

…combined dyslipidaemia, non HDL C is particularly relevant because it captures triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk…

…ultrasound imaging: The ultrasound image displays non existing structures. The ultrasound image does not display existing structures. The ultrasound image misrepresents the echogenicity of structures…

…X linked or other non autosomal dominant mechanisms. Complex or multifactorial genetic architecture. The inheritance pattern affects the appropriate scope and duration of family surveillance…

…10 minutes of the diagnosis, if symptom duration is under 12 hours and there is no contraindication After successful fibrinolysis Transfer directly to a PCI…

…applies where you work. They assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick…

…Nevertheless, the clinical importance of non fatal gastrointestinal and intracranial haemorrhage is substantial, particularly because the absolute cardiovascular benefit is small in many primary prevention…

…and SCORE2 Older Persons (SCORE2 OP) are European risk prediction models designed to estimate 10 year risk of both fatal and non fatal CVD events…

…and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around…

…exclusively at the infarct related artery (IRA), or it may extend to additional non infarct related lesions. Culprit only revascularization treats the artery responsible for…

…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…

…methods may also contribute. The cardioprotective effect is therefore likely to result from the cumulative influence of multiple modest dietary changes. Mediterranean type diets provide…

…the ischemia/infarction. The location of the thrombus in the artery: a proximally located thrombus will cut off blood flow to more branches, and thus…

…be enough to precipitate the condition [1,2]. Delirium is common but often missed. On medical and geriatric wards a substantial proportion of older patients…

…a clinical tool designed to assess stroke risk in patients with non valvular atrial fibrillation (AF). It is a modification of the widely used CHA₂DS₂…

…disease, aspirin reduced the combined incidence of non fatal MI, non fatal ischaemic stroke, and vascular death from 8.2% to 6.7% per year…

…PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke…

…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…

…present Factors that may be contributing to elevated blood pressure Other cardiovascular risk factors and relevant comorbidities Evidence of hypertension mediated organ damage Existing cardiac…

…for smoking and anticipated barriers to cessation. Exposure to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation…

…the overlapping of vulnerable plaque and thrombogenic blood, which are critical determinants for infarction occurrence and extension. Plaque rupture or erosion leads to thrombus formation…

…of myocardial infarction The Fourth Universal Definition separates MI into five principal types. Type Mechanism or setting Type 1 Acute atherothrombotic MI, usually related to…

…flow limitation. The mechanisms are incompletely defined. Proposed contributors include hypercontractility or hypersensitivity of coronary vascular smooth muscle to vasoconstrictor stimuli, including adrenergic agonists, leukotrienes…

…exposes the lipid core and extracellular matrix to circulating blood. Tissue factor within the plaque and tissue factor bearing microparticles contribute to activation of coagulation…

…condition) In addition to these five conditions, there are numerous other causes of chest pain, but the other causes are either subacute or non acute…

…Rhythm control, on the other hand, attempts to restore sinus rhythm by use of antiarrhythmic drugs. Randomized controlled trials have not demonstrated any clear difference…

…infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to chest…

…lead to dilation of the ventricle: Dilated cardiomyopathy (DCM) Idiopathic or genetic . Ischemic cardiomyopathy Alcoholic cardiomyopathy Diabetic cardiomyopathy Takotsubo cardiomyopathy Tachycardia induced cardiomyopathy Non compaction…

…Clinical features Occlusion of the left main coronary artery (LMCA) abruptly interrupts blood flow to both the left anterior descending (LAD) and left circumflex (LCx…

…necessary to normalize blood pressure. Management of hypertension requires careful consideration of other cardiovascular risk factors and coexisting conditions. Therapy must be tailored to each…

…for 50% of all years of life lost due to cardiovascular disease ( Myerburg et al ). Sudden unexpected cardiac arrest is the mechanism of death for…

…gamma rays to construct images with high spatial and temporal resolution. PET offers higher spatiotemporal quality, as compared with SPECT. Quantification of blood flow using…

…Defibrillation : Use of non synchronized electric shock (i.e. a shock delivered randomly, without considering the phase of the cardiac cycle) to terminate ventricular fibrillation…

…decision to prescribe colchicine requires attention to the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes. Mechanisms of…

…a person of working age Blood pressure Measure initially in both arms if this does not delay reperfusion treatment. A large side to side difference…

…ultrasound gel, a blood pressure cuff of the correct size (the width should correspond to about 40 % of the circumference of the limb), a manual…

…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…

…Only clinical signs of herniation halt the puncture, and antibiotics and a corticosteroid are then given immediately after blood cultures. For questions other than acute…

…balanced crystalloid in the first instance. Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse, peripheral perfusion…

…87 95% confidence interval: 0.79–0.96 P = .004 Other summaries of the trial describe a 14% reduction in the same composite outcome…

…impaired renal function further increases blood pressure. Non traditional cardiovascular mechanisms include: Uraemia associated inflammation Oxidative stress Vascular dysfunction Promotion of vascular calcification Albuminuria and…

…thought to result from right ventricular ischemia that develops during physical exertion [5]. Associated Findings: Exertional dyspnea, dizziness, and syncope may also occur [5]. Non…

…with reported reductions of up to 50–55% in guideline summaries. It also lowers non HDL C by up to approximately 50% and apolipoprotein B…

…is consequently recommended to complement ICA, particularly for intermediate non left main coronary stenoses. Myocardial ischaemia may occur despite the absence of significant epicardial obstruction…

…based on the principle that flow limiting coronary disease limits the ability of a myocardial territory to augment blood flow during exercise or pharmacological vasodilation…

…underlying process usually involves acute thrombotic obstruction of an epicardial coronary artery. A vulnerable atherosclerotic plaque and thrombogenic blood interact to initiate and extend thrombosis…

…dissection of the coronary artery wall with accumulation of blood within the false lumen, which compresses the true lumen to varying degrees; this non atherosclerotic…

…syndromes are commonly related to atherothrombotic events, myocardial ischaemia may also result from other mechanisms. Differential diagnoses and alternative causes of troponin release must therefore…

…profound driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke and systemic embolism. The contemporary understanding of AF has…

…cardiac arrest due to pulmonary embolism the initial rhythm is typically PEA, which is explained by the fact that the embolus prevents blood from passing…

…or other ECG changes (see below) should lead to a suspicion of ARVC. The gradual loss of myocardium leads to ventricular dilation and right heart…

…0.4 0.8 2.1 Table 1. Survival in out of hospital cardiac arrest due to external causes ( Kitamura et al). References DeBehnke DJ…

…DW, Wickman LL, Swart GL. The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity. Resuscitation 1995;30:16975…

…on the size of the thrombus and the plaque. The patient will experience severe chest pain due to the abrupt reduction of coronary blood flow…