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

…on the other hand, is caused by a complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive…

…infarction Definition and clinical concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of…

…interpretation in the context of the clinical presentation and other findings. A reduced CFR may occur with angiographically insignificant epicardial disease because of abnormalities in…

…not routinely undergo immediate angiography. A selective or delayed approach is recommended in this setting unless other findings justify urgent intervention. Risk scores Several risk…

…atherosclerotic peripheral arterial disease, and other very high risk settings described in the source material. The statin should be prescribed at the highest tolerated dose…

…asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or duodenal ulcers…

…Non HDL C and apoB are secondary targets or risk refining measures, particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance…

Echocardiography Ultrasound artifacts The following artifacts are common in ultrasound imaging: The ultrasound image displays non existing structures. The ultrasound image does not display existing…

…Less commonly, autosomal recessive inheritance. X linked or other non autosomal dominant mechanisms. Complex or multifactorial genetic architecture. The inheritance pattern affects the appropriate scope…

…NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical…

…hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick reference for dosing in impaired renal function. Respiratory tract…

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

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

…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…

…or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular dysfunction and/or MVD…

…with STEMI or other very high risk features. Noninferiority studies designed mainly around bleeding outcomes may not reliably exclude clinically important differences in ischemic events…

…the most favourable patterns generally contain more minimally processed, fibre rich and bioactive foods, including fruits, non starchy vegetables, beans, whole grains, nuts and seeds…

…NSTEMI, Non STEMI) and STE ACS (STEMI) is slightly simplified. In reality, the course in acute myocardial infarction (AMI) is modified by several factors. The…

…the possible causes, apply several non pharmacological measures at the same time, and use drugs only in severe agitation or marked distress. Delirium is an…

…bleeding complications. The CHA₂DS₂ VA score is a clinical tool designed to assess stroke risk in patients with non valvular atrial fibrillation (AF). It is…

…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…

…particularly in the broader assessment of peripheral arterial and aortic disease; planned surgery, especially carotid endarterectomy (CEA), coronary artery bypass grafting (CABG), or major non…

…intoxication, or other sympathomimetic exposure, including methamphetamine. Abrupt withdrawal of antihypertensive medication, particularly clonidine, can also precipitate a hypertensive crisis. Pregnancy Hypertensive emergencies in pre

…of secondary hypertension cases. Coarctation of the aorta and renovascular disease are important non endocrine causes, particularly in patients with resistant hypertension. Dietary sodium and…

…may remain elevated thereafter. The overall health benefit is greater still when reductions in non cardiovascular morbidity and mortality are included. Clinical presentation and assessment…

…elevations in cardiac troponin concentrations. Based on the presenting electrocardiogram (ECG) and the presence of troponin elevation, ACS are classified into unstable angina (UA), non…

…and/or fall in cTn values. An elevated cTn alone does not establish MI, because myocardial injury may occur without myocardial ischaemia. Non ischaemic myocardial…

…generally younger than those with atherosclerotic non ST elevation acute coronary syndromes. Cigarette smoking is a prominent association, whereas other conventional coronary risk factors may…

…dissection. Coronary embolism of cardiac or non cardiac origin. Oxygen supply–demand mismatch, including demand related events in the presence of fixed coronary disease. More…

…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…

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

…ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or other…

…induced cardiomyopathy Non compaction cardiomyopathy Peripartum cardiomyopathy Cardiomyopathy secondary to valvular heart disease Long term prognosis varies markedly across these conditions. The prognosis in idiopathic…

…a window of opportunity for reperfusion. In addition, some patients present with severe LMCA stenosis exacerbated by other conditions, and these must also be recognized…

…hypertension. Developing and non Western countries rarely display the blood pressure trajectories and high prevalence of hypertension that is ubiquitous in high income Western countries…

…10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle. In other words, the heart…

…The absence of thallium uptake indicates non viable myocardium, while redistribution into initially hypoperfused regions suggests viability. What is myocardial redistribution? In myocardial perfusion imaging…

…and other tachyarrhythmias with discernible QRS complexes. Shockable rhythm : Tachyarrhythmias that can be treated with defibrillation (ventricular fibrillation) or cardioversion (ventricular tachycardia). Non shockable rhythm…

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

…2]. In a meta analysis of three phase 3 trials, tenecteplase was non inferior to alteplase with respect to an excellent functional outcome, without an…

…tendon. Measure in the same way as on the arm. 4. Posterior tibial artery — behind the medial malleolus. Measure. 5. Repeat on the other leg…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

…the right place. In suspected bacterial meningitis it is the time to antibiotics that saves the patient — the puncture must never delay it. Indications Suspected…

…mortality than non variceal bleeding [1,2]. Upper gastrointestinal bleeding can present as haematemesis, coffee ground vomiting or melaena. Haematochezia can occur in massive upper…

…coenzyme A reductase in the cholesterol synthesis pathway. Inhibition of ACL reduces hepatic cholesterol synthesis and produces reductions in LDL C, non high density lipoprotein…

…75 mL/min/1.73 m², the probability of coronary artery disease (CAD) increases in an approximately linear manner. At an eGFR of 15 mL…

…syndrome associated with ischemic heart disease is broader than chest pain itself, encompassing symptoms like tightness, pressure, and discomfort in the chest, arms, neck, jaw…

…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…

…obstructive CAD on ICA should therefore not automatically be interpreted as evidence that the patient’s symptoms are non cardiac. In acute coronary syndrome (ACS)…

…account for attenuation and other technical factors. Relative perfusion assessment has an important limitation: it requires a normally perfused reference territory. In diffuse coronary disease…

…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…

…MI and non ischaemic myocardial injury may coexist, and certain disease entities can span both categories; for example, acute heart failure may occur in the…

…Reduced exercise tolerance. Excessive fatigue. These non chest pain manifestations are reported more frequently in females, older adults and people with diabetes. Ischaemic heart disease…

…systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical cul de sac [19] …

…rhythm ( Thorén et al ). The initial rhythm has immense significance for survival in cardiac arrest, regardless of all other circumstances. The initial rhythm is an…

…or cardiac arrest–particularly during physical activity–in a young adult with T wave inversions in V1–V4, or other ECG changes (see below) should…

…et al. Epidemiology and outcome of adult out of hospital cardiac arrest of non cardiac origin in Osaka: a population based study. BMJ Open 2014…

…used for non pregnant adults. The fetus is not harmed by defibrillation, amiodarone, or adrenaline (epinephrine). In the event of a cardiac arrest in a…

…are confirmed in patients with NSTE ACS, the condition is classified as NSTEMI (Non ST elevation myocardial infarction) . If troponin levels are normal in patients…