…QRS configurations are also indicate of previous myocardial infarction. New conduction defect Myocardial infarction/ischemia may be complicated with conduction defects (discussed in separate article…

…set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines the need for…

…summary of the indications, contraindications, dosage, administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with…

…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…

…patients with diabetes and combined dyslipidaemia, non HDL C is particularly relevant because it captures triglyceride rich lipoproteins in addition to LDL and other apoB…

…with ischemia or increased workload STATUS OF CORONARY ARTERY SETTING EFFECT ECG REACTION Normal coronary artery (no atherosclerosis) At rest Oxygen supply is adequate and…

…indicated with continuing ischaemia, shock, serious arrhythmia or acute heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic…

…The test presupposes that the patient has spontaneous nystagmus at the time of examination and that the examiner is experienced with the head impulse test…

…Use with caution in patients on low dose acetylsalicylic acid for cardioprotection. Pharmacokinetic interactions Methotrexate: NSAIDs inhibit tubular secretion of methotrexate, increasing plasma levels and…

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

…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…

…one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary…

…two vascular beds. Carotid disease therefore commonly coexists with coronary artery disease (CAD), peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal…

…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…

…levels (but nothing else) and increases the risk of acute myocardial infarction by more than 50 times. Individuals with homozygous FH typically die from acute…

…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…

…BP ≥180/110 mmHg with acute HMOD, although other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence of ongoing acute organ…

…with left main coronary artery disease, diabetes mellitus, left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and…

…threatening ischaemia (CLTI). Clinical presentation and symptoms Asymptomatic and atypical disease Fewer than half of patients with PAD have typical symptoms. Many have impaired walking…

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

…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…

…ECG has low sensitivity with respect to detecting biventricular hypertrophy. This is because the strong and oppositely directed forces tend to cancel each other out…

…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…

…sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves. The cardinal difference between continuous wave Doppler and…

…annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect these gamma rays to construct images with high spatial and temporal…

…with opposite angle of observation. Other vectors may interfere with the injury currents, and inhibit them from being detected by leads with opposite angles of…

…with a frequency of roughly 40 beats per minute. If the escape rhythm has wide QRS complexes and a frequency of 20–40 it is…

…lowest rib and the iliac crest, at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement…

…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…

…Assessment of treatment response and measurement of residual disease (MRD). Fever of unknown origin or suspected granulomatous disease with marrow involvement. Work up of unexplained…

…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…

…front , and this is why the margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis…

…obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…of effect, the dosing, the adverse effects and the important precautions. A hypertensive emergency is defined by a markedly raised blood pressure in combination with…

…meal or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating…

…urine osmolality and urine sodium before treatment. 5. With severe symptoms: give hypertonic saline immediately. Do not wait for a complete work up of the…

…GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance. Synthetic function and…

…the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and organ dysfunction…

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

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…

…bundle branch block in acute anterior infarction, and before drugs or procedures with a known risk of bradycardia. Transvenous pacing is chosen when the need…

…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…

…factors : previous dissection, family history of dissection, severe aortic regurgitation or mitral regurgitation, planning pregnancy, uncontrolled hypertension or annual growth 3 mm. Limitations Formulas assume…

…of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist for patients with AF, including HAS BLED, HEMORR2HAGES, and…

…AF patients. Evidence suggests that the increased stroke risk in women is more closely associated with other comorbidities and age rather than sex alone. Consequently…

…BLED score is a widely recognized and validated tool used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF)…

…3 Interpretation of HEMORR₂HAGES score. Comparison with ATRIA and HAS BLED Scores Several studies have compared the predictive performance of HEMORR₂HAGES with other bleeding risk…

…should begin with a comprehensive history and physical examination. Clinicians should inquire about historical clues suggesting alternative etiologies, such as a sensation of postnasal drip…

…definition of MI. Type 1 MI is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and…

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

…cardiovascular implications of lower alcohol intake remain controversial. Epidemiological studies have often described a J shaped association between consumption and cardiovascular outcomes, with apparently lower…

…antithrombotic surface, and control the adhesion and migration of inflammatory cells. Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The…

…of stroke and other thromboembolic events. Subclinical cerebral injury may contribute to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with…

…stiffness with both low DBP and increased mortality. Older adults have a higher absolute cardiovascular risk than younger adults. Thus, although a smaller number of…

…outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections…

…relevant in adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors…

…min/1.73 m² Abnormal urinalysis or renal imaging Risk of progression rises with proteinuria and depends on cause 2 60 mL/min/1.73…

…the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes. Mechanisms of action Colchicine Colchicine appears to exert several…

…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…