…valvular heart disease, heart failure, atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to…

…AVNRT, AVRT (WPW syndrome) and other conditions involving an accessory pathway. Paroxysmal atrial fibrillation in patients with severe symptoms, provided that first line therapies have…

…Atrial fibrillation (AF) is a major independent risk factor for thromboembolism, including ischaemic stroke. This risk applies across the clinical patterns of AF—paroxysmal, persistent…

…compared with atrial fibrillation, atrial flutter is not capable of persisting for longer periods of time. This is due to the fact that atrial flutter…

…patients whose atrial tachycardia is induced by the drug. Management of all other cases aligns with the approach used for atrial fibrillation and atrial flutter…

…Conversely, atrial fibrillation and non cardiac comorbidities are less frequent than in HFpEF. The clinical population is heterogeneous because the HFmrEF range includes both patients…

…which means that it usually is atrial myocardium. Asystole occurs if no escape rhythm awakes. It is uncommon that sinus arrest leads to persistent asystole…

…sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive…

…electrocardiographic abnormalities and with or without an acute rise in cardiac troponin. The spectrum ranges from symptom free presentation to persistent chest discomfort, cardiac arrest…

…limiting epicardial coronary stenosis. It is therefore a disorder of coronary microvascular perfusion rather than persistent obstruction of the treated epicardial segment. The phenomenon occurs…

…elevation myocardial infarction (STEMI) is an acute coronary syndrome characterized clinically by acute myocardial ischaemic symptoms or equivalent presentations together with persistent ST segment elevation…

…the sensitization of sensory nerve endings due to the accumulation of bradykinin. ACE is responsible for metabolizing bradykinin and other tachykinins, such as substance P…

…Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory…

…or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia…

…Other guideline formulations similarly define resistant hypertension as blood pressure above goal despite three or more antihypertensive drugs from different classes at maximally tolerated doses…

…permit vascular remodelling and renal impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated with a greater likelihood…

…with a collection of pus. Persistent painful induration after a few days of antibiotics — suggests that an abscess has formed. Ultrasound settles the question when…

…1. Assess airway, breathing and circulation. 2. Assess the neurological symptoms and at the same time exclude other acute causes, for example hypoglycaemia, poisoning, stroke…

…disease The extent of jeopardized myocardium Left ventricular systolic function Diabetes and other comorbidities Anatomical complexity and completeness of possible revascularization A proximal lesion jeopardizes…

…patients whose initial findings are less definitive. The defining electrocardiographic feature is the absence of persistent ST segment elevation. This does not imply low risk…

…incomplete apposition, or persistent disease at the inflow or outflow edges. The contemporary incidence of stent thrombosis is approximately 1% during the first year after…

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

…Acute balance syndrome Acute persistent unsteadiness or ataxia without clear spontaneous nystagmus Cerebellar or brainstem infarction, intoxication, Wernicke's encephalopathy, other central disease Neurological examination…

…severe and persistent ischaemia. The limb may be cold, pale, cyanotic or mottled. Capillary refill is delayed, and venous filling may be reduced. Other possible…

…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…

…Iatrogenic lesions commonly follow cardiac surgery, coronary angiography or other invasive procedures, and affected patients may be relatively painless compared with those with spontaneous dissection…

…of foamy macrophages. The occurrence of neoatherosclerosis helps explain why ISR and other stent related events may arise well after the initial intervention. Mechanical mechanisms…

…inducible ischaemia. A persistent defect on stress and rest images may represent scar, although interpretation must account for attenuation and other technical factors. Relative perfusion…

…Definition and pathophysiology Familial hypercholesterolaemia (FH) is an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…a pulse that can be felt. The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous)…

…those individuals genuinely at risk of arrest. This predictive problem has proven persistently resistant to resolution. Known predictors of cardiac arrest The only risk biomarker…

…hypoactivity, hallucinations and marked autonomic hyperactivity Up to 5 to 7 days, sometimes longer Persisting withdrawal, particularly after previous severe episodes, with concurrent physical illness…

…myocardial oxygen supply and demand. In many cases, the initiating process is plaque disruption with thrombosis; other cases result from spasm, microvascular dysfunction, embolism, dissection…

…By contrast, chronic hypoperfusion may result in hibernating myocardium: a persistently dysfunctional but potentially recoverable state. The chronically dysfunctional myocardium in ischemic cardiomyopathy is therefore…

…of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI…

…administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for…

…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…

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

…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…

…drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre…

…Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing bleeding risk. Monitor coagulation…

…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…

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

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

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

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

…Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction…

…syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI), or medical…

…acute HMOD, although other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence of ongoing acute organ injury is decisive. The pathophysiology…

…left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures…

…with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption…

…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…

…when recording during chest pain is not consistent with myocardial ischemia. In other words, chest pain caused by ischemia will always result in ischemic ST…

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

…radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect…

…1 A ). Concave ST segment elevations, on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted…

…degree AV block, no atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is…

…and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90, women 0.85 = abdominal…

…Doses in atrial fibrillation Drug Standard dose Reduced dose and criterion : : : Apixaban 5 mg twice daily 2.5 mg twice daily if at least two…