…transport—MRs are also present in cardiac myocytes, vascular smooth muscle, endothelial cells, macrophages, neurons and other tissues. This distribution helps explain why PA produces…

…S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization…

…Hypocalcemia Causes of hypocalcemia Acute pancreatitis, pancreas surgery, alkalosis (hyperventilation), rhabdomyolysis, septicemia (sepsis), osteolytic cancer metastases, abnormal calcium absorption (gastrointestinal) and resorption (from primary urine…

…Abnormal Abnormal A compensated simple disorder, or two opposing primary disorders It is therefore not enough to ask which of the pCO₂ and the HCO₃…

…disorders account for many secondary forms. Primary hyperaldosteronism is identified as the most frequent cause, comprising approximately 20–25% of secondary hypertension cases. Coarctation of…

…primary and secondary. Primary and secondary ST T changes Primary ST T changes are caused by abnormal repolarization . This is seen in ischemia, electrolyte disorders…

…and herpes zoster pain are other considerations when assessing chest pain [2]. Autoimmune/Malignancy: A history suggesting an autoimmune disorder or known malignancy may suggest…

…Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other circumstances that may affect…

…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…

Procedurer Benign paroxysmal positional vertigo is the commonest cause of vertigo in primary care and one of the few diagnoses that can be cured on…

…ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source…

…a therapeutic objective. LDL C as the primary treatment target Current lipid management frameworks place LDL C at the centre of treatment. Lifestyle intervention is…

…table below shows a systematic history taking in patients presenting with chest pain (chest discomfort) or other symptoms suggestive of the five conditions listed above…

…primary PCI if the total expected time is 120 minutes or less If PCI cannot be performed within 120 minutes Fibrinolysis within 10 minutes of…

…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…

…It is a modification of the widely used CHA₂DS₂ VASc score, with the primary distinction being the exclusion of sex parameter (female sex) as a…

…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…

…syndrome (BrS) has evolved from an obscure electrocardiographic curiosity into a major focus of contemporary cardiac electrophysiology [1] . Recognized as a primary inherited arrhythmia syndrome…

…most of them are myxomas and next papillary fibroelastoma is most common. Among children, rhabdomyoma is most common. Myxoma Myxoma is the most common primary…

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

…JAMA): [...] Of every 10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle. In other…

…significance of the ST segment depression differs markedly in NSTE ACS and STE ACS. In NSTE ACS the ST segment depressions are the primary ischemic…

…be handled routinely in primary care or in the emergency department without contacting the appropriate specialty: Location Risk Management : : : Medial triangle of the face (nasal…

…primary infection, low risk of recurrence vancomycin 125 mg × 4 PO 10 days Clostridioides difficile, high risk of recurrence fidaxomicin 200 mg × 2 PO 10…

…prediction tool currently exists. At the other end, roughly two thirds of ICDs implanted for reduced LVEF never deliver an appropriate shock, so the false…

…Other anti inflammatory strategies have produced less favourable results. Canakinumab, a monoclonal antibody directed against interleukin 1β, provided proof of concept but was not…

…of multiple modest dietary changes. Mediterranean type diets provide polyphenols from extra virgin olive oil, fruits, vegetables, nuts and legumes; unsaturated fatty acids and other…

…AV nodal refractoriness. Its electrophysiologic effects on the His Purkinje system and ventricular muscle are minimal, except in cases of toxic concentrations. In most patients…

…Differential Diagnosis of ST Elevation Several nonischemic conditions can produce ST segment elevations that mimic acute myocardial infarction. Acute pericarditis is a primary differential diagnosis…

…whereas disruption of the adventitia can result in rupture. An alternative proposed mechanism is primary rupture of the vasa vasorum, followed by disruption of the…

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

…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…

…involving 192 patients with cardiogenic shock, researchers compared the effectiveness of milrinone and dobutamine . The primary composite outcome included in hospital mortality, resuscitated cardiac arrest…

…On the other hand, sinus bradycardia developing during physical exercise is considered abnormal, because heart rate must increase during exercise. Mechanisms of cardiac arrhythmias The…

…of cardiac arrest : In cases where cardiac arrest is caused by myocardial ischemia, myocardial infarction, or primary arrhythmias, shockable rhythm indicates that the duration of…

…degradation. Histologically, a vulnerable plaque is defined by a fibrous cap thickness of less than 65 μm, heavy macrophage infiltration, sparse smooth muscle c

…angina may diminish or disappear. Others have no recognized history of angina or MI, making the distinction from primary dilated cardiomyopathy particularly difficult. When present…

…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…

…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…

…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…

…C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression. As the burden of retained…

…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…

…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…

…follow. Consider people with the genetic disorder familial hypercholesterolemia (FH), which is caused by genetic mutations affecting the elimination of LDL cholesterol from the blood…

…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…

…a manifestation of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial…

…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…

…tomographic images of the left ventricle. In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron, they annihilate each other…

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

…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…

…BMI of 23 and obesity from 27.5, because cardiometabolic risk appears at a lower BMI. BMI is misleading in athletes with a large muscle…

…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…