…C reactive protein, has been a major therapeutic target. This concept is clinically relevant because cardiovascular risk may persist despite appropriate lipid lowering and other…

…lowering. Diabetes and glycaemic outcomes Among participants with diabetes, bempedoic acid produced significant relative and absolute reductions in four component major adverse cardiovascular events. The…

…al also report a significant association between troponin T levels and C reactive protein (CRP) and N terminal pro B type natriuretic peptide (NT pro…

…Smooth muscle cells (SMCs) migrate from the tunica media into the intima, driven by platelet derived growth factor (PDGF) and other cytokines. Within the intima…

…ROSC), the midbrain may receive enough oxygen to preserve some pupillary reflex. Importantly, pupillary size and reactivity are influenced by factors beyond neural activity. Systemic…

…However, other inheritance patterns, de novo variants, incomplete penetrance and variable phenotypic expression complicate risk prediction. Familial clustering may also reflect shared environmental or behavioural…

…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…

…effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to…

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

…increased workload STATUS OF CORONARY ARTERY SETTING EFFECT ECG REACTION Normal coronary artery (no atherosclerosis) At rest Oxygen supply is adequate and ischemia cannot occur…

…intravenous) Loading dose by weight, maintenance dose by renal function and drug concentration Gentamicin and other aminoglycosides A single dose initially. If treatment is continued…

…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…

…block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise during…

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…

…fatal ischaemic stroke, and vascular death from 8.2% to 6.7% per year. The relative reductions were approximately 31% for non fatal MI, 22%…

…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…

…Vascular complications 0.43 Contrast agent reaction 0.37 Haemodynamic complications 0.26 Cardiac chamber perforation 0.03 Other complications 0.28 Total major complications…

…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…

…other imaging methods, namely exercise capacity (and VO2 max , see below). In addition to exercise capacity, stress testing also provides information on electrocardiographic (ECG) reaction…

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

…but only if the examiner is trained. Brief attacks triggered by the position of the head relative to gravity: perform Dix Hallpike and, if needed…

…cold urticaria. Relative: Basal cell carcinoma and squamous cell carcinoma — these can be treated with cryotherapy by an experienced practitioner in selected cases, but surgery…

…until pressure necrosis and perforation occur. If you find one magnet, actively look for another , in the other nostril, in the ears and in the…

…route for puncture — surgical drainage or pericardiotomy instead. Relative: uncorrected coagulopathy, thrombocytopenia and ongoing anticoagulant treatment. In tamponade with shock the coagulation is corrected in…

…spike is followed by a wide QRS complex and a pulse that can be felt. The other predictable error is forgetting that pacing hurts a…

…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…

…and inadequate coronary flow relative to myocardial oxygen demand. Consequently, an elevated cardiac troponin concentration and new ST segment depression in new onset AF should…

…rupture or erosion. The relative contributions of plaque disease and thrombus vary considerably. Thrombotic material may embolize distally and cause additional myocyte necrosis. Plaque disruption…

…severe hypotension, or high degree AV block. Caffeine and other methylxanthines, which antagonize adenosine receptors, should be avoided for at least 12 hours before testing…

…outweighs the risk, then relative contraindications may be disregarded. Absolute contraindications for exercise ECG Aortic dissection – due to risk of progression and rupture. Acute myocardial…

…angles relative to the long axis. With regards to echocardiography, this implies that the following planes are used: short axis, vertical long axis, and horizontal…

…a relative risk of 0.90 (95% CI: 0.69 to 1.19; P=0.47). The study suggests that in cardiogenic shock, milrinone and dobutamine…

…order to evaluate ventricular function, since it may affect the choice of device therapy and also suggest whether other interventions (e.g. heart failure management…

…referred for echocardiography should receive information regarding the conduction of the examination. Some patient engagement is required to obtain all views and the best possible…

…and in these cases, the likelihood of ROSC is higher as compared to other etiologies and presentations. Asystole and pulseless electrical activity (PEA) often have…

…be normal (QRS duration <0.12 s), because both bundle branches receive the impulse and spread it. If the impulse is discharged distal to the…

Arrhythmias and arrhythmology ECG Sinus bradycardia: ECG, causes & management Definition of sinus bradycardia Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate…

…via electrodes. Figure 2. The ultrasound transducer and the piezoelectric crystals that generate and receive ultrasound waves. Piezoelectric crystals have unique electromechanical properties. When an…

…compression The ankle brachial index measured with Doppler determines whether compression may be applied at all, and if so at what pressure. Palpable foot pulses…

…higher prevalence of cardiovascular complications and death than men. Despite the effectiveness of preventive interventions in both sexes, women are less likely to receive statins…

…Relative flow reserve compares perfusion in a stenotic territory with that in a normal reference region under similar haemodynamic conditions. CFR and FFR interrogate related…

…means that some myocardial regions will be refractory while others will be excitable at the same time. As previously discussed (refer to Reentry and arrhy

…sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI. QTc prolongation The QT…

…6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV…

…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…

…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…

…STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based on symptoms, the ECG and…

…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…

…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…

…Other life threatening cardiopulmonary conditions account for approximately 5% of presentations in some populations. Despite this relatively low prevalence, missed myocardial infarction remains consequential, and…

…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…

…and cerebral involvement. Catecholamine excess and drug related presentations Severe hypertension may result from phaeochromocytoma, monoamine oxidase inhibitor crisis, cocaine intoxication, or other sympathomimetic exposure…

…Typical symptoms include: Ischaemic rest pain. Coldness or numbness of the foot and toes. Pain that is worse at night or when the limb is…

…other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption but to achieve complete abstinence from tobacco and ultimately…

…with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2:1 block will be difficult…

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

…segment elevations that are not caused by ischemia and a significant proportion have ST T changes caused by other pathological conditions (such as bundle branch…

…and the other for analyzing reflected sound waves. The cardinal difference between continuous wave Doppler and pulsed wave Doppler is that ultrasound is emitted 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…