Myocardial ischemia and infarction Definition and Clinical Significance In stent restenosis (ISR) is recurrent narrowing within a previously implanted coronary stent. It represents a form…

…on the extent of microvascular obstruction and the territory supplied by the treated vessel. Possible manifestations include: Persistent or recurrent myocardial ischemia Deterioration in ventricular…

…A selective or delayed approach is recommended in this setting unless other findings justify urgent intervention. Risk scores Several risk scores integrate clinical, ECG, and…

…is characteristically nonproductive and dry. Patients may describe a persistent tickle or sensitivity in the throat. In recent years, the concept of a distinct "cough…

…and fibrin formation. Within a stented segment, thrombus may also develop because of disturbed flow, residual dissection, inadequate stent expansion, incomplete apposition, or persistent disease…

…or without ECG abnormalities and with or without an elevation in cardiac troponin. The underlying pathological mechanism is not restricted to a single lesion or…

…dL), and at least a 50% reduction from baseline. For a patient who experiences a recurrent atherothrombotic event while receiving maximally tolerated statin therapy, an…

…ischaemia Paraplegia or paraparesis Persistent or recurrent pain Hypertension that remains uncontrolled despite optimal therapy Acute type A dissection has a particularly rapid early mortality…

…opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast not recommended [1,5]. STEMI criteria and occlusion…

…when ischemic cardiomyopathy is associated with recurrent MI, ventricular arrhythmias, or a large burden of hibernating myocardium. Evaluation and physical examination The assessment should establish…

…response. The ECG in ectopic atrial rhythm and atrial tachycardia A regular rhythm with P waves that differ in contour from sinus P waves. If…

…plus a P2Y12 receptor inhibitor. In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other…

…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…

…has been a major therapeutic target. This concept is clinically relevant because cardiovascular risk may persist despite appropriate lipid lowering and other guideline directed therapies…

…sinus arrhythmia may also be observed as a consequence of drug toxicity, such as digitalis excess. Biomarkers and Laboratory Findings The source material does not…

…recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a…

…flow limiting disease may continue to cause ischaemia, recurrent symptoms, myocardial infarction, or other major adverse cardiovascular events. Complete revascularization is therefore considered an important…

…LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease (ASCVD). This causal relationship is supported by genetic, observational and…

…of left ventricular dysfunction among patients with atrial fibrillation and other supraventricular tachyarrhythmias. Moreover, ventricular tachyarrhythmias (including recurrent episodes of ventricular tachycardia) can also cause…

…or extrapolation from other fields (e.g. sepsis research) or physiological reasoning. Cardiac arrest care is advanced and should preferably only be conducted in specialized…

…any other arrhythmia. Figure 1. Ventricular fibrillation and asystole. ECG Case 1: Ventricular tachycardia progressing to ventricular fibrillation Below are sequential ECG recordings during a…

…the presence of clinical signs of infection — all chronic wounds are colonised, and a culture taken without clinical suspicion leads only to unnecessary antibiotics. 5…

…low risk of recurrence. Atrial fibrillation in other circumstances (particularly those listed above) is usually a progressive disease. Complications of atrial fibrillation and available treatments…

…and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS have more comorbidities and a higher risk of…

…ischaemia. A focused history should establish: Quality of the discomfort. Location and radiation. Onset and temporal pattern. Duration and recurrence. Provoking and relieving factors. Associated…

…to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity: Do not administer to patients with a history of…

…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…

…bottles. Intravenous fluid and a vasopressor prepared. The patient is positioned semi recumbent, at 30–45 degrees — the fluid then collects anteriorly and inferiorly, which…

…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…

…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…

Info Table 1 provides a summary of the indications, contraindications, dosage, administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary…

…individual has a 50% risk of transmitting the relevant variant to each child. However, other inheritance patterns, de novo variants, incomplete penetrance and variable phenotypic…

…a storage form of glucose) which can be used to produce ATP in absence of oxygen. Unfortunately, glycogen yields only small amounts of ATP and…

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

…IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non HDL C provides a broader estimate of…

…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…

…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…

…among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However, association is not the same as causation . A cause is…

Cardiology Emergency medicine Definition and Pathophysiology A hypertensive emergency is severe blood pressure elevation accompanied by acute hypertension mediated target organ damage (HMOD). The European…

…associated with less complete revascularization, less durable relief of angina in some patients and a greater likelihood of repeat PCI. Multivessel disease in ACS is…

…Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather…

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

…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…

…are displayed below the baseline and velocities towards the transducer are displayed above the baseline. This image shows a fast and distinct flow (almost 5…

…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…

…1 B ). This is noted in both North American and European guidelines. However, a concave ST segment does not rule out ischemia, it merely reduces…

…electrically dissociated from each other. This condition is referred to as atrioventricular (AV) dissociation. Importantly, for the ventricles to have any electrical (and thus pumping)…

…index 15–19 kg/m² 17–22 kg/m² Ideal and dosing weight Drug dosing often requires a weight other than the actual body weight…

…as in the table above for rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible according to FASS…

…side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of…

…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…

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

…Hypotension and haemodynamic instability. Respiratory compromise during an ongoing crisis. Distinguish the conditions instead by temporarily withdrawing the cholinesterase inhibitor, under monitoring in a setting…

…and severe pre eclampsia or eclampsia. The blood pressure is often at least 180/120 mmHg, but no absolute threshold defines the condition. A rapid…

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

…neurological symptoms and at the same time exclude other acute causes, for example hypoglycaemia, poisoning, stroke, meningitis and a postictal state. 3. Check a repeat…

…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…

…cell transplantation and patients treated with CAR T cells or other advanced immunotherapies may require separate local protocols. Definition Criterion Practical definition : : Fever A single…

…corticosteroid and the lidocaine in the same syringe. The anaesthetic confirms that the injection has gone to the right place — immediate pain relief is a…