…for pathological R wave progression is considerably lower than pathological Q waves and guidelines do not state any ECG criteria specific to R wave progression…

…Female specific and female predominant risk factors Risk assessment should include reproductive and pregnancy related history. Female specific or female predominant factors associated with later…

…present Factors that may be contributing to elevated blood pressure Other cardiovascular risk factors and relevant comorbidities Evidence of hypertension mediated organ damage Existing cardiac…

…acute pericarditis is typically diffuse, involving all leads except aVR and often V1, and does not correspond to a specific coronary anatomic distribution [4, 5]…

…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…

…release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin, so biomarker interpretation…

…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…

…not be strongly flow limiting. In contrast, preserved FFR with reduced CFR may indicate coronary microvascular dysfunction or diffuse epicardial disease. Concordantly normal FFR and…

…60 % and is not specific: motor neurone disease, myopathies and Lambert–Eaton syndrome may also give a positive result. A negative test does not exclude…

…channel blocker or digitalis, while awaiting the antidote and specific treatment. Bradyasystole during and after cardiac arrest with persisting electrical activity. Overdrive pacing in bradycardia…

…an incomplete representation of atherogenic burden. Clinical Presentation and Symptoms ApoB elevation and increased non HDL C are laboratory abnormalities and do not produce specific

…should not be applied as the principal risk tool in people with: Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific risk…

…during effective decongestion and overall clinical improvement does not necessarily indicate an adverse outcome. Classification of CKD CKD severity is classified by eGFR and albuminuria…

…a specific high affinity site on the extracytoplasmic face of the alpha subunit of the Na+ K+ ATPase. This binding is entropically driven and preferentially…

…cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac amyloidosis, BNP or NT proBNP may be markedly elevated even when overt congestion is not apparent…

…concentration above the assay specific 99th percentile upper reference limit (URL). It is considered acute when there is a rise and/or fall in cTn…

…obesity, smoking and other conventional risk factors, together with diabetes specific vascular and metabolic abnormalities. Diabetes is associated with inflammation, thrombosis and accelerated atherosclerosis. In…

…used if other methods fail to open the airway. Figure 1. Methods to open the airway. No large study has compared oropharyngeal and nasopharyngeal airways…

…have specific contraindications: Adenosine, Dipyridamole, Regadenoson : Should be avoided in patients with active bronchospasm, severe hypotension, or high degree AV block. Caffeine and other methylxanthines…

…third degree AV block (not caused by medications) Stroke within 1 month Preparations for exercise stress testing The laboratory and personnel Exercise stress testing may…

…and allows for standardized comparisons of serial examinations. If pathology is discovered during the standard examination, other examinations (which are not included in the standard…

…structures (discussed in detail in Chapter 1): Specific clusters of atrial myocardium : There are clusters of atrial myocardium that possess automaticity and thus pacemaker function…

…In STE ACS, on the other hand, the ST segment depressions are secondary findings and the primary findings are the ST segment elevations. As explained…

…the other valves. The area is calculated by measuring the diameter of the valve ( area = π × radius 2 , where radius = diameter/2 ), and…

…intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis and can also be seen when the bleeding is slow or has stopped. The…

…but without cardiac specific troponin elevation above the 99th percentile. The clinical presentation should not be interpreted in isolation. The initial diagnosis and triage depend…

…does not provide specific details regarding the physical examination or general evaluation of patients with bradycardia. Diagnostics Electrocardiographic assessment is fundamental to the diagnosis and…

…patient’s specific procedural risks. Vascular access and access site complications Radial and femoral access Radial access is generally preferred for coronary angiography and PCI…

…thrombus, although haziness is not specific. Intravascular imaging can identify plaque disruption, thrombus and other structural features that may not be evident on angiography alone…

…are not specific to left main disease. The examination should nevertheless assess the consequences of extensive myocardial ischaemia, including heart failure, haemodynamic compromise and rhythm…

…are not included in the European guideline definition. Clinical Presentation and Symptoms The source material does not describe a distinctive symptom profile for resistant hypertension…

…2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities, does not significantly increase stroke risk. Conversely, the 2023…

…however, display both ECG changes and symptoms. Troponins and other biomarkers of myocardial necrosis (infarction) Myocardium can endure 20 to 30 minutes of complete ischemia…

…age specific normal interval. P wave with constant morphology preceding every QRS complex. The P wave is positive in lead II (and also I and…

…the sinoatrial node) is a common finding in athletes and during sleep; in these scenarios, it should not be considered abnormal. On the other hand…

…the volume, echogenicity and location of the effusion. Regarding the location, an effusion may be general (circumferential) or localized to a specific area. The effusion…

…result does not exclude delirium, however, and an abnormal result is not specific to delirium. Symptoms are often worse in the evening and at night…

…is both insensitive and non specific for SCD. Most people who die suddenly never had an ejection fraction measured before death, and among those who…

…higher than 18 mg are unlikely to revert a tachycardia and should not be used. Specific dosing adjustments are required in certain patient populations: Pediatric…

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

…material does not specify symptom patterns in detail. Physical manifestations Tendinous xanthomas, particularly over extensor tendons, are characteristic clinical manifestations of untreated FH and may…

…thrombus can fragment, embolize to other coronary branches or vascular beds, propagate through gaps between stent struts, and compromise the treated lumen. Conventional angiography has…

…There are however other disorders that may bring about similar ECG changes, and these are as follows: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVC/ARVD) – ARVC…

…Perfusion defects are further classified based on the intensity of tracer uptake and associated myocardial changes: Mild defects : Characterized by decreased tracer counts while preserving…

…of electrolyte imbalance and the visible ECG changes. Specific electrolyte disorders 1. Sodium Increased (hypernatremia) and decreased (hyponatremia) sodium levels do not have any effect…

…concentrations are given in mmol/L and the result in mosm/kg. Urea is included in the total osmolality but not in the effective osmolality…

…persistent, long standing persistent and permanent—and is not determined solely by the apparent frequency or duration of documented episodes. The central therapeutic objective is…

…failed fibrinolysis Immediate rescue PCI The 120 minute limit is a ceiling for the choice between primary PCI and fibrinolysis, not an acceptable routine target…

…maintenance treatment. The source material does not specify the loading dose. Efficacy and harms In secondary prevention trials involving patients with previous vascular disease, aspirin…

…ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies designed mainly around bleeding outcomes may not reliably…

…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…

…a tool to make rehabilitation possible, not an alternative to it. See the separate guide to joint aspiration and injection. Indications Condition Injection site Comment…

…other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive ventilation is not…

…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…

…C pharmacologically has not been shown to reduce cardiovascular events. Very high HDL C may paradoxically be associated with increased risk, and HDL C should…

ECG Myocardial ischemia and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes…

…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…

…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…