…potentially indicating microvascular dysfunction or other pathologies. The software allows for detailed regional analysis of myocardial perfusion, highlighting specific segments of the left ventricle that…

…and infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings, cardiac biomarkers…

…the Purkinje network, but rather via spread of the depolarization from the right ventricle. The abnormal ventricular depolarization will cause an abnormal repolarization. For this…

…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…

…and guidelines do not state any ECG criteria specific to R wave progression. Figure 1. Pathological R wave progression is indicative of previous myocardial infarction…

…Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic…

…atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The association is…

…all other situations, sinus arrest/pause should be considered abnormal, and the following differential diagnoses are at hand: Sinus node dysfunction. Side effects of drugs…

…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…

…causing microvascular embolization (i.e occluding smaller vessels downstream). The thrombosis causes occlusion of the artery; blood flow may be partially or completely obstructed. Consequently…

…to recite the months of the year backwards. A normal result does not exclude delirium, however, and an abnormal result is not specific to delirium…

…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…

…whereas others have brief or asymptomatic episodes that are not detected during routine clinical assessment. The clinical burden of AF does not reliably predict stroke…

…implantation should always be specified. Coronary arterial thrombi are predominantly platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or…

…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…

…at marked risk of arrhythmia. 4. Take a full blood count, electrolytes, creatinine, glucose, high sensitivity troponin and, where needed, coagulation tests. Blood sampling must…

…10–20 mg 20–40 mg 1–2 mL The doses follow the summaries of product characteristics: Lederspan specifies 10–20 mg periarticularly in bursitis…

…Female specific or female predominant factors associated with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational…

…elevated blood pressure Other cardiovascular risk factors and relevant comorbidities Evidence of hypertension mediated organ damage Existing cardiac, cerebrovascular, or renal disease The possibility of…

…Criteria for ST Elevation Myocardial Infarction (STEMI) The diagnosis of STEMI relies on specific electrocardiographic thresholds for ST segment elevation measured at the J point…

…specific adverse effects. Most of these adverse events are related to the suppression of the renin angiotensin aldosterone system (RAAS), such as decreases in blood…

…Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated…

…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…

…in the context of the clinical presentation and other findings. A reduced CFR may occur with angiographically insignificant epicardial disease because of abnormalities in the…

…responds to further cholinesterase inhibition. The test has a sensitivity of around 60 % and is not specific: motor neurone disease, myopathies and Lambert–Eaton syndrome…

…preferably anteroposteriorly : one anteriorly over the praecordium to the left of the sternum, the other on the back between the left scapula and the spine…

…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…

…control in atrial fibrillation, particularly when other therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across…

Cardiology Clinical chemistry & laboratory medicine Definition and Pathophysiology B type natriuretic peptide (BNP) and N terminal pro BNP (NT proBNP) are circulating markers of myocardial…

…is mediated by the combined effects of hyperglycaemia, hypertension, dyslipidaemia, obesity, smoking and other conventional risk factors, together with diabetes specific vascular and metabolic abnormalities…

…to treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy of these interventions is much lower or uncertain…

…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…

…and subject preparations. We will also discuss the relevance of withholding specific cardioactive medications during exercise testing (exercise ECG). Indications for exercise stress test Indications…

…examination, other examinations (which are not included in the standard examination), may be warranted. For most pathological conditions, there are specific guidelines (see links below)…

…product of area (a) of the cylinder and the velocity (v) of the fluid (i.e blood). The volume (V) that passes a specific segment…

…Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse, peripheral perfusion, mental state and chest findings. Avoid

…functional abnormalities of the coronary arteries or coronary microcirculation. These abnormalities can produce a transient and reversible mismatch between myocardial oxygen demand and blood supply…

…digitalis excess. Biomarkers and Laboratory Findings The source material does not provide information on biomarkers or laboratory findings specific to the evaluation of bradycardia. Treatment…

…with acute coronary syndrome, randomized evidence has demonstrated lower rates of access site bleeding, surgical repair, and blood transfusion with radial access. Radial access has…

…findings may reflect plaque disruption or thrombus. A rounded or polypoid intraluminal mass and lesion haziness raise suspicion of thrombus, although haziness is not specific…

…and CABG. Physical examination findings are not specific to left main disease. The examination should nevertheless assess the consequences of extensive myocardial ischaemia, including heart…

…blood pressure despite multidrug treatment rather than through specific symptoms. The clinical importance lies in its association with: Increased cardiovascular disease risk; Greater risk of…

…familiar with normal findings, normal variants, and pathology in neonates, infants and during the childhood years. Below follows a discussion on each of the nine…

…blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI). Anatomy of the pericardium…

…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…

…of supraventricular tachycardias (SVTs), usually within 30 seconds. Doses higher than 18 mg are unlikely to revert a tachycardia and should not be used. Specific…

…or patients with diabetes [4]. Associated Findings: The sudden onset of symptoms coupled with diaphoresis should always raise concern for a cardiovascular cause [4]. 2…

…history of premature CAD, cerebral vascular disease or peripheral vascular disease. A family history of premature myocardial infarction, vascular disease or marked hypercholesterolaemia. Physical findings…

…features of Brugada syndrome are fairly specific to the disorder, provided that the clinical characteristics are in line with the disorder. There are however other…

…of care. The clinical state, the circulation, comorbidity and the precipitating cause carry at least as much weight as the laboratory values [1]. Grade Blood…

…the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines the need for ventilatory…

…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…

…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…

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

…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…

…aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The…

…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…

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