…gradually from V1 to V5 and then diminishes again in V6. Refer to Figure 1 . Abnormal R wave progression implies that the gradual increase from…

…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…

…m² Abnormal urinalysis or renal imaging Mild progression risk, increased by proteinuria 3a 45–60 mL/min/1.73 m² Cardiovascular disease or other organ…

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

…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…

…intense emotional stress, acute pain or other stimuli that increases vagal tone. In all other situations, sinus arrest/pause should be considered abnormal, and the…

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

…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…

…upper reference limit is considered elevated (abnormal) and thus indicates myocardial necrosis. The upper reference limit is currently the 99th percentile in a healthy population…

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

…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…

…owing to changes in intra and extracellular electrolyte concentrations. Some electrolyte imbalances are clinically negligible (from an electrophysiological standpoint), whereas others may be life threatening…

…atrial appendage, although competing mechanisms such as large artery atherosclerosis and small vessel disease may also contribute to stroke in patients with AF. Stroke risk…

…used for type 1 myocardial infarction are fulfilled. The temporal relationship to stent implantation should always be specified. Coronary arterial thrombi are predominantly platelet rich…

…be blocked. The degree of blocking in the atrioventricular node is specified by counting the number of flutter waves preceding each QRS complex. If 3…

…NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical…

…Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in the adjacent joint…

…risk enhancing conditions and are more prevalent in women. Chronic kidney disease and several other comorbidities also contribute to the disproportionate cardiovascular burden in women…

…hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every patient with newly diagnosed or referred hypertension…

…aVR and often V1, and does not correspond to a specific coronary anatomic distribution [4, 5]. In contrast to acute myocardial infarction, pericarditis lacks prominent…

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

…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…

…Definition and scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition…

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

…residual weakness in a patient with known myasthenia responds to further cholinesterase inhibition. The test has a sensitivity of around 60 % and is not specific:…

…while awaiting the antidote and specific treatment. Bradyasystole during and after cardiac arrest with persisting electrical activity. Overdrive pacing in bradycardia dependent torsades de pointes…

…contained in all apoB containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride…

…adequate volume control. It is also utilized for ventricular rate control in atrial fibrillation, particularly when other therapeutic options cannot be pursued. Patients receiving digoxin…

…dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies, particularly cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac amyloidosis, BNP or NT proBNP may be markedly…

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

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

…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…

…the relevance of withholding specific cardioactive medications during exercise testing (exercise ECG). Indications for exercise stress test Indications have been discussed in Introduction to Exercise…

…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)…

…can be used to estimate blood flow across the valves. As illustrated in Figure 1, the orifice of the aortic valve and the ascending aorta…

…for other reasons. Extubate as soon as it is safe to do so after the endoscopy. Fluid and monitoring Use a balanced crystalloid in the…

…UA presents with compatible ischaemic symptoms but without cardiac specific troponin elevation above the 99th percentile. The clinical presentation should not be interpreted in isolation…

…arrest, it is essential to reconfirm the rhythm in two leads if possible to distinguish true bradyarrhythmic or asystolic arrest from other tachyarrhythmic events. On…

…37 Haemodynamic complications 0.26 Cardiac chamber perforation 0.03 Other complications 0.28 Total major complications 1.70 In another large diagnostic catheterization analysis…

…findings from non invasive testing and the anticipated effect of the result on management. ICA with available coronary pressure assessment is recommended in patients with…

…should influence the choice between PCI and CABG. Physical examination findings are not specific to left main disease. The examination should nevertheless assess the consequences…

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

…of the nine parameters listed above. Many of the diagnoses mentioned below are discussed in detail in other chapters, to which links are provided throughout…

…exudate). Often pericardial effusion is detected randomly (for example, in CT, MRI, echocardiography). In other cases, the effusion is detected under more dramatic circumstances, as…

…the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no practical risk prediction tool currently exists. At the other end…

…should not be used. Specific dosing adjustments are required in certain patient populations: Pediatric patients: For patients weighing less than 50 kg, the dosing should…

…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…

…may develop when the disorder is not recognized early in life. Corneal arcus and xanthelasma can also occur, although they are less specific for FH…

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

…The condition occurs above all in: treatment with SGLT2 inhibitors pregnancy prolonged fasting or a very low carbohydrate intake excessive alcohol consumption vomiting or othe

…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…

…precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for the prevention…

…particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance or metabolic syndrome Elevated triglycerides Low or apparently well controlled LDL C…

…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…

…spot, in three minutes, without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The…

…80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin…

…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…

…only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and…

…or other atherosclerotic disease; diabetes and other cardiovascular risk factors; smoking, hypertension, hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral…

…1960s. In 1948 the NHLBI initiated the Framingham Heart Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were…