…Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis…

…decline and increased mortality [3,4]. Do this first 1. Assess vital signs and level of consciousness immediately. 2. Check oxygen saturation and capillary glucose…

…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…

…most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…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…

…Diagnostic criteria for acute myocardial infarction A diagnosis of myocardial infarction is based on the following three components: Cardiac troponins – Elevation of cardiac troponins in…

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

ECG Myocardial ischemia and infarction ST segment depression due to acute myocardial ischemia ST segment depressions caused by ischemia are characterized by a horizontal or…

…the other leads apply in the absence of left ventricular hypertrophy or left bundle branch block [8, 10]. Characteristics of ST Elevation in Acute Transmural…

…by an acute coronary process. Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may…

…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…

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

…diseases: effusion and tamponade A long series of conditions can affect the pericardium (pericardium). The most common of these are acute pericarditis (perimyocarditis), constrictive pericarditis…

…a pulse that can be felt. The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous)…

…burden of retained atherogenic particles accumulates over time, the probability of an acute atherosclerotic cardiovascular event increases. Non HDL Cholesterol Non HDL C is calculated…

…provide information on biomarkers or laboratory findings specific to the evaluation of bradycardia. Treatment and Management, Including Acute and Long Term Strategies The initial approach…

…contraindicated in patients with acute myocardial infarction, unstable angina, severe aortic stenosis, decompensated heart failure, and uncontrolled arrhythmias. Pharmacologic stress agents have specific contraindications: Adenosine…

…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…

…or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic, rare lipid, or BP disorders Pregnancy Established ASCVD includes previous acute coronary syndrome…

…stroke, coronary perforation, haemodynamic collapse, acute kidney injury, and death. The risk profile differs between diagnostic angiography and PCI, and is strongly influenced by the…

…and other relevant investigations. Clinical Presentation and Symptoms Natriuretic peptide testing is particularly useful when symptoms suggest HF but the diagnosis remains uncertain. Acute HF…

…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…

…disease The extent of jeopardized myocardium Left ventricular systolic function Diabetes and other comorbidities Anatomical complexity and completeness of possible revascularization A proximal lesion jeopardizes…

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

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

…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…

…electrolyte imbalances are clinically negligible (from an electrophysiological standpoint), whereas others may be life threatening. The most common and clinically most relevant electrolyte imbalances concern…

…or develop during acute management. AF is often haemodynamically tolerated and may require no specific acute therapy beyond appropriate anticoagulation and management of ventricular rate…

…a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint…

Cardiology Endocrinology & metabolism Definition and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every…

…Despite their proven morbidity and mortality benefits, their use is limited by specific adverse effects. Most of these adverse events are related to the suppression…

…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…

…reserve (FFR) is an invasive, lesion specific physiological index used to estimate the functional significance of an epicardial coronary stenosis. It is defined during maximal…

…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…

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

…discouraged. However, it retains a specific niche in contemporary cardiovascular pharmacotherapy. The pharmacologic foundation of digoxin lies in its inhibition of the Na+ K+ ATPase…

…the interventions available in BLS, the number needed to treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy…

…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)…

…aorta can be regarded as a cylinder, and the same assumption can be made for the other valves. The area is calculated by measuring the…

…Other guideline formulations similarly define resistant hypertension as blood pressure above goal despite three or more antihypertensive drugs from different classes at maximally tolerated doses…

…systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical cul de sac [19] …

…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…

…of arrhythmias) is presented in this chapter, followed by in depth discussions of specific arrhythmias in subsequent chapters. Cardiac arrhythmias can be subdivided into the…

…familiar to every electrophysiologist, is that LVEF is both insensitive and non specific for SCD. Most people who die suddenly never had an ejection fraction…

…as a rapid intravenous bolus. Unlike many other intravenous medications where rapid boluses risk hemodynamic instability or transiently toxic concentrations, adenosine requires a rapidly delivered…

…Corneal arcus and xanthelasma can also occur, although they are less specific for FH. Corneal arcus is particularly informative when it occurs before age 45…

…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…

…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 patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and HHS are dynamic…

…Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas…

…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) 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…

…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…

…Risk of acute kidney injury increases when combined with ACE inhibitors. Corticosteroids and other NSAIDs: Increased risk of gastrointestinal bleeding when combined with acetylsalicylic acid…

…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…

…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…

…with homozygous FH typically die from acute myocardial infarction at 20 to 30 years of age. People with familial hypercholesterolemia have no other metabolic aberration…