…cysts and tumors of the pericardium, as well as congenital malformations leading to an incomplete or absent pericardium. In case of suspicion of pericardial disease…

…specific genetic architecture HCM is predominantly associated with variants affecting sarcomeric proteins, particularly MYH7 and MYBPC3. Approximately 40–60% of tested patients have a single…

…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…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…treatment — modification of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection…

…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…

…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…

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

…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…

…alternative etiologies are excluded by diagnostic testing or failed therapeutic trials. If alternative causes of cough are suspected, specific diagnostic pathways may be pursued. Spirometry

…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…

…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…

…obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked…

…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…

…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…

…Diagnostics Electrocardiography and Electrophysiology Electrocardiographic evaluation of patients receiving digoxin reveals specific electrophysiologic profiles. Digoxin's autonomic actions largely slow the sinus node discharge rate…

…plasma concentrations of the two peptides are not interchangeable. Natriuretic peptide concentrations reflect haemodynamic stress, but their release is not specific to left ventricular systolic…

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

…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…

…if there is suspicion of cervical spine injury, in which scenario head tilt chin lift should only be used if other methods fail to open…

…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)…

…the most common cause of sinus arrest/pause. It commonly affects younger individuals who endure intense emotional stress, acute pain or other stimuli that increases…

…of the ST segment depression. The horizontal ST segment depression is more specific than the downsloping depression. Refer to Figure 1 . Figure 1. Characteristics of…

…and the same assumption can be made for the other valves. The area is calculated by measuring the diameter of the valve ( area = π …

…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…

…specific troponin elevation above the 99th percentile. The clinical presentation should not be interpreted in isolation. The initial diagnosis and triage depend on integration of…

…true bradyarrhythmic or asystolic arrest from other tachyarrhythmic events. On the surface electrocardiogram, sinus bradycardia may appear at rates of 40 to 48 beats per…

…ostia. It remains the reference standard for defining the extent of coronary artery disease because it provides anatomical information while permitting functional assessment and, when…

…and lesion haziness raise suspicion of thrombus, although haziness is not specific. Intravascular imaging can identify plaque disruption, thrombus and other structural features that may…

…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…

…than through specific symptoms. The clinical importance lies in its association with: Increased cardiovascular disease risk; Greater risk of myocardial infarction; Increased risk of stroke…

…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…

…the onset of myocardial infarction. Cardiac troponin T and troponin I have emerged as the preferred biomarkers because they are extremely sensitive and specific for…

…mentioned below are discussed in detail in other chapters, to which links are provided throughout the text. Heart rate During the first week of life…

…On the other hand, sinus bradycardia developing during physical exercise is considered abnormal, because heart rate must increase during exercise. Mechanisms of cardiac arrhythmias The…

…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…

…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…

…accumulation of cyclic adenosine monophosphate (cAMP), which in turn reduces the L type calcium current (Ica.L) and the pacemaker current (If) in sinus node…

…history suggesting an autoimmune disorder or known malignancy may suggest specific, nonidiopathic etiologies [2]. Summary of Pain Characteristics The following table synthesizes the key differential…

…availability of hepatic LDL receptors. Rare biallelic variants in LDLRAP1, which impair LDL receptor endocytosis and produce an FH like phenotype. Individuals with a single…

…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…

…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…

…All degrees of AV block. Sinus node dysfunction and tach brady syndrome. Ventricular tachycardia, ventricular fibrillation and torsade de pointes. Hypocalcemia Causes of hypocalcemia Acute…

…Always follow the local protocol for exact infusion rates, electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises…

…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…

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

…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…

…A single central feature is enough to proceed with urgent investigation , and a normal CT of the brain does not exclude an infarction in the…

…acetylsalicylic acid at the first sign of skin rash, mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit…

…DAPT), while treatment with one antiplatelet drug constitutes single antiplatelet therapy (SAPT). The benefit of antiplatelet therapy must always be balanced against bleeding. This balance…

…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…

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