…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…

…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…

…heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast not recommended [1,5]. STEMI…

…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…

…criteria specific to R wave progression. Figure 1. Pathological R wave progression is indicative of previous myocardial infarction. U wave changes New U waves (in…

…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…

…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…

…diagnosis of STEMI relies on specific electrocardiographic thresholds for ST segment elevation measured at the J point. The diagnostic criteria require new ST elevation in…

…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…

…although some series report 10–20%. Other life threatening cardiopulmonary conditions account for approximately 5% of presentations in some populations. Despite this relatively low prevalence…

…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:…

…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 in atherosclerotic cardiovascular disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB…

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

…aldosterone system. In heart failure, the interaction between the cardiac and renal axes may produce cardiorenal syndrome. Worsening renal function in the presence of persistent…

…nodal refractoriness. Its electrophysiologic effects on the His Purkinje system and ventricular muscle are minimal, except in cases of toxic concentrations. In most patients, the…

…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…

…4b and 4c fulfil the criteria for type 1 MI because they represent coronary atherothrombotic events in the setting of a stent thrombosis or restenosis…

…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 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…

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

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

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

…the primary ECG finding is the ST segment depressions. In STE ACS, on the other hand, the ST segment depressions are secondary findings and the…

…the valves. As illustrated in Figure 1, the orifice of the aortic valve and the ascending aorta can be regarded as a cylinder, and the…

…Intubation is reasonable in: a reduced level of consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged…

…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…

…setting of cardiac arrest, it is essential to reconfirm the rhythm in two leads if possible to distinguish true bradyarrhythmic or asystolic arrest from other…

…radial access. Radial access has also been associated with lower overall major adverse cardiac events and mortality in pooled analyses of randomized trials. Femoral access…

…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…

…function Diabetes and other comorbidities Anatomical complexity and completeness of possible revascularization A proximal lesion jeopardizes more myocardium than a distal lesion. In observational data…

…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…

…increase in NSTEMI and a corresponding decrease in unstable angina in the past two decades (many of those who would previously have been classified as…

…age variations in heart rate are due to variations in the activity of the autonomic nervous system and changes in the automaticity of the sinoatrial…

…of specific arrhythmias in subsequent chapters. Cardiac arrhythmias can be subdivided into the following categories: Bradyarrhythmia s (bradycardia): arrhythmias commonly due to dysfunctional automaticity in…

…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…

…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…

…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…

…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…

…consequent excess risk of premature atherosclerotic cardiovascular disease (ASCVD), particularly coronary artery disease (CAD). FH results from pathogenic variants affecting proteins in the hepatic LDL…

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

…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…

…of serious arrhythmias. This is possible because there is a correlation between the severity of electrolyte imbalance and the visible ECG changes. Specific electrolyte disorders…

…electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises the order in which measures are taken and the…

…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…

…on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic…

…a summary of the indications, contraindications, dosage, administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination…

…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…

…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…

…the clinical importance of non fatal gastrointestinal and intracranial haemorrhage is substantial, particularly because the absolute cardiovascular benefit is small in many primary prevention populations…

…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…