…and kidney disease All patients with diabetes should be assessed for: ASCVD Severe target organ damage (TOD) HF AF CKD Other clinically relevant cardiovascular disease…

…with: Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific risk assessment or risk categorization is applicable Moderate or severe chronic kidney…

…and procedural risk factors The risk of adverse events is increased by: advanced age; diabetes mellitus; chronic kidney disease or renal failure; congestive heart failure…

…possible stent thrombosis for clinical research and outcome assessment. Predisposing factors Domain Factors associated with stent thrombosis Clinical Acute myocardial infarction, diabetes mellitus, renal failure…

…hypertrophic cardiomyopathy, diabetes mellitus, hypertension, heart failure, older age, vascular disease and renal dysfunction. The commonly used CHA2DS2 VASc score incorporates the following variables: Risk…

Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…

…diseases, including systemic lupus erythematosus and rheumatoid arthritis, are important risk enhancing conditions and are more prevalent in women. Chronic kidney disease and several other…

…phenotype later and require delayed or individualized assessment. Disease specific genetic architecture HCM is predominantly associated with variants affecting sarcomeric proteins, particularly MYH7 and MYBPC3…

…and kidney specific pathways. Diabetes, hypertension, dyslipidaemia, obesity, smoking and increasing age are common risk factors for CKD and CVD. Hypertension and renal disease are…

…atherogenic cholesterol than LDL C alone. It is particularly informative when triglyceride rich lipoproteins are increased, as commonly occurs with obesity, diabetes, prediabetes, insulin resistance…

…stenosis Distal bifurcation involvement Coexisting multivessel disease The extent of jeopardized myocardium Left ventricular systolic function Diabetes and other comorbidities Anatomical complexity and completeness of…

…chest discomfort requires a systematic differential diagnosis, as the syndrome associated with ischemic heart disease is broader than chest pain itself, encompassing symptoms like tightness…

…associated with a greater cardiovascular risk among those with resistant hypertension, including older age, Black ethnicity, elevated body mass index, diabetes, or chronic kidney disease…

…diagnosis of DKA requires three components: diabetes or hyperglycaemia, ketosis and metabolic acidosis. A very high glucose value is no longer required [1]. Diabetic ketoacidosis…

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

…for the other valves. The area is calculated by measuring the diameter of the valve ( area = π × radius 2 , where radius = diameter/2…

…persons with significant heart disease, predominantly ischemic heart disease. However, most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular…

…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…

…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…

…preferably while the patient is receiving a stable diuretic dose. Other clinical contexts Secondary causes should be pursued when abnormalities are identified on initial testing…

…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…

…medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial infarction (MI) care…

…elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin, so biomarker interpretation must be integrated with the clinical…

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

…The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous) pacing in bradycardia with haemodynamic compromise…

…related arrhythmias. The clinician must evaluate for the presence of worsening renal function, advanced age, hypokalemia, chronic lung disease, hypothyroidism, and amyloidosis. Furthermore, ongoing ischemia…

…uncertain. Acute HF generally produces higher BNP and NT proBNP concentrations than chronic, stable disease, and greater volume overload is usually associated with higher levels…

…Myocarditis Chronic kidney disease Cardiomyopathy Stroke or subarachnoid haemorrhage Takotsubo syndrome Pulmonary embolism Recent coronary revascularization Infiltrative disease, such as amyloidosis or sarcoidosis Other cardiac…

…be delivered by virtually anyone, advanced cardiopulmonary resuscitation (ACLS) is provided by healthcare professionals with the skills and equipment required. Although ACLS is more advanced…

…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…

…for conducting the test. All personnel must be appropriately trained and the laboratory must be equipped with defibrillators and other emergency instruments. Personnel conducting the…

…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)…

…either of the following three structures (discussed in detail in Chapter 1): Specific clusters of atrial myocardium : There are clusters of atrial myocardium that possess…

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

…Haematochezia can occur in massive upper bleeding with rapid intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis and can also be seen…

…Manifestations include angina, other chest discomfort, dyspnoea, or no symptoms. Although chronic coronary disease may remain stable for prolonged periods, it can progress or destabilize…

…Long term pharmacological management of chronic sinus bradycardia with a pacemaker is usually not necessary unless sinus rates are too slow to meet physiologic needs…

…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…

…driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke and systemic embolism. The contemporary understanding of AF has evolved…

…symptoms or ECG changes consistent with myocardial infarction/ischemia. Most patients, however, display both ECG changes and symptoms. Troponins and other biomarkers of myocardial necrosis…

…by the following criteria: Regular rhythm with a ventricular rate within the age specific normal interval. P wave with constant morphology preceding every QRS complex…

…most common arrhythmias encountered in clinical practice, beginning with a discussion of the underlying mechanisms of cardiac arrhythmias. While a detailed understanding of these mechanisms…

…is recorded in all patients with suspected pericardial disease. In addition to echocardiography, ECG and clinical examination, blood tests and other radiological examinations are most…

…and the incidence is particularly high after hip fracture, major surgery and intensive care [1,2]. The condition is associated with falls, aspiration, pressure sores…

…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…

…Pathophysiology Adenosine is an endogenous nucleoside present throughout the body that interacts with G protein coupled A1 receptors located on the extracellular surface of cardiac…

…magnitude of untreated LDL C elevation. The presence and age of onset of premature CAD or other vascular disease. A history of myocardial infarction or…

…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…

…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…

…chest Very severe airflow obstruction pH below 7.35 with raised pCO₂ Acute or acute on chronic hypercapnic respiratory failure Rapidly falling pH An urgent…

…Use with caution in patients with asthma/chronic obstructive pulmonary disease (COPD). Dyspnea has been reported in patients treated with ticagrelor. Patients with a history…

…patients with diabetes and combined dyslipidaemia, non HDL C is particularly relevant because it captures triglyceride rich lipoproteins in addition to LDL and other apoB…

…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…

…kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease…

…chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term antiplatelet therapy after STEMI is associated with…

…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…

…stroke; symptoms suggesting current or recent cerebral ischaemia; known CAD, PAD, or other atherosclerotic disease; diabetes and other cardiovascular risk factors; smoking, hypertension, hypercholesterolaemia, and…

…which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However…