…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…

…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…

…the principal risk tool in people with: Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific risk assessment or risk categorization is…

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

…AF pattern. Important predictors include previous stroke or transient ischaemic attack (TIA), mitral stenosis, hypertrophic cardiomyopathy, diabetes mellitus, hypertension, heart failure, older age, vascular disease…

…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…

…specific or female predominant factors associated with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational diabetes…

…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…

…worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The association is mediated by both traditional and kidney specific pathways. Diabetes, hypertension…

…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…

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

…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…

…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…

…Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and…

…with angiographically insignificant epicardial disease because of abnormalities in the coronary resistance vessels. Left ventricular hypertrophy also reduces coronary flow reserve: myocardial mass increases without…

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

…the US and many other countries, a 2:1 block will be difficult to discern because the flutter wave may fuse with the preceding T…

…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…

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

…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…

…cough is primarily clinical and relies on the temporal association of the cough with the medication. Specific diagnostic criteria for cough hypersensitivity syndrome are lacking…

…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…

…Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm…

…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…

…control in atrial fibrillation, particularly when other therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across…

…but their release is not specific to left ventricular systolic dysfunction. Levels may also rise with: Left ventricular diastolic dysfunction Valvular heart disease Pulmonary hypertension…

…hours. The extent and tempo of injury are influenced by collateral flow, myocardial oxygen consumption, and intermittent occlusion with reperfusion. Prompt reperfusion, when appropriate, reduces…

…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…

…and subsequent fall in cardiac specific troponin attributable to myocardial ischaemia. UA presents with compatible ischaemic symptoms but without cardiac specific troponin elevation above the…

…there are generally no reliable and safe drugs available for long term heart rate augmentation without undesirable side effects. Drugs, With Doses and Practical Co

…thrombus and other structural features that may not be evident on angiography alone. It is particularly useful when ACS occurs without significant obstructive CAD or…

…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…

…of consciousness immediately. 2. Check oxygen saturation and capillary glucose. 3. Exclude immediately treatable threats without delay: hypoxia, hypoglycaemia, circulatory failure, sepsis, stroke, intracranial haemorrhage…

…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…

…are less specific for FH. Corneal arcus is particularly informative when it occurs before age 45 years. Homozygous familial hypercholesterolaemia HoFH typically presents with: Extensive…

…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…

…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…

…at high risk of developing a new event. Administration Ticagrelor can be administered with or without food. For patients who cannot swallow the tablets whole…

…to LDL and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years without diabetes and with LDL C between…

…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…

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

…reported with acetylsalicylic acid. Discontinue acetylsalicylic acid at the first sign of skin rash, mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other…

…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…

…limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established…

…in people without diabetes. Carotid disease is also a marker of systemic cardiovascular risk. The presence of a carotid bruit is associated with approximately double…

…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…