…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…

…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…

…and the relationship between diameter stenosis and haemodynamic significance is weak, particularly for intermediate lesions. Even lesions with a visual diameter reduction of 50–70…

…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…

…still indicated with continuing ischaemia, shock, serious arrhythmia or acute heart failure. Routine opening of a persistently occluded infarct related artery in a stable and…

…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…

…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…

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

…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…

…failure are among the conditions associated with myocardial injury. Relationship to chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations arising from…

…arrest. Evaluation and Physical Examination The source material does not provide specific details regarding the physical examination or general evaluation of patients with bradycardia. Diagnostics…

…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…

…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…

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

…precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for the prevention…

…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…

…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…

…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…