…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…

…crush technique, stent fracture or collapse Lesion specific angiographic features Residual dissection at a stent margin, impaired flow into or out of the stent, stent…

…are more prevalent in women. Chronic kidney disease and several other comorbidities also contribute to the disproportionate cardiovascular burden in women. Depression and anxiety are…

…and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI). Anatomy of the pericardium The pericardium…

…Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease…

…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…

…atherothrombosis. It is usually precipitated by disruption of an atherosclerotic plaque through rupture or erosion. The relative contributions of plaque disease and thrombus vary considerably…

…and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The association is mediated by…

…of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome associated with ischemic heart disease…

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

…Relevant predispositions, such as connective tissue disease. No single pain descriptor is diagnostic. The severity of pain also has limited discriminatory value. Features suggesting myocardial…

…chronic kidney disease, ST segment elevation myocardial infarction, and cardiogenic shock. Patient related and procedural risk factors The risk of adverse events is increased by…

…our understanding of the pathophysiology of cardiac disease. Ultrasound systems have become cheaper, more portable, more powerful, equipped with an increasing number of methods to…

…artery disease (CAD) : Myocardial perfusion imaging can confirm or rule out CAD in patients with symptoms suggestive of CAD. SPECT imaging is recommended as the…

…They supersede risk models that estimate cardiovascular mortality alone because non fatal events constitute an important component of the overall burden of atherosclerotic cardiovascular disease…

…Acute myocardial infarction is the most severe complication of coronary artery disease. The most common initiating mechanism is rupture or erosion of a vulnerable (unstable…

…responds to further cholinesterase inhibition. The test has a sensitivity of around 60 % and is not specific: motor neurone disease, myopathies and Lambert–Eaton syndrome…

…their use is limited by specific adverse effects. Most of these adverse events are related to the suppression of the renin angiotensin aldosterone system (RAAS)…

…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…

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

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

…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…

…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…

…the fourth universal definition of MI. Type 1 MI is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of…

…chronic lung disease, hypothyroidism, and amyloidosis. Furthermore, ongoing ischemia, hypomagnesemia, and moderate to severe renal impairment increase the likelihood of digitalis intoxication even at therapeutic…

…Natriuretic peptides have three principal roles: Supporting or excluding the diagnosis of HF Estimating disease severity and prognosis Contributing to longitudinal assessment and risk stratification…

…and age of onset of premature CAD or other vascular disease. A history of myocardial infarction or raised cholesterol among relatives. The presence of tendon…

…measurements permit assessment of the physiological significance of selected stenoses using fractional flow reserve (FFR) and instantaneous wave free ratio (iFR). Other invasive techniques can…

…disease and amplifies cardiovascular and all cause mortality. The excess risk is mediated by the combined effects of hyperglycaemia, hypertension, dyslipidaemia, obesity, smoking and other…

…s disease and digoxin intoxication may also cause hyperkalemia. ECG in mild hyperkalemia (potassium 6,0 mmol/L) The earliest sign of hyperkalemia is the…

…stroke or TIA. The presence of mitral stenosis, a mechanical heart valve or hypertrophic cardiomyopathy. Heart failure, hypertension, diabetes and vascular disease. Age and sex…

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

…ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes…

…is a common and early electrocardiographic sign of acute pericarditis, reflecting pericardial involvement overlying the atria [4, 5]. Other Differential Diagnoses ST segment elevations simulating…

…anteriorly over the praecordium to the left of the sternum, the other on the back between the left scapula and the spine. The anterolateral position…

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

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

…Otherwise, ischemia is unlikely to be the cause of the ST segment depression. The horizontal ST segment depression is more specific than the downsloping depression…

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

…monitoring Use a balanced crystalloid in the first instance. Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure…

…rate. Within the context of acute coronary syndromes, particularly ST elevation myocardial infarction (STEMI), ischemic injury can disrupt the conduction system at any level, producing…

…induces a systemic hypercoagulable state, characterized by elevated biomarkers such as D dimer, von Willebrand factor, and increased thrombin generation. The clinical consequence of this…

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

…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…

…the patient to recite the months of the year backwards. A normal result does not exclude delirium, however, and an abnormal result is not specific…

…value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no practical risk prediction tool currently exists. At the other…

…from the extracellular space via washout, enzymatic degradation to inosine, phosphorylation to AMP, and reuptake into cells through a nucleoside transport system. Because of these…

…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…

…indicating microvascular dysfunction or other pathologies. The software allows for detailed regional analysis of myocardial perfusion, highlighting specific segments of the left ventricle that demonstrate…

…circulatory shock require a specific protocol and early specialist involvement. DKA and HHS are dynamic conditions. Treatment must be guided by the clinical response and…

…a systemic corticosteroid if the exacerbation is more than mild. 6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal…

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

…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 …

…the cell will die. Death of myocardial cells is referred to as myocardial infarction. Myocardial ischemia in clinical practice: coronary artery disease In clinical practice…

…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…

…Prophylaxis against recurrence of cerebrovascular disease: 75–80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant…

…after PCI; reduce recurrent atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term…

…affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary…

…Carotid disease therefore commonly coexists with coronary artery disease (CAD), peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is…

…This knowledge has been translated into remarkable advances in the management of coronary artery disease, as demonstrated in the figure below (from Nabel et al…