…and other tachykinins, such as substance P. When ACE is inhibited, the resulting accumulation of these peptides irritates afferent neural pathways in the respiratory tract…

…investigations. The emergency differential also reflects distinct mechanisms of acute cardiopulmonary disease: Pulmonary embolism and spontaneous pneumothorax may produce abrupt chest pain and respiratory distress…

…injury. Myocardial injury Myocardial injury is defined by at least one cardiac troponin (cTn) concentration above the assay specific 99th percentile upper reference limit (URL)…

…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…

…the onset of myocardial infarction. Cardiac troponin T and troponin I have emerged as the preferred biomarkers because they are extremely sensitive and specific for…

…beats per minute. Note that with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2…

…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…

…management, treatment response and outcomes of cardiovascular disease. The biological differences between females and males arise partly from the chromosomal distinction between XX and XY…

…serious (e. g. malignancy, amyloidosis). In case of suspicion of pericardial disease, in the first place, an echocardiographic examination is done. With echocardiography, good conditions…

…Disease specific genetic architecture HCM is predominantly associated with variants affecting sarcomeric proteins, particularly MYH7 and MYBPC3. Approximately 40–60% of tested patients have a…

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…

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

…and CABG. Physical examination findings are not specific to left main disease. The examination should nevertheless assess the consequences of extensive myocardial ischaemia, including heart…

…ostia. It remains the reference standard for defining the extent of coronary artery disease because it provides anatomical information while permitting functional assessment and, when…

…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…

…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)…

Cardiology Definition and purpose Cardiovascular risk assessment estimates an individual’s probability of experiencing cardiovascular disease (CVD) over a defined period. SCORE2 and SCORE2 Older…

…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…

…Their clinical importance arises from the causal role of low density lipoprotein cholesterol (LDL C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD)…

…patients with impaired renal function, reflecting both reduced clearance and the high prevalence of structural heart disease in this population. Obesity is associated with lower…

…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…

…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…

…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…

…protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise during an ongoing crisis…

…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…

…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…

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

…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…

…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…

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

…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…

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

…and guidelines do not state any ECG criteria specific to R wave progression. Figure 1. Pathological R wave progression is indicative of previous myocardial infarction…

…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…

…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…

…to treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy of these interventions is much lower or uncertain…

…pacemaker (or other ectopic focus) are referred to as an escape rhythm. In most cases, the escape rhythm originates in either of the following three…

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

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

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

…digitalis excess. Biomarkers and Laboratory Findings The source material does not provide information on biomarkers or laboratory findings specific to the evaluation of bradycardia. Treatment…

…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…

…mentioned below are discussed in detail in other chapters, to which links are provided throughout the text. Heart rate During the first week of life…

…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…

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

…prediction tool currently exists. At the other end, roughly two thirds of ICDs implanted for reduced LVEF never deliver an appropriate shock, so the false…

…of supraventricular tachycardias (SVTs), usually within 30 seconds. Doses higher than 18 mg are unlikely to revert a tachycardia and should not be used. Specific…

…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…

…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…

…gas is needed mainly when concomitant respiratory failure or an exact assessment of oxygenation requires it [3]. Calculation of osmolality Use the same formula throughout…

…cardiac disease Oxygen targets Patient Initial target saturation : : Known COPD or another clear risk of hypercapnic respiratory failure 88 to 92 percent No risk of…

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

…is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease (ASCVD)…

…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…

…history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks of vertigo, seconds…

…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…

…Male sex Previous upper gastrointestinal disease Hepatic or renal disease Multiple cardiovascular risk factors Concomitant nonsteroidal anti inflammatory drugs Corticosteroid therapy Other antiplatelet or antithrombotic…

…components of assessment. The history should include: previous TIA or stroke; symptoms suggesting current or recent cerebral ischaemia; known CAD, PAD, or other atherosclerotic disease…

…three main questions discussed in media, blogs and on social plattforms: Is high cholesterol a true cause of coronary artery disease? Does diet affect cholesterol…