…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…

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

…and infarction Definition and pathophysiology Fractional flow reserve (FFR) is an invasive, lesion specific physiological index used to estimate the functional significance of an epicardial…

…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…

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

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

…is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months and have health implications…

…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)…

…discouraged. However, it retains a specific niche in contemporary cardiovascular pharmacotherapy. The pharmacologic foundation of digoxin lies in its inhibition of the Na+ K+ ATPase…

…structures (discussed in detail in Chapter 1): Specific clusters of atrial myocardium : There are clusters of atrial myocardium that possess automaticity and thus pacemaker function…

…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…

…a pulse that can be felt. The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous)…

…Natriuretic peptide concentrations reflect haemodynamic stress, but their release is not specific to left ventricular systolic dysfunction. Levels may also rise with: Left ventricular diastolic…

…Other guideline formulations similarly define resistant hypertension as blood pressure above goal despite three or more antihypertensive drugs from different classes at maximally tolerated doses…

…care [1,2]. The condition is associated with falls, aspiration, pressure sores, loss of function, longer length of stay, institutional care, readmission, cognitive decline and…

…from other tachyarrhythmic events. On the surface electrocardiogram, sinus bradycardia may appear at rates of 40 to 48 beats per minute, occasionally accompanied by junctional…

…may develop when the disorder is not recognized early in life. Corneal arcus and xanthelasma can also occur, although they are less specific for FH…

…of other comorbidities, does not significantly increase stroke risk. Conversely, the 2023 ACC/AHA guidelines retain the "VASc" nomenclature but clarify that female sex functions…

…ECG and clinical examination, blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI…

…risk must be considered alongside thromboembolic risk. The HAS BLED score includes hypertension, abnormal renal or liver function, prior stroke, bleeding tendency or previous bleeding…

…used for type 1 myocardial infarction are fulfilled. The temporal relationship to stent implantation should always be specified. Coronary arterial thrombi are predominantly platelet rich…

…most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals…

…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…

…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…

Cardiology Endocrinology & metabolism Definition and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every…

…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…

…Despite their proven morbidity and mortality benefits, their use is limited by specific adverse effects. Most of these adverse events are related to the suppression…

…release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin, so biomarker interpretation…

…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…

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

…HMOD) Probable or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic, rare lipid, or BP disorders Pregnancy Established ASCVD includes previous acute…

…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)…

…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 interventions available in BLS, the number needed to treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy…

…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…

…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…

…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 …

…aorta can be regarded as a cylinder, and the same assumption can be made for the other valves. The area is calculated by measuring the…

…ECG changes and symptoms. Troponins and other biomarkers of myocardial necrosis (infarction) Myocardium can endure 20 to 30 minutes of complete ischemia. After this period…

…of the nine parameters listed above. Many of the diagnoses mentioned below are discussed in detail in other chapters, to which links are provided throughout…

…of arrhythmias) is presented in this chapter, followed by in depth discussions of specific arrhythmias in subsequent chapters. Cardiac arrhythmias can be subdivided into the…

…familiar to every electrophysiologist, is that LVEF is both insensitive and non specific for SCD. Most people who die suddenly never had an ejection fraction…

…as a rapid intravenous bolus. Unlike many other intravenous medications where rapid boluses risk hemodynamic instability or transiently toxic concentrations, adenosine requires a rapidly delivered…

…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…

…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…

…a correlation between the severity of electrolyte imbalance and the visible ECG changes. Specific electrolyte disorders 1. Sodium Increased (hypernatremia) and decreased (hyponatremia) sodium levels…

…and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and HHS are dynamic…

…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…

…Information about concurrent ticagrelor treatment is required for interpreting platelet function tests for HIT. Other cosiderations Based on a relationship observed in the PLATO study…

…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…

…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…

…Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing bleeding risk. Monitor coagulation…

…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…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

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