…parathyroid gland surgery, use of bisphosphonates, excess calcitonin, use of phenytoin, use of phosphate substitution, use of foscarnet. ECG changes due to hypocalcemia Common ECG…

…length Large thrombotic burdens increase procedural risk because thrombus can fragment, embolize to other coronary branches or vascular beds, propagate through gaps between stent struts…

…This is due to the fact that atrial flutter is caused by a macro re entry circuit (a large re entry circuit) and re entry…

…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…

…or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in the adjacent joint. Known hypersensitivity to the…

…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…

…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…

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…

…aVR and often V1, and does not correspond to a specific coronary anatomic distribution [4, 5]. In contrast to acute myocardial infarction, pericarditis lacks prominent…

…is thought to involve the sensitization of sensory nerve endings due to the accumulation of bradykinin. ACE is responsible for metabolizing bradykinin and other tachykinins…

…Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated…

…dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting the relevant variant to each child. However, other inheritance patterns, de…

…reserve (FFR) is an invasive, lesion specific physiological index used to estimate the functional significance of an epicardial coronary stenosis. It is defined during maximal…

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

…impaired consciousness, heart failure, myocardial ischaemia or syncope — that has not responded to atropine: Complete heart block (third degree AV block) and second degree AV…

…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…

…and SCORE2 Older Persons (SCORE2 OP) are European risk prediction models designed to estimate 10 year risk of both fatal and non fatal CVD events…

…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…

…sodium pump. Digoxin binds reversibly to a specific high affinity site on the extracytoplasmic face of the alpha subunit of the Na+ K+ ATPase. This…

…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…

…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…

…relevance of withholding specific cardioactive medications during exercise testing (exercise ECG). Indications for exercise stress test Indications have been discussed in Introduction to Exercise ECG…

…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)…

…vagal tone does not necessitate treatment but it might be wise to observe the patient for 24 hours (including ECG monitoring). In all other situations…

ECG Myocardial ischemia and infarction ST segment depression due to acute myocardial ischemia ST segment depressions caused by ischemia are characterized by a horizontal or…

…of the cylinder area (a) and flow velocity (v): Q = a • v This principle can be used to estimate blood flow across the valves…

…haemorrhage protocol in uncontrolled bleeding, shock or a rapid transfusion requirement 10 With impaired consciousness, an inability to protect the airway, or ongoing major haematemesis…

…other chest discomfort, dyspnoea, or no symptoms. Although chronic coronary disease may remain stable for prolonged periods, it can progress or destabilize abruptly, leading to…

…does not provide specific details regarding the physical examination or general evaluation of patients with bradycardia. Diagnostics Electrocardiographic assessment is fundamental to the diagnosis and…

…contraindications to coronary angiography in the general sense; the decision depends on balancing the expected diagnostic or therapeutic benefit against the patient’s specific procedural…

…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…

…should influence the choice between PCI and CABG. Physical examination findings are not specific to left main disease. The examination should nevertheless assess the consequences…

…particularly when kidney function is impaired. Inadequate adherence to medication or dietary sodium restriction may therefore mimic pharmacological resistance or contribute directly to persistent hypertension…

…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…

…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…

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

…discussions of specific arrhythmias in subsequent chapters. Cardiac arrhythmias can be subdivided into the following categories: Bradyarrhythmia s (bradycardia): arrhythmias commonly due to dysfunctional automaticity…

…with suspected pericardial disease. In addition to echocardiography, ECG and clinical examination, blood tests and other radiological examinations are most often required, in particular computed…

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

…to discrimination: echocardiography is ubiquitous, standardized, and cheap to interpret. The limitation, familiar to every electrophysiologist, is that LVEF is both insensitive and non specific…

…Due to this rapid clearance, adenosine must be administered as a rapid intravenous bolus. Unlike many other intravenous medications where rapid boluses risk hemodynamic instability…

…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…

…LDLR, which account for most cases. Variants in APOB that impair apolipoprotein B binding to the LDL receptor. Gain of function variants in PCSK9, which…

…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…

…are common to all protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and…

…INR), older age, drugs predisposing to bleeding and alcohol use. A high bleeding risk score should prompt correction of modifiable risk factors and closer surveillance…

…The main mechanisms are impaired ventilation–perfusion matching, increased physiological dead space and the Haldane effect. It is therefore misleading to explain the whole phenomenon…

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

…combined dyslipidaemia, non HDL C is particularly relevant because it captures triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk…

…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…

…test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks of vertigo, seconds to a minute or so…

…min). Patients with mild to moderate heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function)…

…with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and aggregation contribute importantly to arterial thrombus formation…

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

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

…That study spread like a virus through social media and it is likely that it may have resulted in increased mortality due to stopping statins…