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

…fluid (exudate) to pure blood (exudate). Often pericardial effusion is detected randomly (for example, in CT, MRI, echocardiography). In other cases, the effusion is detected…

…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…

…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…

…injection under fluoroscopy. The procedure is performed by advancing guidewires and diagnostic catheters from a percutaneous arterial access site to the aortic root, engaging the…

…first passage through the circulation. Due to this rapid clearance, adenosine must be administered as a rapid intravenous bolus. Unlike many other intravenous medications where…

…and other biomarkers of myocardial necrosis (infarction) Myocardium can endure 20 to 30 minutes of complete ischemia. After this period the cells die and the…

…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…

…thrombus can fragment, embolize to other coronary branches or vascular beds, propagate through gaps between stent struts, and compromise the treated lumen. Conventional angiography has…

…atrial flutter is not capable of persisting for longer periods of time. This is due to the fact that atrial flutter is caused by a…

…than 12 hours, immediate fibrinolysis is recommended in the absence of contraindications, followed by direct transfer to a PCI centre [1,5]. Situation Practical target…

…the specificity for pathological R wave progression is considerably lower than pathological Q waves and guidelines do not state any ECG criteria specific to R…

…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…

…attributable to a specific, identifiable underlying cause. It should be considered in every patient with newly diagnosed or referred hypertension, with particular vigilance when the…

…The ST segment elevation in acute pericarditis is typically diffuse, involving all leads except aVR and often V1, and does not correspond to a specific…

…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…

…is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin, so biomarker interpretation must be integrated with the clinical history…

…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…

…lesion specific physiological index used to estimate the functional significance of an epicardial coronary stenosis. It is defined during maximal pharmacological coronary vasodilation as the…

…non HDL C primarily reflect cholesterol content. The amount of cholesterol carried by individual particles varies according to particle size and composition. As a result…

…adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast…

…CAD to peripheral arterial disease, cerebrovascular disease, valvular heart disease, heart failure, atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis…

…therapeutic to toxic windows, and its routine use in adult patients is generally discouraged. However, it retains a specific niche in contemporary cardiovascular pharmacotherapy. The…

…plasma concentrations of the two peptides are not interchangeable. Natriuretic peptide concentrations reflect haemodynamic stress, but their release is not specific to left ventricular systolic…

…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)…

…The excess risk is mediated by the combined effects of hyperglycaemia, hypertension, dyslipidaemia, obesity, smoking and other conventional risk factors, together with diabetes specific vascular…

…which scenario head tilt chin lift should only be used if other methods fail to open the airway. Figure 1. Methods to open the airway…

…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…

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

…during the standard examination, other examinations (which are not included in the standard examination), may be warranted. For most pathological conditions, there are specific guidelines…

…but it might be wise to observe the patient for 24 hours (including ECG monitoring). In all other situations, the underlying condition should be targeted…

…unlikely to be the cause of the ST segment depression. The horizontal ST segment depression is more specific than the downsloping depression. Refer to Figure…

…by the machine. This area is referred to as the VTI (Velocity Time Integral) , and it measures how far blood travels during the time period…

…for other reasons. Extubate as soon as it is safe to do so after the endoscopy. Fluid and monitoring Use a balanced crystalloid in the…

…coronary disease may remain stable for prolonged periods, it can progress or destabilize abruptly, leading to ACS. Thus, “disease” refers to the underlying coronary pathology…

…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…

…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…

…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…

…The apparently uncontrolled office blood pressure must be confirmed using home blood pressure monitoring or ambulatory blood pressure monitoring. Other guideline formulations similarly define resistant…

…cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke and systemic embolism. The contemporary understanding of AF has evolved significantly; it is…

…reasonable to acquire an understanding of the overarching concepts. Arrhythmogenesis (mechanisms of arrhythmias) is presented in this chapter, followed by in depth discussions of specific…

…however, and an abnormal result is not specific to delirium. Symptoms are often worse in the evening and at night, but diurnal variation is not…

…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…

…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…

…Physical findings related to cholesterol deposition. Untreated or inadequately treated patients may develop premature CAD. Symptoms therefore depend on the vascular territory involved and may…

…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…

…of myocardial perfusion, highlighting specific segments of the left ventricle that demonstrate abnormalities. These tools compare perfusion data to population based reference databases, often adjusted…

…to changes in intra and extracellular electrolyte concentrations. Some electrolyte imbalances are clinically negligible (from an electrophysiological standpoint), whereas others may be life threatening. The…

…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…

…vessel disease may also contribute to stroke in patients with AF. Stroke risk is heterogeneous and is determined principally by the patient’s underlying clinical…

…and circulation. 2. Give controlled oxygen with a target of 88 to 92 percent until the risk of hypercapnia has been assessed. 3. Take an…

…or a prior heart attack and a high risk of developing an atherothrombotic event. Contraindications Hypersensitivity to the active substance or any excipient. Active bleeding…

…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…

…the supply and demand of ATP; increased cardiac workload results in increased ATP production and vice versa. Importantly, cardiac myocytes require aerobic metabolism (oxygen) to…

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

…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…

…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…

…of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of severe asymptomatic stenosis is low, screening has not been shown to…

…cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However, association is not the same as causation . A…