…always be specified. Coronary arterial thrombi are predominantly platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated…

…laboratory medicine Myocardial ischemia and infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia…

…from a peripheral artery to the aortic root and coronary ostia. It remains the reference standard for defining the extent of coronary artery disease because…

…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…

…Other leads Greater than or equal to 1 mm These criteria for the other leads apply in the absence of left ventricular hypertrophy or left…

…Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis…

…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…

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

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

…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…

…heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast not recommended [1,5]. STEMI…

…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…

…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…

…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…

…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…

…alternative etiologies are excluded by diagnostic testing or failed therapeutic trials. If alternative causes of cough are suspected, specific diagnostic pathways may be pursued. Spirometry

…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…

…left main stem or proximal left anterior descending artery are more likely to affect flow because they supply a larger myocardial territory. The response of…

…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…

…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…

…C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression. As the burden of retained…

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…

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

…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…

…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…

…syndromes and acute coronary syndromes HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD with associated cardiovascular…

…disability that precludes safe and adequate testing Relative contraindications Known obstructive left main coronary artery stenosis Moderate to severe aortic stenosis with uncertain relation to…

…risk of embolization Relative contraindications for exercise ECG Severe hypertension (systolic blood pressure 200 mmHg or diastolic blood pressure 110 mmHg). Left main coronary artery…

…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)…

…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…

…segment depressions with prominent T waves in the majority of the chest leads may indicate an acute occlusion in the LAD (left anterior descending artery)…

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

…intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis and can also be seen when the bleeding is slow or has stopped. The…

…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…

…a lesion proximal to the first septal perforator of the left anterior descending artery was associated with lower five year survival than a more distal…

…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…

…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…

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

…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…

…delivered bolus to achieve sufficiently high concentrations at its clinical site of action—the coronary artery perfusing the AV node—before the drug is eliminated…

…2], [5]. Localization: While often retrosternal, the pain may be localized to the left anterior chest and can radiate to the neck, shoulders, and arms…

…low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic cardiovascular disease (ASCVD), particularly coronary artery disease (CAD)…

…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…

…at the top. Refer to Figure 1 . Patients with left ventricular hypertrophy may instead display normalization of secondary T wave inversions (lead V5, V6, aVL…

…Always follow the local protocol for exact infusion rates, electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises…

…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…

…Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood…

…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…

…benefit of therapy. Lifestyle modification is appropriate across the risk spectrum. Statin therapy is considered when the anticipated benefit is sufficient, with coronary artery calcium…

…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…

…Gufoni manoeuvre for treatment. Contraindications Absolute: Unstable cervical spine injury, recent cervical spine surgery, atlantoaxial instability, severe rheumatoid arthritis of the neck. Symptomatic carotid stenosis…

…the efficacy of diuretics and antihypertensives. Risk of acute kidney injury increases when combined with ACE inhibitors. Corticosteroids and other NSAIDs: Increased risk of gastrointestinal…

…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…

…other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic cardiovascular disease (ASCVD), coronary artery…

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

…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…