…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…

…coronary occlusion and progress over time. Experimentally, necrosis advances from the subendocardium towards the subepicardium over several hours. The extent and tempo of injury are…

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

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

ECG Myocardial ischemia and infarction Lathundar ECG Criteria for ST Elevation Myocardial Infarction (STEMI) The diagnosis of STEMI relies on specific electrocardiographic thresholds for ST…

…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…

…biomarkers because they are extremely sensitive and specific for myocardial injury. Elevated levels of cardiac troponins is firm evidence of myocardial necrosis (i.e infarction…

…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…

…NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical…

…1 mL Plantar fascia 10–20 mg 20–40 mg 1–2 mL The doses follow the summaries of product characteristics: Lederspan specifies 10–20…

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

…than men after approximately 65 years of age. Hypertension related left ventricular hypertrophy, concentric remodelling, reduced longitudinal strain and heart failure with preserved ejection fraction…

…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…

…accumulation of bradykinin. ACE is responsible for metabolizing bradykinin and other tachykinins, such as substance P. When ACE is inhibited, the resulting accumulation of these…

…X linked or other non autosomal dominant mechanisms. Complex or multifactorial genetic architecture. The inheritance pattern affects the appropriate scope and duration of family surveillance…

…clinical presentation and other findings. A reduced CFR may occur with angiographically insignificant epicardial disease because of abnormalities in the coronary resistance vessels. Left ventricular…

…obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked…

…to the left of the sternum, the other on the back between the left scapula and the spine. The anterolateral position also works and is…

…low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non HDL C provides a broader estimate of atherogenic cholesterol than LDL C alone…

…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…

…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…

…evaluation of patients receiving digoxin reveals specific electrophysiologic profiles. Digoxin's autonomic actions largely slow the sinus node discharge rate, shorten atrial refractoriness, and prolong…

…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…

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

…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…

…contraindications, and subject preparations. We will also discuss the relevance of withholding specific cardioactive medications during exercise testing (exercise ECG). Indications for exercise stress test…

…increases the quality of the examination, and allows for standardized comparisons of serial examinations. If pathology is discovered during the standard examination, other examinations (which…

…benign and the most common cause of sinus arrest/pause. It commonly affects younger individuals who endure intense emotional stress, acute pain or other stimuli…

…American and European guidelines assert that the ST segment must be either downsloping or horizontal. Otherwise, ischemia is unlikely to be the cause of the…

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

…the last dose, the renal function and the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not routinely stop aspirin…

…intraluminal mass and lesion haziness raise suspicion of thrombus, although haziness is not specific. Intravascular imaging can identify plaque disruption, thrombus and other structural features…

…a specific examination profile or diagnostic physical signs for LMCAD. Diagnostic Assessment Coronary angiography Invasive coronary angiography defines: The presence and severity of left main…

…kidney function; Excess dietary sodium and volume overload; Concomitant drugs or conditions that increase blood pressure; or An undiagnosed secondary cause of hypertension. White coat…

…loss of organized atrial systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical…

…P wave PR interval QRS complex ST segment T wave U wave QT (QTc) interval Pediatric and neonatal electrocardiograms differ markedly – in terms of rhythm…

Arrhythmias and arrhythmology ECG Mechanisms of cardiac arrhythmias: from automaticity to re entry This section introduces the most common arrhythmias encountered in clinical practice, beginning…

…the volume, echogenicity and location of the effusion. Regarding the location, an effusion may be general (circumferential) or localized to a specific area. The effusion…

…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…

…known malignancy may suggest specific, nonidiopathic etiologies [2]. Summary of Pain Characteristics The following table synthesizes the key differential diagnoses and their characteristic pain patterns…

…and age of onset of premature CAD or other vascular disease. A history of myocardial infarction or raised cholesterol among relatives. The presence of tendon…

…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…

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

…waves are tall and narrow at the top. Refer to Figure 1 . Patients with left ventricular hypertrophy may instead display normalization of secondary T wave…

…response and by repeated laboratory measurements, not by the values on admission alone. Diagnosis Current diagnostic criteria According to the international consensus report of 2024…

…develop during acute management. AF is often haemodynamically tolerated and may require no specific acute therapy beyond appropriate anticoagulation and management of ventricular rate. However…

…set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines the need for…

…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…

…density lipoprotein and chylomicron remnants. It is calculated as: Non HDL C = total cholesterol − HDL C Apolipoprotein B (apoB) reflects the concentration of circulating…

ECG Myocardial ischemia and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes…

…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…

…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…

…and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and…

…vasoconstriction and platelet aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other…

…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…

…FH). Heterozygous FH results in high LDL cholesterol levels (but nothing else) and increases the risk of acute myocardial infarction by more than 50 times…