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

…support is given as an infusion of isoprenaline, adrenaline or dopamine according to local practice, and does not replace pacing when the patient is markedly…

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

…airway) should be established as early as possible. Airway management should not interrupt compressions for more than 5 seconds. The effect of cricoid pressure and…

…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…

…crush technique, stent fracture or collapse Lesion specific angiographic features Residual dissection at a stent margin, impaired flow into or out of the stent, stent…

…be blocked. The degree of blocking in the atrioventricular node is specified by counting the number of flutter waves preceding each QRS complex. If 3…

…diagnosis at a non PCI hospital to wire crossing As quickly as possible, primary PCI if the total expected time is 120 minutes or less…

…ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes…

…kidney disease and several other comorbidities also contribute to the disproportionate cardiovascular burden in women. Depression and anxiety are approximately twice as prevalent in women…

…hypertension, defined in the cited recommendation as blood pressure ≥140/90 mmHg. Screening is particularly pertinent in the presence of hypokalaemia or treatment resistance. Hypokalaemia…

…10]. The specific voltage thresholds vary based on patient age, sex, and lead location, as detailed below [8, 10]: Patient Demographic Lead Group ST Elevation…

…bradykinin and other tachykinins, such as substance P. When ACE is inhibited, the resulting accumulation of these peptides irritates afferent neural pathways in the respiratory…

…Relevant predispositions, such as connective tissue disease. No single pain descriptor is diagnostic. The severity of pain also has limited discriminatory value. Features suggesting myocardial…

…scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular…

…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…

…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…

…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…

…not be applied as the principal risk tool in people with: Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific risk assessment…

…The cardiovascular burden of CKD extends beyond CAD to peripheral arterial disease, cerebrovascular disease, valvular heart disease, heart failure, atrial fibrillation, and other arrhythmias or…

…Diagnostics Electrocardiography and Electrophysiology Electrocardiographic evaluation of patients receiving digoxin reveals specific electrophysiologic profiles. Digoxin's autonomic actions largely slow the sinus node discharge rate…

…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…

…such as amyloidosis or sarcoidosis Other cardiac procedures Chemotherapeutic agents Catheter ablation Critical illness Defibrillator shocks Strenuous exercise Cardiac contusion The diagnosis should therefore distinguish…

…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…

…Evaluating the success of revascularization : Myocardial perfusion imaging can assess effectiveness of procedures such as coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI…

…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…

…as detection of T waves and R waves. It is essential that T waves and R waves are clearly visible, since these waves trigger the…

…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…

…referred to as secondary ST T changes. It is actually expected that these conditions display such secondary ST T changes; the absence of such changes…

…the renal function and the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not routinely stop aspirin given as secondary…

…the fourth universal definition of MI. Type 1 MI is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of…

…such as digitalis excess. Biomarkers and Laboratory Findings The source material does not provide information on biomarkers or laboratory findings specific to the evaluation of…

…failure, and heart failure have been identified as important risk factors. Severe atherosclerosis of the axillary or subclavian arteries may increase the risk of embolization…

…regarded as an anatomical examination, contemporary ICA can provide complementary functional and structural information. Coronary pressure measurements permit assessment of the physiological significance of selected…

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

…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…

…explicitly removing female sex as an independent risk factor [2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities…

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

…Below follows a discussion on each of the nine parameters listed above. Many of the diagnoses mentioned below are discussed in detail in other chapters…

…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…

…as acute brain failure. It is precipitated by somatic illness, drugs, poisoning, withdrawal, surgery or several concurrent factors. A diagnosis of delirium is therefore the…

…value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no practical risk prediction tool currently exists. At the other…

…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…

…Lathundar Differential Diagnosis of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome associated with…

…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…

…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…

…are of utmost clinical significance. There is a rather strong correlation between plasma potassium level and ECG changes, as well as the risk of arrhythmia…

…coma may occur Mixed picture of DKA and HHS Overlap is common. Treat as mixed DKA and HHS if the patient has marked hyperosmolality together…

…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…

…and other sedating drugs. Thromboembolic risk, for example immobilisation, cancer and previous venous thromboembolism. A documented decision on the ceiling of care. Signs of a…

…and are at high risk of a new event. Treatment can be started without interruption as continuation treatment after the initial one year treatment with…

…a therapeutic objective. LDL C as the primary treatment target Current lipid management frameworks place LDL C at the centre of treatment. Lifestyle intervention is…

…ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source…

…pillow to place under the shoulders as an alternative to a hanging head. Frenzel goggles or video Frenzel if available — small beats of nystagmus can…

…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…

…administered as soon as possible in the absence of contraindications, using a loading dose followed by maintenance treatment. The source material does not specify the…

…affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary…

…operative assessment, or evaluation of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of severe asymptomatic stenosis is low, screening has…

…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…