…sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive…

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

…Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…environmental factors and genetic background. Thrombotic susceptibility is likewise affected by inflammation and other systemic influences. The severity of myocardial injury is determined not only…

…Tachycardia Low systolic blood pressure Respiratory insufficiency, manifested by tachypnoea and/or low arterial oxygen saturation Syncope These findings may occur singly or in combination…

…changes in a single intermediate marker such as cholesterol. Dietary composition may influence blood pressure, glucose–insulin homeostasis, lipids and apolipoproteins, endothelial function, systemic inflammation…

…smoking may be present despite relatively few other conventional atherosclerotic risk factors. A substantial proportion present with NSTEMI, although STEMI occurs in approximately one third…

…upper reference limit (URL). It is considered acute when there is a rise and/or fall in cTn values. An elevated cTn alone does not…

…may be the dominant cause of ischaemia. Other mechanisms capable of obstructing coronary arteries include embolism, dissection, coronary arteritis associated with systemic vasculitis, extrinsic compression…

…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…

…distention. Other frequent symptoms are pulsus paradoxus, pericardial friction sounds, tachycardia, tachypnea, weakened peripheral pulses, edema, cyanosis. Cardiac tamponade is seen in Video 1 . Video…

…immune system to reach the bacteria. Endocarditis can lead to the destruction of the valvular apparatus, as well as to embolization in the systemic circulation…

…systemic steroid given early [2,3]. Grading Grade the severity by the most serious finding. A patient does not have to meet every criterion in…

…standard formulas. Therefore, while MAP is a valuable indicator of hemodynamic status, it should be interpreted in conjunction with other clinical assessments and diagnostic information.

…promotes peripheral vasodilation through reduced systemic vascular resistance. The resulting mild reduction in blood pressure is often accompanied by a compensatory rise in cardiac output…

…free wall rupture after infarction Anticoagulant associated bleeding Renal failure Systemic inflammatory disease Catheter based electrophysiological and structural cardiac procedures In patients with acute pericarditis…

…Systemic inflammation results in increased levels of circulating pro inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic plaque rupture is…

…Beyond its direct cellular actions, digoxin exerts significant systemic effects via the autonomic nervous system. It attenuates carotid sinus baroreceptor activity and acts centrally and…

…ventricular failure. Mechanisms of Shock The central consequence of extensive infarction is loss of contractile myocardium, with reduced cardiac output and systemic hypoperfusion. LV failure…

…association, whereas other conventional coronary risk factors may be absent. The condition is more prevalent in Japan and South Korea than in Western populations, and…

…imbalance between myocardial oxygen supply and demand. In many cases, the initiating process is plaque disruption with thrombosis; other cases result from spasm, microvascular dysfunction…

…and enter the systemic circulation which causes thromboembolic occlusions of arteries in the brain, limbs or other organs. However, the increased risk in mortality is…

…to the ICU or CCU depends on the system of care and patient status. The absolute majority of patients should be managed in the ICU…

…and they tend to accompany each other. Therefore, the term perimyocarditis is often used in clinical practice (this article will use all three terms interchangeably…

…and other cytokines. Within the intima, SMCs undergo a phenotypic switch from a contractile to a synthetic state, producing abundant extracellular matrix (ECM) components, primarily…

…function. Central venous pressure, pulmonary capillary wedge pressure and systemic vascular resistance increases. Harmful neurohormonal pathways are activated, similar to those seen in heart failure…

…systematic differential diagnosis, as the syndrome associated with ischemic heart disease is broader than chest pain itself, encompassing symptoms like tightness, pressure, and discomfort in…

…in the groin or on the neck Bleeding, vascular injury, pseudoaneurysm Surgeon, ultrasound first Other situations that argue for the operating theatre rather than the…

…may suggest phaeochromocytoma. Systemic sclerosis, kidney disease, autoimmune disease or previous thrombotic microangiopathy. Antidepressants can affect the blood pressure in several ways. Monoamine oxidase inhibitors…

…both legs acutely increases preload. Untreated deep vein thrombosis in the acute phase. Septic phlebitis, ongoing soft tissue infection with systemic involvement. Relative: Condition Adaptation…

…distal to the suspected obstruction Arterial and venous Doppler signals Evidence of systemic disease or a potential embolic source Neurological assessment is central to triage…

…including systemic lupus erythematosus and rheumatoid arthritis, are important risk enhancing conditions and are more prevalent in women. Chronic kidney disease and several other comorbidities…

…120 seconds of cardiac arrest and light reactivity is lost when cerebral blood flow ceases. In other words, during prolonged cardiac arrest without effective perfusion…

…frequency or duration of documented episodes. The central therapeutic objective is prevention of thromboembolic complications, particularly stroke. In untreated AF, stroke risk is increased approximately…

…reflects ultrasound waves. In order to analyze myocardial motion, the ultrasound system must filter out all sound waves reflected by other structures, notably sound waves…

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

…SPECT images involves a systematic comparison of rest and stress images to assess myocardial ischemia and infarction. The key steps in this process are outlined…

…of the heart and it is created by analyzing several electrodes. In other words, each ECG lead is computed by analyzing the electrical currents detected…

…No demonstrated reduction in cardiovascular or all cause mortality. Absolute benefit is modest. Across the updated systematic review, absolute reductions in major ASCVD events ranged…

…and cardiac resynchronization therapy (CRT) devices. Implantable loop recorders are diagnostic devices rather than pacing or defibrillation systems, but their stored data may also be…

…to reduce office systolic and diastolic blood pressure to below 140 mmHg and 90 mmHg, respectively, despite: Appropriate lifestyle measures; A renin–angiotensin system blocker…

…end tidal carbon dioxide, ETCO2) Capnography refers to the measurement of end tidal carbon dioxide (ETCO 2 ) in the respiratory system. ETCO 2 is the…

…injuries : Direct trauma can cause airway injuries, resulting in obstruction. Central nervous system (CNS) injuries might cause apnea or hypoventilation. Respiratory conditions : Tension pneumothorax Drowning…

…Echocardiography in dilated cardiomyopathy (DCM) In dilated cardiomyopathy (DCM), both ventricles are dilated and left ventricular systolic function is impaired (i.e ejection fraction is…

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

…serial examinations. If pathology is discovered during the standard examination, other examinations (which are not included in the standard examination), may be warranted. For most…

…without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and…

…s triad; complete in a minority Tachycardia, tachypnoea, cold periphery Almost always Pulsus paradoxus above 10 mmHg A fall in systolic blood pressure during inspiration;…

…serum concentration. Alkalinisation increases renal elimination several fold and at the same time reduces the passage of salicylate into the central nervous system. Contact your…

…of these adverse events are related to the suppression of the renin angiotensin aldosterone system (RAAS), such as decreases in blood pressure and mild azotemia…

…ischemic injury can disrupt the conduction system at any level, producing atrioventricular (AV) or intraventricular blocks. Isolated sinus bradycardia in the early hours following infarction…

…illness, treatment, or other interventions. Frailty commonly overlaps with multimorbidity and is frequent in patients with cardiovascular disease, including heart failure and ischaemic heart disease…

…haemodynamic instability, anaemia and other nephrotoxic exposures may contribute to tubular injury, making attribution to contrast alone difficult. In patients with normal renal function, the…

…aortic wall shear stress and rapidly lower systolic pressure. Renal and microvascular complications Renal involvement may manifest as deterioration in renal function and urinary abnormalities…

…dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies, particularly cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac amyloidosis, BNP or NT proBNP may be markedly…

…thrombus, and implanted stents. The principal modalities used in the catheterization laboratory are intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Unlike coronary angiography, which…

…ventricular systolic function Diabetes and other comorbidities Anatomical complexity and completeness of possible revascularization A proximal lesion jeopardizes more myocardium than a distal lesion. In…

…The table below shows a systematic history taking in patients presenting with chest pain (chest discomfort) or other symptoms suggestive of the five conditions listed…

…other cardiovascular risk factors and coexisting conditions. Therapy must be tailored to each patient. Optimal blood pressure Optimal blood pressure is 115 mm Hg systolic…