…cardiac transplantation or mechanical circulatory support, nonfatal myocardial infarction, transient ischemic attack or stroke, and initiation of renal replacement therapy. The study found no significant…

…interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing bleeding risk. Monitor coagulation. Cyclosporine, tacrolimus…

…drinking in either sex. Other definitions of unhealthy drinking include at least two drinks daily in women or three in men, or at least four…

…PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke…

…formerly termed Prinzmetal or variant angina, is myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible…

…or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the…

…chadsva] The CHA₂DS₂ VA score has superseded the CHA₂DS₂ VASc score. As of 2025, it is recommended to use the CHA₂DS₂ VA score for stroke…

…arise during the course of treatment. Even transient, self terminating AF during ST elevation myocardial infarction may indicate an increased long term risk of stroke…

…ostia. It remains the reference standard for defining the extent of coronary artery disease because it provides anatomical information while permitting functional assessment and, when…

…A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance…

…Angioedema Angioedema secondary to ACE inhibitor therapy occurs in approximately 1% of patients. It manifests as localized, transient swelling of the subcutaneous or submucosal tissues…

…arising from structural or functional abnormalities of the coronary arteries or coronary microcirculation. These abnormalities can produce a transient and reversible mismatch between myocardial oxygen…

…as a rapid intravenous bolus. Unlike many other intravenous medications where rapid boluses risk hemodynamic instability or transiently toxic concentrations, adenosine requires a rapidly delivered…

…HMOD) Probable or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic, rare lipid, or BP disorders Pregnancy Established ASCVD includes previous acute…

…chemistry & laboratory medicine Definition and Pathophysiology B type natriuretic peptide (BNP) and N terminal pro BNP (NT proBNP) are circulating markers of myocardial wall stress…

…hypertrophy, LV dysfunction, or other pathology that could affect the safety or interpretation of the examination. Evaluation and Physical Examination Before stress echocardiography, clinical assessment…

…repeated cycles of transient ischemia induce the protective effect. Some studies (including randomized clinical trials) have suggested the benefit of ischemic preconditioning, while other studies…

…severe hypotension, or high degree AV block. Caffeine and other methylxanthines, which antagonize adenosine receptors, should be avoided for at least 12 hours before testing…

…that a reduction in $I {Na}$ leaves the transient outward potassium current ($I {to}$) unopposed during phase 1 of the action potential [11] …

…manifestations of chronic structural and/or functional disease involving the epicardial coronary arteries and/or the coronary microcirculation. These abnormalities may produce a transient mismatch…

…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…

…shortened or unchanged in ischemia. R wave amplitude Acute transmural ischemia may transiently increase the amplitude of the R waves. This is believed to be…

…atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular…

…coffee ground vomiting or melaena. Haematochezia can occur in massive upper bleeding with rapid intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis…

…of Brugada syndrome are fairly specific to the disorder, provided that the clinical characteristics are in line with the disorder. There are however other disorders…

…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…

…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…

…189 mg/dL, 10 year risk of a first hard ASCVD event—fatal or nonfatal myocardial infarction or stroke—should be estimated. The risk categories…

…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…

…is unstable or at marked risk of arrhythmia. 4. Take a full blood count, electrolytes, creatinine, glucose, high sensitivity troponin and, where needed, coagulation tests…

…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…

…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…

…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…

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

…and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around…

…follow. Consider people with the genetic disorder familial hypercholesterolemia (FH), which is caused by genetic mutations affecting the elimination of LDL cholesterol from the blood…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures…

…a manifestation of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial…

…Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other circumstances that may affect…

…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…

…cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In case the ECG or other examinations suggest…

…myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of upper abdominal pain. An…

…1). This is possible by using two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves…

…tomographic images of the left ventricle. In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron, they annihilate each other…

…opposite angle of observation. Other vectors may interfere with the injury currents, and inhibit them from being detected by leads with opposite angles of observation…

…at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist…

…the bleeding risk of the procedure and by renal function. In markedly reduced renal function (dabigatran at eGFR <30 mL/min, the other DOACs at…

…marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of site The posterior superior…

…plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous…

…margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is…

…high grade AV block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability…

…applies where you work. They assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick…

…organ damage. Isolated malignant retinopathy without other acute organ damage can often be treated more cautiously with oral drugs under careful observation [3,4]. A…

…physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient…

…rise can cause osmotic demyelination syndrome [1,2]. Hyponatraemia is primarily a disorder of water balance. The plasma sodium reflects the ratio between the body…

…a blood gas, coagulation tests and other investigations according to the clinical picture 5 Take cultures or molecular tests from the suspected focus, but avoid…

…tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which…

…treatment — modification of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection…