Myocardial ischemia and infarction Definition and Pathophysiology Type 2 myocardial infarction (MI) is defined as an ischaemic myocardial injury occurring in the context of a…

…coronary atherothrombotic events in the setting of a stent thrombosis or restenosis. Type 1 myocardial infarction Definition and pathophysiology Type 1 MI results from acute…

…It may be broken, as in Figure 1 . Any type of infarction may cause pathological R wave progression. However, the specificity for pathological R wave…

…myocardial infarction, stroke, heart failure (HF), atrial fibrillation (AF), aortic disease, and peripheral artery disease (PAD). Diabetes also substantially increases the risk of chronic kidney…

…In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography…

…Particular attention is required for evidence of: Ongoing or recurrent chest discomfort. Haemodynamic instability. Electrical instability or arrhythmia. Heart failure. Cardiogenic shock. Recent myocardial infarction…

…small vessels, multivessel disease, bifurcation lesions, treatment of acute myocardial infarction Procedural and mechanical Stent underexpansion, incomplete wall apposition, residual inflow or outflow disease, edge…

ECG Myocardial ischemia and infarction Approach to patients with chest pain: differential diagnoses, evaluation and management Chest pain is one of the most common symptoms…

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

…are as follows: Myocardial ischemia/infarction – Particularly ischemia or infarction located to the inferior wall of the left ventricle. This type of bradycardia is due…

…interventions than with low fat control diets. In one trial of patients with previous myocardial infarction, the Mediterranean intervention involved greater consumption of fruits, vegetables…

…sex and blood pressure, affected patients have more frequent stroke, nonfatal myocardial infarction and atrial fibrillation, as well as greater cardiovascular mortality. Metabolic syndrome and…

…acute myocardial infarction, pericarditis/myocarditis or pulmonary embolism is often a reversible arrhythmia with low risk of recurrence. Atrial fibrillation in other circumstances (particularly those…

…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…

…requires attention to the type of stroke and the possibility of thrombolytic treatment. Cardiac and pulmonary complications Acute hypertension may precipitate myocardial ischemia or infarction…

…elevated cardiac troponin concentration and new ST segment depression in new onset AF should not automatically be labelled type 2 myocardial infarction without further assessment…

…Cardiac surgery and other iatrogenic cardiovascular procedures Acute aortic disease, particularly ascending or type A aortic dissection Myocardial free wall rupture after infarction Anticoagulant associated…

…The composite major adverse cardiovascular outcome—cardiovascular death, nonfatal myocardial infarction, nonfatal stroke or coronary revascularization—occurred in 819 patients receiving bempedoic acid (11.7…

…driven inflammatory disease of the arterial intima that serves as the fundamental pathophysiological substrate for acute coronary syndromes (ACS), including ST Elevation Myocardial Infarction (STEMI…

…Figure 1. Types of ST segment elevations on ECG. Current guideline criteria for ischemic ST segment elevation: New ST segment elevations in at least two…

…Mechanisms of ventricular tachycardia Ventricular tachycardia (VT) may emerge due to increased/abnormal automaticity, re entry or triggered activity. All types of myocardial cells may…

…range of diseases and medications may cause sinus tachycardia; e.g congestive heart failure, lung disease (e.g COPD), fever, infections, anemia, myocardial ischemia/infarction…

…outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections…

…wall disruption, rupture and compromise of branch vessels. Type A disease may cause cardiac tamponade, severe acute aortic regurgitation, coronary malperfusion, myocardial ischaemia, heart failure…

…Failure to capture Definition : pacing does not result in myocardial activation. Two types of failure to capture should be distinguished: Genuine failure to capture occurs…

…AV block 2 Mobitz type 2 and AV block 3. The only treatment with a class I recommendation for the management of acute bradycardia is…

…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…

…AV block (second degree Mobitz type 2 AV block, third degree AV block). Sick sinus syndrome or symptomatic bradycardia in the absence of a pacemaker…

…This type of cardiomyopathy, referred to as tachycardia induced cardiomyopathy , can be caused by any tachyarrhythmia leading to prolonged periods of rapid ventricular rate (Table…

…focus arises in or near the bundle of His, the impulse may be delivered to both bundle branches and subsequently the entire ventricular myocardium normally…

…other electronic equipment may also interfere with device function. The clinical consequences depend on the device, the patient's dependence on pacing, the presence of…

…to the QRS morphology during LBBB. Stimulation in other regions of the ventricle may result in a different QRS morphology. If the lead tip is…

…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…

…RNA (siRNA) designed to reduce production of proprotein convertase subtilisin/kexin type 9 (PCSK9). It acts through degradation of the messenger RNA encoding PCSK9 within…

…patients, regardless of the type of oral anticoagulant used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such…

…Women with type 2 diabetes also have a higher prevalence of cardiovascular complications and death than men. Despite the effectiveness of preventive interventions in both…

…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…

…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…

…and QRS 110 ms. Brugada pattern type 1: ST elevation ≥ 2 mm of coved type with a negative T wave in V1–V2. Early repolarisation:…

…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…

…times or decremental conduction properties. Furthermore, adenosine binds to four types of receptors. Binding to A2A receptors induces coronary vasodilation, whereas binding to the A1…

…and whether the other variable lies within the expected range of compensation. Sample type and baseline values An arterial blood gas is the reference method…

…settings, while the broader lipid lowering recommendation refers to a recurrent event without requiring that it be of the same type as the initial event…

…not distinguish different types of dilated cardiomyopathy. Other causes of ventricular dilation ( e.g ischemic cardiomyopathy) must be excluded before establishing a diagnosis of DCM…

…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…

…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…

…closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with…

…impulse reaches the atrioventricular node when there are two pathways, one being refractory and the other capable of conducting the impulse, re entry may arise…

…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…

…Dosage: Prior Myocardial Infarction Ticagrelor 60 mg twice daily is the recommended dose for extended treatment for patients who had a heart attack at least…

…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…

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…

…of myocardium at risk. Over 48 hours: urgent PCI is still indicated with continuing ischaemia, shock, serious arrhythmia or acute heart failure. Routine opening of…

…side lying variant of the Dix–Hallpike test. Marked obesity or spinal disease that makes positioning impossible. Severe angina, heart failure or recent myocardial infarction…

…Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon as possible after…

…interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease…

…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…

…analysis of primary prevention trials involving individuals with an estimated 10 year cardiovascular risk of 10%. Approximately 12% reduction in non fatal myocardial infarction with…

…also a marker of systemic cardiovascular risk. The presence of a carotid bruit is associated with approximately double the risk of myocardial infarction and cardiovascular…

…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…