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

…perception in patients without demonstrable ischaemia. The absence of obstructive disease therefore does not establish a benign diagnosis. ANOCA/INOCA is associated with recurrent symptoms…

…hypertrophy, or echocardiographic evidence of impaired filling, make the diagnosis more likely. HFpEF and HFmrEF together account for approximately half of patients with symptomatic HF…

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

…conventional hypertension threshold. The traditional diagnostic threshold of 140/90 mmHg derives from epidemiological observations associating pressures above this level with increased mortality. Contemporary management…

Cardiology Diagnosis and treatment of bradycardia (bradyarrhythmia) Acute bradycardia with hemodynamic instability Acute bradycardia with hemodynamic effects is a potentially life threatening condition and should…

…updated. For example, exercise stress testing is no longer recommended in the initial evaluation of patients with suspected coronary artery disease (i.e. CCS). The…

…troponin levels are normal in patients with NSTE ACS, the condition is classified as unstable angina (UA) . Please refer to Diagnostic Criteria for Myocardial Infarction…

…in patients with structurally normal hearts [2] . Epidemiologically, BrS is responsible for up to 20% of sudden cardiac deaths in patients without structural heart disease…

…patients with carotid bruits, possible or known plaques, or stenosis. Diagnostics Electrocardiogram and Cardiac Monitoring An ECG should be performed if there is suspicion of…

…of AV blocks (AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical history (with emphasis on causes of…

…patients with high suspicion of posterior acute myocardial infarction (e.g due to reciprocal ST segment depressions in V1, V2, V3). IIa B In patients…

…spectrum of non ST elevation acute coronary syndrome (NSTE ACS). The clinical spectrum includes patients with a confirmed NSTEMI, patients with a working diagnosis of…

…communities. Late presentation is clinically important: Within 12 hours of symptom onset: reperfusion therapy is recommended for all patients with a working diagnosis of STEMI…

…associated with coronary artery bypass grafting (CABG). Clinical Presentation and Symptoms The diagnosis of an acute MI remains a comprehensive clinical diagnosis based on patient…

…Establishing a diagnosis of Q wave infarction requires that pathological Q waves be present in at least two anatomically contiguous leads. In patients with STEMI…

…The absence of chest pain does not exclude clinically important CCS. Silent or minimally symptomatic disease may occur in patients with diabetes and autonomic neuropathy…

…threatening ischaemia (CLTI). Clinical presentation and symptoms Asymptomatic and atypical disease Fewer than half of patients with PAD have typical symptoms. Many have impaired walking…

…interpreted within a target of 10 minutes. Prehospital ECG acquisition can shorten the time to diagnosis and facilitate triage of patients with suspected ST segment…

…unexplained drop in arterial pressure. Silent or unrecognized infarction occurs more often in patients without antecedent angina and in those with diabetes and hypertension. Of

…conscious patients who experienced a brief cardiac arrest. Post resuscitation care is an integral component of the chain of survival. It includes diagnosis of post…

…can be used to diagnose endocarditis. With 2D and later 3D ultrasound, the technology has been greatly refined. Similarly, the development of transesophageal echocardiography (TEE…

…quality of life. Approximately half of all patients with heart failure die suddenly, as a result of ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation). Early diagnosis…

…Diagnosis (ECG), Criteria & Management Acute ST Elevation Myocardial Infarction (STEMI) is the most severe manifestation of coronary artery disease. This chapter deals with the pathophysiology…

…A patient with persistently mildly reduced systolic function. This dynamic nature makes prior imaging particularly important when interpreting a current LVEF of 41–49%. Diagnostic…

…not every patient with an initial STEMI pattern has myocardial infarction as the final diagnosis. The underlying process usually involves acute thrombotic obstruction of an…

…NSTEMI) and Unstable Angina (UA) The focus of this chapter is the diagnosis and management of patients with Non ST Elevation Myocardial Infarction (NSTEMI) and…

…resemble those of STEMI associated with obstructive atherosclerotic disease. Patients with MINOCA tend to be younger and more often female than patients with atherosclerotic mediated…

…treated patients may develop premature CAD. Symptoms therefore depend on the vascular territory involved and may include manifestations of coronary, cerebral or peripheral arterial disease…

…posterior circulation stroke is the most important dangerous differential diagnosis. Clear focal neurological findings are absent in roughly half of patients with a central cause…

…morbidity or mortality attributable to these events. Clinical presentation and symptoms Most patients with stent thrombosis present with ACS. Clinical manifestations therefore commonly include recurrent…

…central clinical danger is progressive aortic wall disruption, rupture and compromise of branch vessels. Type A disease may cause cardiac tamponade, severe acute aortic regurgitation…

…suggests vascular disease, and the arm with the higher reading is used thereafter Two to three measurements one minute apart, taking the mean of the…

…myocardial perfusion imaging Diagnosis of coronary artery disease (CAD) : Myocardial perfusion imaging can confirm or rule out CAD in patients with symptoms suggestive of CAD…

…help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of aortic root dilation. Key Formulas BSA Calculation (Mosteller formula): [ …

…Patients with previous acute coronary syndromes (ACS) Exercise stress testing is routinely performed after acute myocardial infarction in order to assess the presence of myocardial…

…antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure, including lower extremity edema, ascites…

…reperfusion therapy. This approach fails to identify a substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting…

…COPD. Adenosine has caused mild to moderate exacerbation of asthma symptoms. Adenosine should be used with caution in patients with obstructive lung disease or asthma…

…of morbidity in patients with structural heart disease, VT necessitates a nuanced, multidisciplinary approach to diagnosis and management. Over the past decade, the landscape of…

…Coimbra R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life upon hospital arrival: a retrospective multicenter study. Crit Care…

…R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life of life hospital arrival upon arrival: a retrospective multicenter study…

…oxidative stress. Metabolic dysfunction associated fatty liver disease affects approximately 10% of non obese individuals and up to 65% of patients with metabolic syndrome. A…

…Genetic testing of patients with confirmed or likely dilated cardiomyopathy can be recommended. There are several commercially available gene panels, which enables testing of over…

…or general evaluation of patients with bradycardia. Diagnostics Electrocardiographic assessment is fundamental to the diagnosis and management of bradyarrhythmias. In the setting of cardiac arrest…

…segment elevations that mimic acute myocardial infarction. Acute pericarditis is a primary differential diagnosis and presents with distinct characteristics compared to transmural ischemia [4, 5]…

…Prinzmetal's angina (coronary vasospasm), electrolyte disorders , congenital heart disease and catecholamine induced ventricular tachycardia . The vast majority of patients with ventricular tachycardia either have…

…infarction (STEMI) is a working diagnosis based on persistent ST segment elevation or an equivalent electrocardiographic pattern in a patient with symptoms of myocardial ischaemia…

…Mixed picture of DKA and HHS Overlap is common. Treat as mixed DKA and HHS if the patient has marked hyperosmolality together with significant ketosis…

…and in patients with diabetes or renal failure the index may be falsely normal because of medial sclerosis — in that case add toe pressure measurement…

…strongly with total and cardiovascular mortality ( Curtis et al ). Among patients with coronary heart disease, left ventricular function is actually a stronger predictor of death…

…spectrum of clinical presentations caused by suspected acute myocardial ischaemia. It includes patients with recent changes in symptoms or clinical signs, with or without diagnostic…

…lung disease or hypoxia, chronic thromboembolic obstruction, or a range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis and classification must integrate haemodynamics with…

…Brugada syndrome. This disorder is easy to diagnose with a simple blood test and the ST segment elevations resolve after normalization of potassium levels. Brugada…

…selected patients with suspected coronary artery disease (CAD), particularly those with stable chest pain, no previous diagnosis of CAD, and a low clinical likelihood of…

…Risk factors for calcification overlap with risk factors for coronary heart disease (atherosclerosis). The average age at diagnosis of aortic stenosis is 75 years in…

…The diagnosis requires elevated levels of cardiac troponins. In addition to elevated troponins, the patient must display either symptoms or ECG changes consistent with myocardial…

…In patients presenting with angioedema, a rapid assessment of the airway is paramount to evaluate for impending respiratory compromise. Diagnostics The diagnosis of ACE inhibitor…

…Patients with hypotension, marked low output, or persistent severe symptoms require close monitoring and consideration of invasive haemodynamic assessment when precise measurements are needed to…

…approximately 20–25% of secondary hypertension cases. Coarctation of the aorta and renovascular disease are important non endocrine causes, particularly in patients with resistant hypertension…