…Atrial fibrillation (AF) is a major independent risk factor for thromboembolism, including ischaemic stroke. This risk applies across the clinical patterns of AF—paroxysmal, persistent…

…persistent atrial fibrillation where rhythm control is the aim. Atrial flutter, which often converts at low energy and is difficult to terminate pharmacologically. Ectopic atrial…

…organized tachyarrhythmias such as atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, and hemodynamically compromising ventricular tachycardia, while defibrillation (unsynchronized shock) is reserved for ventricular fibrillation…

…resulting in increased AV block. Sinus node dysfunction can be caused by supraventricular tachyarrhythmias (e.g. atrial fibrillation). Typically, periods of sinus node dysfunction occur…

…MI. Persistent elevation without a significant dynamic change is consistent with chronic myocardial injury. Non ischaemic conditions, including myocarditis, rapid ventricular rate atrial fibrillation, marked…

…effective only when the patient is in sinus rhythm. Its role in atrial fibrillation remains uncertain, although it may have a rate reducing effect in…

…TABLE 1. SOURCES OF CARDIAC EMBOLI AND EMBOLIC POTENTIAL HIGH EMBOLIC POTENTIAL Atrial arrhythmias — especially atrial fibrillation and atrial flutter. Ischemic heart disease Both acute…

…cerebrovascular disease, valvular heart disease, heart failure, atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking…

…threatening arrhythmias. Antiarrhythmic drugs Disopyramide Indications Prophylaxis and treatment of symptomatic ventricular tachyarrhythmias. Prophylaxis and treatment of atrial fibrillation. Effects of disopyramide on ECG, heart…

…from sudden cardiac death. Atrial fibrillation and ventricular arrhythmias were observed in the fifth decade of life in several family members. Imaging studies did not…

…an important contributor. Older age, female sex, atrial fibrillation (AF), chronic kidney disease (CKD), and multiple non cardiovascular conditions are frequent features. A proposed disease…

…paid to potentially reversible causes and associated cardiovascular conditions, including coronary syndromes, valvular disease, atrial fibrillation, ventricular arrhythmias, conduction disease and hypertension. Non cardiovascular contributors

…compared with atrial fibrillation, atrial flutter is not capable of persisting for longer periods of time. This is due to the fact that atrial flutter…

…patients whose atrial tachycardia is induced by the drug. Management of all other cases aligns with the approach used for atrial fibrillation and atrial flutter…

…Conversely, atrial fibrillation and non cardiac comorbidities are less frequent than in HFpEF. The clinical population is heterogeneous because the HFmrEF range includes both patients…

…without antiphospholipid syndrome. The doses in venous thromboembolism include an initial high dose phase and differ from the doses used in atrial fibrillation. Follow the…

…Hypoperfusion with persistent organ injury Consider mechanical circulatory support Refractory advanced disease Consider palliative care Right ventricular failure is characterized by increased right atrial and…

…may become markedly depressed. Right sided filling pressures—including central venous, right atrial, and right ventricular end diastolic pressures—are elevated, whereas left ventricular filling…

…which means that it usually is atrial myocardium. Asystole occurs if no escape rhythm awakes. It is uncommon that sinus arrest leads to persistent asystole…

Cardiology Myocardial ischemia and infarction Definition and Pathophysiology Refractory angina is a chronic syndrome of persistent ischaemic symptoms despite the exhaustion of conventional therapeutic options…

Info This page summarises the most current recommendations for the management of acute coronary syndromes with persistent ST segment elevations (i.e STEMI, ST segment…

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

…electrocardiographic abnormalities and with or without an acute rise in cardiac troponin. The spectrum ranges from symptom free presentation to persistent chest discomfort, cardiac arrest…

…limiting epicardial coronary stenosis. It is therefore a disorder of coronary microvascular perfusion rather than persistent obstruction of the treated epicardial segment. The phenomenon occurs…

…elevation myocardial infarction (STEMI) is an acute coronary syndrome characterized clinically by acute myocardial ischaemic symptoms or equivalent presentations together with persistent ST segment elevation…

…STEMI) is an acute myocardial infarction associated with a working diagnosis of persistent ST segment elevation or an accepted equivalent in the setting of ischaemic…

…with a collection of pus. Persistent painful induration after a few days of antibiotics — suggests that an abscess has formed. Ultrasound settles the question when…

…and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive ventilation is not immediately required. 8…

…these agents. The cough is characteristically nonproductive and dry. Patients may describe a persistent tickle or sensitivity in the throat. In recent years, the concept…

…lipids within the intima; recruitment of innate and adaptive inflammatory leukocytes; oxidative stress and persistent local inflammation; smooth muscle cell migration and proliferation; extracellular matrix…

…patients whose initial findings are less definitive. The defining electrocardiographic feature is the absence of persistent ST segment elevation. This does not imply low risk…

…function is impaired. Inadequate adherence to medication or dietary sodium restriction may therefore mimic pharmacological resistance or contribute directly to persistent hypertension. Resistant hypertension is…

…permit vascular remodelling and renal impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated with a greater likelihood…

…incomplete apposition, or persistent disease at the inflow or outflow edges. The contemporary incidence of stent thrombosis is approximately 1% during the first year after…

…a genetic mutation in the RYR1 receptor, resulting in persistent muscle contraction upon administration of halogenated anesthetic agents. As an idiosyncratic response to substances such…

…present, neurological examination, gait and truncal stability Acute balance syndrome Acute persistent unsteadiness or ataxia without clear spontaneous nystagmus Cerebellar or brainstem infarction, intoxication, Wernicke…

…intracranial pressure or impending herniation Moderately severe symptoms New confusion Severe headache Persistent nausea Moderately reduced consciousness Marked gait instability The specificity of the symptoms…

…weakness to paralysis and is a particularly important marker of threatened limb viability. Paralysis generally indicates severe and persistent ischaemia. The limb may be cold…

…initiation and after each adjustment. Persistent symptoms despite appropriately titrated medical therapy should prompt consideration of coronary angiography and possible revascularization. Revascularization may be selected…

…directly attributable to CVD. Excess mortality becomes apparent approximately 7–10 years after diagnosis and is associated with persistent disease activity, rheumatoid factor and anti…

…plus ezetimibe. Consider bempedoic acid in selected patients, particularly those with statin intolerance or persistent failure to reach goal. For statin intolerant patients, ezetimibe may…

…mesenteric or lower limb ischaemia Paraplegia or paraparesis Persistent or recurrent pain Hypertension that remains uncontrolled despite optimal therapy Acute type A dissection has a…

…Stent malapposition Stent fracture or collapse Residual edge dissection Incomplete lesion preparation Persistent stenosis within the treated segment Mechanical factors are particularly important because correction…

…ischaemic burden. In chronic coronary syndrome, revascularisation is particularly indicated when functionally significant disease produces persistent, lifestyle limiting symptoms despite guideline directed medical treatment. Neither…

…syndromes. Clinical suspicion should be heightened after: Anterior STEMI. A large or transmural infarction. Persistent apical akinesis or dyskinesis. LV aneurysm formation. LVEF below 40%…

…greater prevalence of MVA. Symptoms may be persistent or episodic and may not follow a classical pattern of stable exertional angina. Vasospastic angina should be…

…hypoperfusion and is consistent with inducible ischaemia. A persistent defect on stress and rest images may represent scar, although interpretation must account for attenuation and…

…Improvement when the leg is placed in a dependent position. With advanced disease, rest pain may become persistent. Tissue loss, ulcers and gangrene may develop…

…is compatible with acute coronary syndrome. Recurrent or persistent symptoms should prompt repeat ECG acquisition and consideration of additional leads. Evaluation and Physical Examination At…

…hypertension, defined as blood pressure ≥160/110 mmHg Headache that does not respond to medication Visual disturbance Persistent severe epigastric pain Pulmonary oedema Thrombocytopenia, with…

…clinical spectrum of ACS is broad. Patients may be asymptomatic at presentation, have persistent chest discomfort, or present with cardiac arrest, electrical or haemodynamic instability…

…examination include: Unexplained systolic blood pressure < 90 mmHg Suggestion of gastrointestinal hemorrhage Persistent bradycardia (< 40 beats/min) Undiagnosed systolic murmur Carotid sinus massage…

…Definition and pathophysiology Familial hypercholesterolaemia (FH) is an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and…

…Definition and pathophysiology A chronic total occlusion (CTO) is a complete or nearly complete coronary arterial obstruction that has persisted for at least 30 days…

…while awaiting the antidote and specific treatment. Bradyasystole during and after cardiac arrest with persisting electrical activity. Overdrive pacing in bradycardia dependent torsades de pointes…

…those individuals genuinely at risk of arrest. This predictive problem has proven persistently resistant to resolution. Known predictors of cardiac arrest The only risk biomarker…

…By contrast, chronic hypoperfusion may result in hibernating myocardium: a persistently dysfunctional but potentially recoverable state. The chronically dysfunctional myocardium in ischemic cardiomyopathy is therefore…

…meal; that thus excited, it is accompanied with a sensation, which threatens instant death if the motion is persisted in; and, that on stopping, the…

…drug treatment and transport planning [1,5]. Symptom duration Under 12 hours: reperfusion is indicated in persisting STEMI. 12 to 48 hours: primary PCI should…

…hypoactivity, hallucinations and marked autonomic hyperactivity Up to 5 to 7 days, sometimes longer Persisting withdrawal, particularly after previous severe episodes, with concurrent physical illness…