…Smoking. Dyslipidemia (hyperlipidemia). Obesity and/or diabetes. Psychosocial stress. Alcohol abuse. Physical inactivity. Unhealthy diet. Cerebral / peripheral vascular disease. Cancer. Acute coronary syndromes cause symptoms…

Cardiology Clinical medicine Definition and Clinical Rationale Physical activity comprises bodily movement that increases energy expenditure, including walking, household tasks, active commuting and recreational activities…

…Hemodynamics is the study of blood flow dynamics. The physical laws that govern blood flow are fundamental in echocardiography. Conventional two dimensional (2D) echocardiography and…

Cardiology Indications for pharmacologic agents Pharmacologic stress tests are indicated in the following scenarios: Inability to exercise due to physical limitations. Contraindications to exercise, such…

Echocardiography Basic sound and ultrasound physics Unlike light waves, which can propagate through vacuum, sound waves can only propagate through a physical medium. This medium…

…with cardiovascular disease, including those recovering from myocardial infarction. It extends beyond exercise training to incorporate individualized physical activity counselling, risk factor modification, nutritional care…

…with suspected AV blocks requires a thorough medical history (with emphasis on causes of AV blocks; please refer to theCauses of AV blocks) and physical…

…pneumothorax and respiratory arrest [1]. The first few minutes 1. Sit the patient up and minimise physical exertion. 2. Attach continuous pulse oximetry and an…

…Acute aortic dissection. Physical inability to perform the test safely. Relative: Condition Comment : : Left main stenosis Known — perform the test only on a clear indication…

…alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the…

…underlying conditions for which ACE inhibitors are prescribed. Evaluation and Physical Examination Prior to initiating an ACE inhibitor, it is essential to evaluate the patient…

…arrest. Evaluation and Physical Examination The source material does not provide specific details regarding the physical examination or general evaluation of patients with bradycardia. Diagnostics…

…Suspicion of Cardiac Amyloidosis Demographic and Clinical Context Cardiac amyloidosis should be suspected in patients older than 65 years presenting with heart failure and increased…

…smoking exposure, and physical inactivity. The interaction between these acquired risks and age related cardiovascular remodeling contributes to the high incidence and prevalence of coronary…

…LVEF). Heart failure with reduced ejection fraction (HFrEF) is defined by the combination of symptoms, with or without physical signs, and an LVEF below 40%…

…toxins (alcohol, cocaine, cancer therapies), or physical reactions (radiation therapy), frequently involves the conduction system. In these conditions, involvement of the AVN and the conduction…

…body composition, fat distribution, skeletal muscle mass, physical fitness or individual health status. In particular, it cannot distinguish adipose tissue from lean mass. Waist circumference…

…diabetes and glycaemic status, body weight, smoking, diet, physical inactivity, and alcohol consumption. Additional considerations include psychosocial stress, obstructive sleep apnoea, social determinants of health…

…sotalol is prescribed. Evaluation and Physical Examination The source material does not cover the baseline physical examination of patients prior to sotalol initiation. Diagnostics Electrocardiography…

…which is synonymous with tachyarrhythmia. Except for sinus tachycardia during physical activity, all tachycardias should be considered pathological and the task is to clarify the…

…s perceived exertion is a way of estimating the intensity of the physical activity. It is based on the subjective physical sensations experienced during exercise…

…to the assessment of exercise capacity. Metabolic equivalents (METs) can be used to estimate the energy cost of physical activity. One metabolic equivalent (1 MET…

…decreases and vice versa. The physiological purpose of this phenomenon is to allow for faster cardiac cycles during tachycardia (e.g during physical exertion). Therefore…

…angina at rest are not suitable candidates for perfusion imaging. Detecting ischemic regions requires provocation using pharmacologic agents or physical exercise. Pharmacologic agents include dipyridamole…

…oxygen supply. The most characteristic manifestation of ischemic heart disease is angina pectoris developing during physical activity; myocardial oxygen demand increases during physical activity, but…

…means that the automaticity is diminished). Chronotropic incompetence (inability of the sinoatrial node to adequately increase its automaticity during physical activity). Sinus arrest & sinus pause…

…of sinus tachycardia are as follows: Normal (physiologic) sinus tachycardia: The automaticity (rate of spontaneous depolarization) in the sinoatrial node is increased during physical activity…

…severe episodes, with concurrent physical illness or after prolonged very high intake More than 90 percent of withdrawal seizures occur within 48 hours. Seizures later…

…keep still. Sedation is usually better than physical restraint — ketamine provides both immobilisation and less psychological trauma than being held down by three adults. Procedure…

…dyspnoea, wheeze or reduced exercise capacity. Suspected asthma or COPD — diagnosis and follow up. Risk groups: current or former smokers over 40 with respiratory symptoms…

…may predispose to peripheral embolization. Evaluation and Physical Examination The abdominal aorta may be palpable in the mid abdominal region, with its bifurcation usually located…

…point toward gastroesophageal reflux. Physical examination should include a speculum examination of the nose to look for excess mucoid or purulent secretions, inflamed and edematous…

…suspected. Reversible causes may account for up to 50% of SCA cases, though determining the exact underlying cause and its reversibility is often difficult. Physical…

Emergency medicine Myocardial ischemia and infarction Definition and pathophysiology Acute coronary syndrome (ACS) comprises a spectrum of clinical presentations caused by suspected acute myocardial ischaemia…

…limb salvage. Evaluation and physical examination ALI requires immediate clinical assessment by a vascular specialist or urgent transfer to a facility with vascular expertise. The…

…urgent evaluation for reperfusion treatment. Evaluation and physical examination Initial assessment Risk stratification begins with an immediate search for haemodynamic instability. This determines whether the…

…or combinations of these mechanisms. Drug selection can therefore be tailored to the suspected mechanism. No antianginal class has demonstrated consistent superiority for symptom relief…

…underlying secondary cause. Evaluation and physical examination Standardized office measurement Accurate technique is essential because inconsistent or incorrect measurement may lead to misclassification. Blood pressure…

…Immediate cardioversion is reserved primarily for instability. Evaluation and physical examination Initial assessment should establish whether AF is associated with acute haemodynamic compromise, pulmonary oedema…

…obesity and psychosocial factors are associated with a greater cardiovascular impact in women. Obesity, physical inactivity and depression are more common in women. Dyslipidaemia, hypertension…

…neurovascular and brain imaging. Evaluation and Physical Examination Clinical history and examination are the initial components of assessment. The history should include: previous TIA or…

…phase after ACS or coronary revascularization. Non acute heart failure in which an ischaemic or cardiometabolic cause is suspected. Selected asymptomatic individuals in whom coronary…

…and a dedicated multidisciplinary Shock Team. Evaluation and physical examination Assessment should establish: The ACS presentation and its urgency. The presence or absence of haemodynamic…

…that mimics angina pectoris [5]. This pain is thought to result from right ventricular ischemia that develops during physical exertion [5]. Associated Findings: Exertional dyspnea…

…threatening tachyarrhythmias. Evaluation and Physical Examination Physical examination of a patient on digoxin therapy should focus on identifying signs of heart failure decompensation, which may…

…and physical examination The objective of decongestion is clinical euvolemia rather than an isolated numerical change in weight. Assessment should integrate the history, physical examination…

…premature myocardial infarction, vascular disease or marked hypercholesterolaemia. Physical findings related to cholesterol deposition. Untreated or inadequately treated patients may develop premature CAD. Symptoms therefore…

…clinical context, the diagnosis requires evidence of new myocardial ischaemia, which may manifest through symptoms, ECG changes, or angiographic complications. Evaluation and Physical Examination The

…Evaluation and Physical Examination Patients with suspected ACS should undergo expedited emergency department assessment. The initial evaluation includes: Targeted medical history Physical examination Vital sign…

…risks loss of suppression. Clinical presentation and symptoms The source material does not describe specific symptoms or physical manifestations of HTG. Moderate HTG is primarily…

…Evaluation and physical examination The assessment should establish three complementary features: The severity of LV dysfunction The extent and anatomical distribution of CAD The amount…

…or physiological criteria supporting revascularisation. Evaluation and Physical Examination Assessment should establish both clinical risk and the feasibility of complete revascularisation. The clinical evaluation includes…

…thrombus. Evaluation and physical examination The physical examination is directed primarily toward the consequences of the infarction and LV dysfunction rather than toward thrombus itself…

…and pulmonary congestion. In pregnant patients presenting with suspected acute heart failure, urgent hospital admission and referral to an expert centre with advanced heart failure…

…physical examination pattern or biomarker signature specific to CTOs. Evaluation and physical examination Evaluation should establish: The severity and functional impact of angina or anginal…

…including subacute rupture. Evaluation and physical examination The diagnosis of pericarditis is clinical and is supported by additional findings. A definite diagnosis requires a compatible…

…territory. Clinical Presentation and Symptoms The source material addresses posterior infarction primarily in the context of suspected acute coronary syndrome and acute myocardial ischaemia. Patients…

…highly trained athletes in the absence of symptoms. C: Sinus bradycardia should persist with the onset of physical activity. D: Sinus bradycardia with heart rates…

…patients require a mechanism based assessment rather than reassurance based solely on the absence of obstructive CAD. Evaluation and Physical Examination Clinical assessment The asses

…diabetes, or chronic kidney disease. Evaluation and Physical Examination The diagnostic assessment should establish that hypertension is genuine, identify potentially remediable causes, assess comorbidities and…