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…

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…

Emergency medicine Lathundar Differential Diagnosis of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome…

…RVI commonly occur in the setting of an inferior myocardial infarction. The available source material emphasizes the haemodynamic and physical manifestations rather than providing a…

Emergency medicine Myocardial ischemia and infarction Definition and Pathophysiology ST segment elevation myocardial infarction (STEMI) is an acute myocardial infarction associated with a working diagnosis…

…Initial hs cTn measurement Continuous cardiac monitoring The source material does not provide a detailed list of physical examination findings or a specific examination sequence…

Cardiology Clinical medicine Introduction Cardiovascular disease becomes increasingly prevalent with advancing age, while its clinical expression and management become progressively more complex. Older adults, often…

Cardiology Clinical medicine Definition and Scope Primary prevention aims to prevent the clinical manifestation of cardiovascular disease (CVD) in individuals without established clinical CVD. It…

Cardiology Clinical medicine Definition and Pathophysiology An abdominal aortic aneurysm (AAA) is diagnosed when the abdominal aortic diameter exceeds 3 cm. Most AAAs are located…

Cardiology Emergency medicine Definition and pathophysiology Acute pulmonary embolism (PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and…

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

Cardiology Clinical medicine Definition and pathophysiology Cardiovascular disease (CVD) is the leading cause of death among women worldwide and in the United States. In the…

Cardiology Pharmacology & dosing Definition and Pathophysiology Angiotensin converting enzyme (ACE) inhibitors are foundational therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic…

…However, coronary artery disease remains the number one killer in most regions worldwide ( Tsao et al .). The New England Journal of Medicine, 1812. Remarks on…

…setting of ischemia, myocardial contractility is downregulated or completely ceased. The ischemic area will immediately display wall motion abnormalities. This is useful in emergency medicine…

…with resistant hypertension. Dietary sodium and potassium abnormalities and commonly used over the counter medicines may also contribute to apparent treatment resistance. The diagnosis is…

…discussion: the ECG blog ECG The best ECG book is not the one making it simple In the thrilling and ever evolving field of medicine…

…HR, Kern KB, Wenzel V, Chamberlain DA, editors. Cardiac arrest—the science and practice of resuscitation medicine. Kitamura T, Kiyohara K, Sakai T, et al…

…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…

…a sound wave. A familiar example is human speech. Humans speak by setting their vocal cords in motion. When vocal cords vibrate, they generate vibrations…

…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…

…history (with emphasis on causes of AV blocks; please refer to theCauses of AV blocks) and physical examination. It is also reasonable to analyze cardiac…

…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…

…in stable angina. Exercise induced arrhythmia or exercise induced syncope. Assessment of chronotropic function and pacemaker settings. Preoperative functional assessment before major surgery. At a…

…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…

…in their mid 60s or older [10]. Physical examination may reveal a normal or low pulse pressure, an elevated jugular venous pressure with a paradoxical…

…this setting, the risk of sudden death and end stage heart failure is high, and assessment for advanced therapies may be required. Evaluation and physical…

…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…

…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…

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

…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…

…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…

…determines its entire value: a poorly performed manoeuvre gives a falsely low FVC and thus a falsely normal FEV₁/FVC. Set aside time, coach actively…

…Evaluation and Physical Examination A comprehensive evaluation is mandatory for patients presenting with sudden cardiac arrest (SCA) if the underlying cardiac disease is unknown or…

…uncontrolled heart failure, and concomitant valvular disease. Risk factor modification, physical activity, dietary and lifestyle measures, high intensity statin therapy, and appropriate antithrombotic treatment form…

…sounds persist, the fourth Korotkoff sound is used. Office blood pressure: blood pressure measured in a clinical setting, manually or with an automated device. Home…

…than the brain. Patients with AF in the setting of ACS have more comorbidities and a higher risk of complications than patients without AF; both…

…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…

…jaw, neck, or upper back. Chest discomfort triggered by emotional stress. Palpitations associated with physical activity, a large meal, emotional upset, or cold exposure. The…

…patients with left ventricular dysfunction and/or MVD. Nevertheless, the optimal extent and timing of intervention depend on the clinical setting, haemodynamic status, coronary anatomy…

…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…

…setting, venous congestion is generally treated initially with diuretics, whereas norepinephrine and/or inotropes are reserved for low output and hemodynamic instability. Evaluation and physical…

…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…

…infarction related to restenosis following PCI. Both type 4b and 4c MIs meet the clinical criteria for a type 1 MI. Type 5 MI: Represents…

…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…

…Evaluation and Physical Examination The source material does not provide a detailed description of the physical examination maneuvers specific to the evaluation of patients requiring…