…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…

…daily living. Workload or exertion required to provoke symptoms. Response to current antianginal therapy. Adverse effects that restrict further drug escalation. Previous PCI, CABG, or…

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…

…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…

…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…

…inhibitors are prescribed. Evaluation and Physical Examination Prior to initiating an ACE inhibitor, it is essential to evaluate the patient's volume status. Because fluid…

…slow rate. In the setting of bradyarrhythmic or asystolic arrest, management priorities shift to establishing control of cardiorespiratory status. This includes continuing cardiopulmonary resuscitation, performing…

…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…

…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…

…principal targets include blood pressure, lipid abnormalities, diabetes and glycaemic status, body weight, smoking, diet, physical inactivity, and alcohol consumption. Additional considerations include psychosocial stress…

…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…

…Cycle ergometer is preferred in Europe, while treadmill testing is predominant in the United States. Treadmill and cycle ergometer both have their advantages and disadvantages…

…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…

…glycopyrronium) 36–48 hours Smoking 1 hour Vigorous physical exertion 30 minutes A large meal 2 hours Withholding applies only to diagnostic spirometry with a…

…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…

…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…

…in isolation. The initial diagnosis and triage depend on integration of symptoms, vital signs, the ECG, and serial cardiac troponin measurements. Evaluation and physical examin

…phlegmasia cerulea dolens, ergotism, hypercoagulable states or iatrogenic vascular injury. Acute occlusion may also occur in an artery with established collateral circulation, particularly an occluded…

…which may worsen early prognosis even when haemodynamic status is initially preserved. Physical examination should therefore focus on: Blood pressure and evidence of hypotension Heart…

…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…

…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…

…angina, angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), post ACS or post revascularization states, and heart failure of ischaemic or cardiometabolic origin…

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

…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…

…with fatigue, depression, sleep disturbance or altered mental status rather than prominent breathlessness. Hemodynamic phenotypes Initial assessment should distinguish congestion from hypoperfusion. This distinction provides…

…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

…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…

…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…

…myocardial tissue whose contractile function improves after coronary revascularization. This functional definition encompasses several physiological states. Brief coronary occlusion or relatively prolonged moderate ischemia may…

…than a more distal lesion. Revascularisation improves myocardial blood flow and angina related health status but does not reverse coronary atherosclerosis. Long term benefit therefore…

…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…

…patients exhibit hypotension—often with a systolic blood pressure less than 90 mmHg—accompanied by signs of poor vital organ perfusion or frank shock states…

…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…

…prompt repeat ECG acquisition and consideration of additional leads. Evaluation and Physical Examination At first medical contact, assessment should occur concurrently with acquisition of the…

…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…

…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…