…post infarction physical activity programmes into a structured centre of secondary cardiovascular prevention in which exercise, lifestyle intervention, education, and guideline directed medical therapy are…

…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…

…valvular disease. Risk factor modification, physical activity, dietary and lifestyle measures, high intensity statin therapy, and appropriate antithrombotic treatment form the broader management framework. Response…

…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…

…to established reversible myocardial ischaemia in either of two settings: Obstructive coronary artery disease (CAD) that cannot be controlled despite escalation of antianginal medical therapy…

…HFrEF. Advanced or refractory heart failure should be considered when there is recurrent clinical deterioration despite careful follow up and appropriate therapy. In this setting…

…the acute setting, whereas long term management only includes pacemaker therapy. Treatment of AV block in the acute setting Treatment in the acute setting is…

…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…

…baseline physical examination of patients prior to sotalol initiation. Diagnostics Electrocardiography (ECG) Electrocardiographic monitoring is central to the safe initiation and maintenance of sotalol therapy…

…dependent. Similarly, angioedema occurring in the setting of ACE inhibitor therapy is bradykinin mediated rather than mast cell mediated, distinguishing it from classic allergic reactions…

…extent and timing of intervention depend on the clinical setting, haemodynamic status, coronary anatomy, comorbidities, procedural complexity, age, frailty, and anticipated adherence to antithrombotic therapy…

…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…

…not reverse coronary atherosclerosis. Long term benefit therefore depends on the integration of revascularisation with guideline directed medical therapy and secondary prevention. Clinical Presentation and…

…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…

…decreasing and the incidence of NSTEMI is increasing, STEMI remains a critical clinical entity requiring immediate reperfusion therapy. The pathophysiology of myocardial infarction injury involves…

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

…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…

…SMI) receiving antipsychotic therapy, sinus tachycardia is common, and symptoms may reflect underlying arrhythmia or sudden cardiac death (SCD). Evaluation and Physical Examination A comprehensive…

…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…

…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…

…resistance Thyroid disease Kidney disease Excessive alcohol consumption Diets high in carbohydrate or fat Glucocorticoids Beta blockers Oestrogen therapy Some antiretroviral therapies Post transplant medications…

…specific context of perioperative care in patients with pulmonary arterial hypertension (PAH), progression of right heart failure may indicate the need for inodilator therapy. Furthermore…

…therapy should incorporate the clinical profile, coronary anatomy, left ventricular ejection fraction, procedural factors and anticipated outcomes. The supplied material does not describe specific physical…

…from: Inaccurate or inconsistent blood pressure measurement; White coat hypertension; Poor adherence or persistence with prescribed therapy; Inadequate dosing; An inappropriate diuretic for kidney function…

…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…

…and severity of underlying cardiovascular disease. Conduction disease and the need for pacemaker therapy may be more frequent in T2DM, although management follows the same…

…when the valve area is reduced to 1.5 cm 2 . During physical activity, mitral stenosis may become symptomatic already at 2.5 cm 2…

…generally not recommended. If deemed necessary after careful individual benefit risk assessment by the prescribing physician: Initial dose : 60 mg single loading dose. Maintenance dose…

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…

…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…

…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…

…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…

…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…

…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…

…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…

…of wall motion abnormalities. Assessment of wall motion abnormalities is particularly important in the setting of chronic or acute coronary artery disease. All types of…

…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…

…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…

…MI). MI denotes cardiomyocyte necrosis occurring in the clinical setting of acute myocardial ischaemia and is diagnosed according to the fourth universal definition of MI…

…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…

…including extracorporeal membrane oxygenation (ECMO), may be required in this setting. Clinical presentation and symptoms The clinical presentation reflects the severity of RV pressure overload…

…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…

…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…

…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…

…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…