…food intake redistributes blood to the gastrointestinal tract which reduces blood availability in the heart. Symptoms of ischemic heart disease are generally not related to…

…2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities, does not significantly increase stroke risk. Conversely, the 2023…

Procedurer The commonest error in paracentesis is not performing it. Every patient admitted with ascites should undergo a diagnostic paracentesis , because spontaneous bacterial peritonitis often…

…antiepileptic drugs, alcohol or sedatives Trauma and medication directed workup This corresponds to the principles of TiTrATE, in which Timing, Triggers And Targeted Examination guide…

…The AF pattern, while recognising that pattern does not determine the anticoagulation indication. Previous stroke or TIA. The presence of mitral stenosis, a mechanical heart…

…e.g. myocardial remodeling in heart failure or after myocardial infarction). Ventricular arrhythmias are easier to induce in the presence of arrhythmogenic substrates. A substrate…

…not recommended in individuals with previous virological failure if it risks loss of suppression. Clinical presentation and symptoms The source material does not describe specific…

…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…

…result, pupils often dilate widely within 30–120 seconds of cardiac arrest and light reactivity is lost when cerebral blood flow ceases. In other words…

…Non specific ST depressions, T wave inversions (negative T waves) do not affect the management of cardiac arrest. Recurrent VT or VF after ROSC in…

…The absence of symptoms indicates that the bradycardia is compensated by an increase in stroke volume. Symptomatic bradycardia may present with chronic or acute symptoms…

…as possible in the acute phase but should not delay reperfusion treatment. I C Blood samples Management Recommendation Level of evidence Serum biomarkers of myocardial…

…the presence of CRT, the type and location of surgery, and the anticipated current pathway. In a pacing dependent patient, inhibition of pacemaker output may…

…is caused by partial occlusion of the artery (i.e. coronary blood flow is not completely obstructed). NSTE ACS typically presents with ST segment depressions…

…without the presence of acute atherothrombosis. Type 3 MI: Describes cardiac death in patients with symptoms suggestive of myocardial ischaemia and presumed new ischaemic ECG…

…delay. In contrast, haemodynamically stable patients without ST segment elevation after successful resuscitation from out of hospital cardiac arrest should not routinely undergo immediate angiography…

…because the clinical value of any diagnostic test depends not only on its sensitivity and specificity but also on disease prevalence in the population being…

…depend not only on plaque composition but also on circulating thrombotic and fibrinolytic factors. Plaque erosion Plaque erosion is increasingly recognized and is present in…

…proximal velocity) can not be ignored. The most common situation is when assessing aortic stenosis in the presence of a narrowing of the LVOT (left…

…Pneumothorax is characterized by the presence of free air in the thoracic cavity. While this can occasionally be benign and manifest even in healthy individuals…

…by Smith and colleagues in 2018. This approach seeks to anchor diagnostic and therapeutic decisions in the presence or absence of an acute coronary occlusion…

…presence of an abnormal amount of fluid in the pericardial space. It can be caused by numerous local and systemic disorders. Accumulation of fluid in…

…The myocardium is capable of upregulating or downregulating metabolism (i.e contractility) according to oxygen supplies. Consequently, reduced oxygen supply would not result in ischemia…

…150) An acute phase protein — a normal ferritin does not exclude iron deficiency in the presence of inflammation Transferrin saturation 15–50 % < 15 % indicates…

…do not delay treatment when there are ECG changes, circulatory compromise or a very strong clinical suspicion. 3. Give intravenous calcium in the presence of…

…in adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In…

…in the vascular assessment. A carotid bruit is an important marker of cardiovascular risk, although the source material does not provide diagnostic sensitivity or specificity…

…is not uniformly present. The proportion of painless or silent STEMIs is greater in patients with diabetes mellitus and increases with age. STEMI may present…

…ventricle can not depolarize normally, which affects the efficiency of contraction. Left ventricular function affects right ventricular function via afterload. In the case of left…

…the clinical evaluation must identify specific hemodynamic profiles: the presence of hypotension, end organ hypoperfusion, shock states, and pulmonary congestion. In pregnant patients presenting with…

…vascular stiffening, and distinct microvascular responses to systemic inflammation [7] . The dominant risk factors for HFpEF include hypertension (present in 80% of cases), obesity, type…

…is amplified in the presence of heart failure. Clinical Presentation and Symptoms Patients with acquired QT prolongation and drug induced TdP typically present with near…

…patients who are not low risk but have either RV dysfunction or elevated biomarkers, or neither of these abnormalities in the presence of abnormal clinical…

…the presence of these features does not imply inevitable clinical disruption. Fewer than 5% of thin capped fibroatheromas have been identified as the source of…

…demand and coronary blood supply, resulting in myocardial hypoperfusion or ischaemia. Ischaemia is commonly precipitated by exertion, emotional stress, or another form of physiological stress…

…In heart failure, the interaction between the cardiac and renal axes may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is…

…surgery. The presence of an indication for oral anticoagulation (OAC). Clinical context and treatment objectives DAPT is used in two principal settings: After ACS , whether…

…segment elevation in acute pericarditis is typically diffuse, involving all leads except aVR and often V1, and does not correspond to a specific coronary anatomic…

…The syndrome remains fundamentally one of impaired cardiac performance, in which the heart cannot provide blood flow commensurate with the body’s requirements or can…

…Patients may present with chest pain, severe breathlessness, hypoxaemia, rales, or respiratory distress. In patients with HFpEF, acute hypertension is a frequent trigger of decompensation…

…applied: Classic Criteria : These include a QRS duration of $\ge 120$ msec , the presence of broad and typically notched R waves in leads I…

…is particularly common in older people and in patients with diabetes. The haemodynamic consequences depend on lesion location, severity, length, the presence of multilevel disease…

…be present intermittently during the illness and, in some series, is reported in up to approximately one third of patients. Its absence therefore does not…

…with accumulation of blood within the false lumen, which compresses the true lumen to varying degrees; this non atherosclerotic condition may occur especially in young…

…on the right side can compromise venous return to the right ventricle. Therefore, in the presence of a tamponade, chest compressions have limited efficacy. Furthermore…

…not affected by the right bundle branch block. Occasionally, right bundle branch block only displays a broad and notched R wave in V1 (instead of…

…HBR) should be assessed in a structured manner. Within the ARC HBR framework, HBR is defined by the presence of at least one major criterion…

…oxygen demand and coronary blood supply. Stress increases myocardial oxygen requirements, principally through increased heart rate and contractility. In the presence of a flow limiting…

…8]. RAD is present in most cases of significant RVH, although it is not typically classified as a formal diagnostic criterion for the condition [17]…

…occur in the presence of obstructive coronary artery disease (CAD), in non obstructive coronary arteries, or in patients with intermediate lesions that do not produce…

…offer the possibility of sensing and pacing in both the atria and ventricles. Sensing The pacemaker can record intrinsic cardiac activity and response appropriately. Specifically…

…ecotdense mass entrenched in the endocardium with impaired mobility (for example, after myocardial infarction), most likely has a parietal thrombus. The presence of ecotdense masses…

…circulation. It is possible to detect elevated levels of myocardial proteins in blood within 2 to 3 hours after the onset of myocardial infarction. Cardiac…

…and specificity of echocardiography depend on several factors, such as image quality, vegetation localization, echogenicity and size, presence of valve prostheses, and the habit of…

…inability to reach their maximal heart rate. Ultimately, the specificity of exercise stress testing is lower in the elderly, as compared to younger individuals. Sensitivity…

…for careful consideration of contraindications. Contraindications may be absolute or relative. Briefly, exercise stress testing must not be performed in the presence of absolute contraindications…

…To address these challenges, researchers have developed ECG criteria designed to identify ischemia in the presence of left bundle branch block. The most widely recognized…

…in leads V1 and V2 and broad, frequently nothed, R wave in V5 and V6. Secondary ST T changes occur invariably in the presence of…

…upper reference limit (URL) in the appropriate clinical context. Unstable Angina presents with clinical and/or electrocardiographic signs of myocardial ischemia but lacks this biomarker…

…ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed available blood flow…