…hemodynamic instability is a potentially life threatening condition and should be managed urgently. The risk of cardiogenic shock is high and pharmacological interventions are often…

…dilated, light unresponsive pupils are indicative of cerebral anoxia or brain death and constitute an adverse prognostic sign. Notably, the presence of dilated, nonreactive pupils…

…already within 2 hours after the onset of infarction. The presence of such Q waves should raise suspicion of ischemia/infarction as the underlying cause…

…hemodynamic effects is a potentially life threatening condition and should be managed urgently. The risk of cardiogenic shock and cardiac arrest is high and pharmacological…

…indicated in the presence of ongoing ischemic symptoms, haemodynamic instability, or life threatening arrhythmias. I C A routine primary PCI strategy should be considered in…

…and anticipated electrical environment. Preoperative evaluation Establish the nature and function of the device The following should be determined before surgery: Device type: pacemaker, ICD…

…heart failure or after myocardial infarction). Ventricular arrhythmias are easier to induce in the presence of arrhythmogenic substrates. A substrate is defined as a physiological…

…presents a classification of acute coronary syndromes and myocardial infarctions. The reader should study this chart carefully. Figure 1. Flowchart showing the natural course of…

…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…

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

…dyspnoea, and the presence of risk factors or previously identified coronary calcification. Age and sex remain important determinants of the expected prevalence of obstructive CAD…

…factors. Plaque erosion Plaque erosion is increasingly recognized and is present in at least one third of acute coronary syndromes in the cited material. Eroded…

…be ignored. The most common situation is when assessing aortic stenosis in the presence of a narrowing of the LVOT (left ventricular outflow tract). Such…

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

…Occlusion Myocardial Infarction (OMI) versus Non Occlusion Myocardial Infarction (NOMI). This method focuses on the presence or absence of ACO, rather than rigid ECG thresholds…

…small amount of serous fluid which acts as a lubricant that prevents friction during ventricular contraction and relaxation. Pericardial effusion is the presence of an…

…with oxygen demands. Depending on several factors– including the severity of the stenosis/occlusion, microvascular function, myocardial oxygen extraction, presence of collateral circulation, etc –ischemia…

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

…or a very strong clinical suspicion. 3. Give intravenous calcium in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells…

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

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

…without acute elevations in cardiac troponin concentrations. Based on the presenting electrocardiogram (ECG) and the presence of troponin elevation, ACS are classified into unstable angina…

…first choice, but today the majority of patients can only be assessed using echocardiography. A common question is the presence of right ventricular load. This…

…progression of right heart failure may indicate the need for inodilator therapy. Furthermore, acute heart failure and cardiogenic shock can present de novo in pregnant…

…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…

…to 50% of SCA cases, though determining the exact underlying cause and its reversibility is often difficult. Physical examination and clinical evaluation should focus on…

…either RV dysfunction or elevated biomarkers, or neither of these abnormalities in the presence of abnormal clinical risk assessment. Low risk PE is characterized by…

…active. Endothelial and smooth muscle cells normally regulate vascular tone, preserve an antithrombotic surface, and control the adhesion and migration of inflammatory cells. Dyslipidaemia, cigarette…

…all of the traditional aggravating and relieving characteristics of angina; many patients report less characteristic symptoms, while others present primarily with exertional dyspnoea. Symptoms should…

…may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is particularly associated with elevated central venous pressure, which is transmitted to…

…The need for non cardiac surgery. The presence of an indication for oral anticoagulation (OAC). Clinical context and treatment objectives DAPT is used in two…

…leads generally indicates very severe ischemia [15]. A key distinguishing feature of ischemic ST elevation is the presence of prominent reciprocal ST depression [4]. Furthermore…

…the diagnosis of heart failure is clinically secure and the LVEF measurement is reliable. Nevertheless, these findings increase diagnostic confidence. The presence of symptoms alone…

…neurological deficits. Neurological involvement Hypertensive encephalopathy may present with somnolence, lethargy, tonic–clonic seizures, cortical blindness, and, in advanced cases, loss of consciousness. Focal neurological…

…pancreatitis. Evaluation and physical examination Evaluation should establish: The triglyceride concentration and whether the sample was fasting or non fasting. The presence of ASCVD, peripheral…

…and V6; occasional RS pattern in V5 and V6 [3] Presence of LVH pattern; slurring and notching of the tall R wave upstroke [3, 7…

…on lesion location, severity, length, the presence of multilevel disease and collateral circulation. Flow limitation may be clinically silent, manifest as exertional symptoms, or progress…

…clinical descriptions. It may be present intermittently during the illness and, in some series, is reported in up to approximately one third of patients. Its…

…setting of acute or chronic heart failure are often better categorised as myocardial injury. Clinical Presentation and Symptoms Patients with Type 2 MI frequently present…

…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…

…the components of the ventricular conduction system, including the right bundle branch (RBBB). In the presence of right bundle branch block, depolarization of the right…

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

…of the examination. Evaluation and Physical Examination Before stress echocardiography, clinical assessment should establish: The nature and stability of symptoms Exercise capacity The presence of…

…axis is a valuable diagnostic step. While a normal ECG does not definitively exclude PH, the presence of RAD significantly raises the clinical suspicion [9]

…this combination is associated with a worse prognosis. VA may occur in the presence of obstructive coronary artery disease (CAD), in non obstructive coronary arteries…

…The inhibition of pacing is appropriate when there is intrinsic cardiac activity; the presence of spontaneous atrial or ventricular activity should inhibit pacing in the…

…The presence of ecotdense masses on valves should lead to suspicion of endocarditis (the masses are vegetations). The risk of endocarditis is especially high for…

…referred to as high sensitive cardiac troponin, may actually detect the presence of troponins in most normal persons. In 2017 it was possible to detect…

…value of echocardiographic examination depends on the pre test probability, which is the probability that the patient actually has endocarditis (this the probability should be…

…revascularized individuals Clinicians should be familiar with the special challenges posed by some patient populations. The sensitivity, specificity, risks, and results of the exercise test…

…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…

…R wave in V5 and V6. Secondary ST T changes occur invariably in the presence of LBBB. The following ECG criteria and characteristics are used…

…and UA hinges entirely on the presence of myocardial necrosis. NSTEMI is confirmed by a typical rise and/or fall of high sensitivity cardiac troponin …

…evaluation should establish: The time of symptom onset and the rate of progression The location and severity of pain The presence and extent of sensory…

…angina is present without anatomical or physiological criteria supporting revascularisation. Evaluation and Physical Examination Assessment should establish both clinical risk and the feasibility of complete…

…multiple variables, including the number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions (CTOs), calcification, and thrombus presence. These factors…

…should prompt reconsideration of the diagnosis. 3. Palpate the pulses and measure the ankle brachial index with Doppler. 4. Culture only in the presence of…

…a fractional excretion of urea below 35 % is a better alternative. Follow up At an eGFR below 60, or in the presence of albuminuria: check…

…ACS, AF may be present before the acute event, detected for the first time during its management, or arise during the course of treatment. Even…