…other electronic equipment may also interfere with device function. The clinical consequences depend on the device, the patient's dependence on pacing, the presence of…

…during management of another condition, or identified only by implanted or wearable devices as subclinical AF. Some patients have frequent symptomatic episodes, whereas others have…

…or other evidence of ongoing ischaemia Symptoms suggesting haemodynamic compromise, such as near syncope or poor perfusion Known arrhythmia or electrical instability The presence of…

…proportion of painless or silent STEMIs is greater in patients with diabetes mellitus and increases with age. STEMI may present as sudden onset breathlessness. Other…

…Identification of PAD also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention. Clinical assessment should include functional status…

…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…

…Coexisting multivessel disease The extent of jeopardized myocardium Left ventricular systolic function Diabetes and other comorbidities Anatomical complexity and completeness of possible revascularization A proximal…

…presence or absence of haemodynamic instability or cardiogenic shock. The likelihood of an identifiable IRA. The extent and complexity of coexisting coronary disease. Renal function…

…metabolic imaging. Contribute to assessment of cardiac inflammation, infective endocarditis, and cardiac amyloidosis using appropriate radiopharmaceuticals. Functional perfusion imaging primarily identifies haemodynamically important disease. Non…

…and venous filling may be reduced. Other possible findings include muscle stiffening and loss of deep tendon reflexes. Pulses are absent distal to the obstruction…

…epicardial vasomotor abnormalities or structural and functional microvascular disease. Thus, the presence of non obstructive epicardial arteries does not exclude a coronary cause of symptoms…

…prognosis. Pathophysiology The defining physiological abnormality is heart failure occurring with mildly impaired LV systolic function. The syndrome remains fundamentally one of impaired cardiac performance…

…Notably, 31.2% of patients discharged with intact neurological function were observed to lack a pupillary reflex upon their initial presentation. An absent pupillary reflex…

…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…

…other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence of ongoing acute organ injury is decisive. The pathophysiology reflects failure of…

…preserve an antithrombotic surface, and control the adhesion and migration of inflammatory cells. Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these…

…requiring dialysis is uncommon except in the presence of substantial pre existing CKD, particularly when congestive heart failure or other causes of ischaemic AKI coexist…

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

…chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations arising from structural or functional abnormalities of the coronary arteries or coronary microcirculation…

…myocardial infarction. A history of cigarette smoking may be present despite relatively few other conventional atherosclerotic risk factors. A substantial proportion present with NSTEMI, although…

…systolic function is depressed or preserved Whether hypotension is present Whether an accessory pathway is suspected, particularly before administration of digoxin The duration of the…

…causes immense strain on the ventricular myocardium, simultaneously as the cause of the arrhythmia already affects cellular function. This results in electrical instability which explains…

…Several underlying conditions increase a patient's sensitivity to digitalis related arrhythmias. The clinician must evaluate for the presence of worsening renal function, advanced age…

…The magnitude of untreated LDL C elevation. The presence and age of onset of premature CAD or other vascular disease. A history of myocardial infarction…

…further reducing myocardial workload. 1 The pharmacokinetic profile of levosimendan is modulated by the presence of an active metabolite, which exerts sustained hemodynamic effects for…

…measurements permit assessment of the physiological significance of selected stenoses using fractional flow reserve (FFR) and instantaneous wave free ratio (iFR). Other invasive techniques can…

…diminish or disappear. Others have no recognized history of angina or MI, making the distinction from primary dilated cardiomyopathy particularly difficult. When present, the clinical…

…generally performed in order to evaluate ventricular function, since it may affect the choice of device therapy and also suggest whether other interventions (e.g…

…structure and function. Ultrasound imaging, including echocardiography, has become a standard tool for clinicians worldwide (Narula et al). This chapter discusses the principles of the…

…kidney injury, AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine value alone but by the course, urine…

…ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator or institutional experience Assessment of…

…the last dose, the renal function and the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not routinely stop aspirin…

…of other comorbidities, does not significantly increase stroke risk. Conversely, the 2023 ACC/AHA guidelines retain the "VASc" nomenclature but clarify that female sex functions…

…from other branches of the same coronary artery or another coronary artery, will alleviate the ischemia, improve myocardial function and increase resistance to episodes of…

…pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response…

…from other tachyarrhythmic events. On the surface electrocardiogram, sinus bradycardia may appear at rates of 40 to 48 beats per minute, occasionally accompanied by junctional…

…without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and…

…present postpartum. Known hypertension and current antihypertensive treatment. Missed doses or abrupt withdrawal of a beta blocker, clonidine or another sympatholytic drug. Cocaine, amfetamine, other…

…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…

…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…

…from out of hospital cardiac arrest should not routinely undergo immediate angiography. A selective or delayed approach is recommended in this setting unless other findings…

…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…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

…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…

…cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other frequent symptoms are pulsus paradoxus, pericardial friction…

…pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of acute PE comprises four clinically useful groups: High risk…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…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…

…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…

…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…

…a long time and be detected randomly when investigating other conditions. More dramatic onset of symptoms can be seen in arrhythmogenic tumors of the myocardium…

…Other microorganisms, generally, cause subacute endocarditis. Endocarditis can affect native (own) valves and valve prostheses. As always, foreign materials pose a high risk of infection…

…hypertension is genuinely present Factors that may be contributing to elevated blood pressure Other cardiovascular risk factors and relevant comorbidities Evidence of hypertension mediated organ…

…Ultimately, the specificity of exercise stress testing is lower in the elderly, as compared to younger individuals. Sensitivity, on the other hand, appears to be…

…and other emergency instruments. Personnel conducting the test must be formally trained to assess cardiovascular response, symptoms, and ECG changes. Although the risk of cardiac…

…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…

…all cause mortality. The excess risk is mediated by the combined effects of hyperglycaemia, hypertension, dyslipidaemia, obesity, smoking and other conventional risk factors, together with…

…closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with…

…with first degree AV block. A shortened PR interval (<0,12 s) indicates pre excitation (presence of an accessory pathway). This is associated with a…

…their diagnosis and management. The recommendations presented throughout this section align with the guidelines issued by the European Society of Cardiology (ESC), the American Heart…