…morphology of valves, the presence of vegetations, hemodynamic status, and the extent of endocarditis. Endocarditis gives three typical findings on echocardiography: Vegetations. Abscesses. Prosthetic detachment…

…2 An oral anticoagulant is recommended A DOAC is preferred to warfarin except in a mechanical valve prosthesis and in moderate to severe mitral stenosis…

…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…

…of an epicardial coronary artery (i.e. STEMI), pathological Q waves can develop already within 2 hours after the onset of infarction. The presence of…

…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…

…I C If time from symptom onset is 12 h, a primary PCI strategy is indicated in the presence of ongoing ischemic symptoms, haemodynamic instability…

…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…

…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…

…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…

…the 99th percentile upper reference limit (URL). The injury is considered acute if there is a documented rise and/or fall of cTn values. However…

…high risk and should influence the urgency of management: Recurrent or ongoing chest pain despite medical treatment Acute heart failure presumed to result from ongoing…

…of obstructive CAD, testing may generate false positive results and unnecessary downstream procedures. In patients with a high probability, testing may add little diagnostic value…

…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…

…to another (in the same lead). This is due to the swinging back and forth of the heart in the pericardial space. Note that tachycardia…

…presence of collateral circulation, etc –ischemia may also develop during resting conditions. Indeed, in patients with ischemic heart disease, the majority of all ischemic episodes…

…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…

…is also a marker of systemic cardiovascular risk. The presence of a carotid bruit is associated with approximately double the risk of myocardial infarction and…

…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…

…heart. The right ventricle has a complicated anatomy. In cross section (SAX, short axis view), the the ventricle is rather a crescent shaped appendage of…

…identify specific hemodynamic profiles: the presence of hypotension, end organ hypoperfusion, shock states, and pulmonary congestion. In pregnant patients presenting with suspected acute heart failure…

…and signs of heart failure (HF) in the presence of a left ventricular ejection fraction (LVEF) of ≥50%, accompanied by objective evidence of structural and…

…pathways. Proarrhythmic events occur in 5% to 10% of patients receiving antiarrhythmic agents, and this risk is amplified in the presence of heart failure. Clinical…

…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…

…post ACS or post revascularization states, and heart failure of ischaemic or cardiometabolic origin. Major clinical presentations The principal outpatient presentations include: Reproducible stress induced…

…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…

…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…

…possibility of thrombolytic treatment. Cardiac and pulmonary complications Acute hypertension may precipitate myocardial ischemia or infarction, acute heart failure, or pulmonary oedema. Patients may present…

…Evaluation should establish: The triglyceride concentration and whether the sample was fasting or non fasting. The presence of ASCVD, peripheral arterial disease or aortic disease…

…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…

…In patients with pericarditis complicated by constriction, symptoms and signs of right sided heart failure may predominate. Pericardial effusions associated with post infarction pericarditis are…

…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…

…the presence of at least one major criterion or two minor criteria. The source material does not provide the individual ARC HBR criteria. Modification of…

…Stress increases myocardial oxygen requirements, principally through increased heart rate and contractility. In the presence of a flow limiting coronary stenosis, supply cannot increase adequately…

…right heart pathology. In adults with clinical suspicion of pulmonary hypertension (PH), such as unexplained dyspnea on exertion, RAD demonstrates a high predictive value for…

…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 behavior of the pacemaker at low and high heart rate, the behavior of the pacemaker in the presence and absence of intrinsic cardiac activity…

…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…

…severity) which may compensate for the inability to reach their maximal heart rate. Ultimately, the specificity of exercise stress testing is lower in the elderly…

…Presence of potentially serious arrhythmias – due to the risk of circulatory collapse. Decompensated heart failure – due to the risk of circulatory collapse and arrhythmias Pulmonary…

…more common in individuals with structural and ischemic heart disease. Assessment of ischemia on ECG is difficult in the presence of left bundle branch block…

…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…

…one value above the 99th percentile upper reference limit (URL) in the appropriate clinical context. Unstable Angina presents with clinical and/or electrocardiographic signs of…

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

…physical signs for LMCAD. Diagnostic Assessment Coronary angiography Invasive coronary angiography defines: The presence and severity of left main stenosis Ostial, shaft or distal bifurcation…

…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…

…0.5 or toe pressure < 30 mmHg. Decompensated heart failure — compression of both legs acutely increases preload. Untreated deep vein thrombosis in the acute…

…or to confirm a creatinine based value The mean of creatinine and cystatin C The most reliable in routine clinical practice Cockcroft–Gault Still used…

…or signs of heart failure Haemodynamic instability Myocardial ischaemic symptoms or electrocardiographic changes Thromboembolic complications, particularly stroke In ACS, AF may be present before the…