…annular dilatation, or both; progressive ventricular remodeling may also occur in primary valvular disease. Increasing severity of mitral regurgitation is associated with worse outcomes. Pulmonary…

…TdP). Drug induced LQTS and TdP represent a multifactorial clinical entity that typically emerges when multiple modifiable and non modifiable risk factors converge. The electrophysiological…

…Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial accumulation of…

Cardiology Coronary Atherosclerosis Coronary atherosclerosis is a chronic, progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental…

…The contemporary understanding of AF has evolved significantly; it is no longer viewed merely as an electrical anomaly but as a progressive, complex atrial myopathy…

…disruption of the adventitia can result in rupture. An alternative proposed mechanism is primary rupture of the vasa vasorum, followed by disruption of the intima…

…and viable myocardium. The incidence has fallen substantially with contemporary reperfusion, particularly primary percutaneous coronary intervention (PCI). In a large epidemiological analysis, mechanical complications occurred…

…may indicate underlying arrhythmias. Age : Younger patients are generally at higher risk of SCD due to the progressive nature of HCM. By combining these factors…

…principal scope of primary prevention, secondary prevention provides an important contrast. Patients with manifest clinical disease are at high risk of progression and generally require…

ECG Exercise stress test Definition and clinical role Exercise electrocardiographic testing is a standardized assessment in which a patient performs progressively increasing external work, usually…

… 150 mg/dL (≥1.7 mmol/L) in ESC primary prevention guidance 175–499 mg/dL (2.0–5.6 mmol/L) Severe HTG ≥500…

…whereas CABG provides a bypass beyond diseased segments. The latter may also protect against future proximal disease progression, while stents do not prevent the development…

…cessation is therefore the preferred therapeutic endpoint. The cardiovascular benefits of cessation extend across primary and secondary prevention. Observational evidence indicates that cessation lowers the…

…declined steadily ever since. The marked decline in death rates and case fatality is most likely explained by successful primary preventive strategies, such as reduced…

…where appropriate, primary care personnel and home visits may reduce rehospitalization for recurrent ischaemia and infarction. Clinical Presentation and Symptoms Cardiac rehabilitation is initiated in…

…balance. The principal sporadic subtypes are: Aldosterone producing adrenal adenoma Bilateral adrenal hyperplasia Primary or unilateral adrenal hyperplasia Rare aldosterone producing adrenal carcinoma Less commonly…

…previous angina. Patients should be advised to seek emergency medical assistance rather than self presenting to an emergency department or contacting primary care first. If…

…include: Approximately 11% reduction in cardiovascular events in a meta analysis of primary prevention trials involving individuals with an estimated 10 year cardiovascular risk of…

Mitral valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation Vena contracta (cm) < 0,3 0,3 0,69 0,69 EROA (cm²…

Tricuspid valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation PISA radius < 0,6 0,6 0,9 0,9 Vena contracta (cm…

Procedurer Two recordings that are performed in primary care but interpreted as specialist investigations. Both fail more often for practical than for medical reasons: the…

Procedurer Benign paroxysmal positional vertigo is the commonest cause of vertigo in primary care and one of the few diagnoses that can be cured on…

…UA) Non ST elevation myocardial infarction (NSTEMI) ST elevation myocardial infarction (STEMI) This applies to patients undergoing either primary or delayed percutaneous coronary intervention (PCI)…

…myocardial dysfunction caused by coronary artery disease (CAD). The clinical syndrome may resemble primary dilated cardiomyopathy, particularly when angina or a previous myocardial infarction (MI…

…reduction of low density lipoprotein cholesterol (LDL C), the primary lipid target in contemporary secondary prevention. Statins inhibit hepatic 3 hydroxy 3 methylglutaryl coenzyme A…

…hypokalaemia. Endocrine disorders account for many secondary forms. Primary hyperaldosteronism is identified as the most frequent cause, comprising approximately 20–25% of secondary hypertension cases…

…one of the most common symptoms in the emergency department, as well as in primary health care. The cause (etiology) of chest pain varies according…

…into a major focus of contemporary cardiac electrophysiology [1] . Recognized as a primary inherited arrhythmia syndrome, BrS is characterized by a distinct electrocardiographic (ECG) signature…

…Like all other cells in the human body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source. ATP is produced by metabolizing carbohydrates …

…predictors in prediction models. Targeting risk factors has been very successful in the primary and secondary prevention of atherosclerotic cardiovascular disease, both at the population…

…cardiovascular medicine. As a primary driver of sudden cardiac death (SCD) and a major cause of morbidity in patients with structural heart disease, VT necessitates…

…to involve a surgeon The following locations must not be handled routinely in primary care or in the emergency department without contacting the appropriate specialty:…

…expected pCO₂ or HCO₃. A value outside the expected range means there is a further primary disorder 4 Is there a metabolic acidosis? Calculate the…

…life produces more marked suppression. Stress dosing in known adrenal insufficiency A patient with primary adrenal insufficiency (Addison's disease), secondary adrenal insufficiency or long…

…Cervical cancer screening in Sweden Since 2017, HPV testing has been the primary screening test throughout the country. Cytology is used as a triage test…

…ventilation is difficult or inadequate. The primary airway in cardiac arrest when the person ventilating is not experienced in intubation. Planned anaesthesia for short procedures…

…stricture, tumour, primary biliary cholangitis, drugs Mixed Both raised Drug induced liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's…

…Addisonian crisis, hydrocortisone must be given immediately — the test must never delay treatment. Indications Suspected primary adrenal insufficiency (Addison's disease): fatigue, weight loss, hyperpigmentation…

…or a dressing alone. Contraindications Primary closure must be avoided or considered carefully in: Bite wounds — particularly cat and human bites, and all bites on…

…widely used CHA₂DS₂ VASc score, with the primary distinction being the exclusion of sex parameter (female sex) as a risk factor. Rationale for the development…

…32–60 25–31 18–24 <17 Tricuspid valve Tricuspid valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation PISA radius < 0,6…

…by echocardiography. Reduced LVEF reliably identifies a high risk group that derives a large, trial proven survival benefit from primary prevention ICDs. Its dominance, though…

…consider both cardiac and non cardiac etiologies [1]. Cardiac Causes The primary differential diagnoses include conditions that directly affect the myocardium or major vessels. 1…

…the enzyme. By inhibiting this pump, digoxin affects multiple cellular processes critical to cardiac myocyte function, ultimately exerting a mild positive inotropic effect. Beyond its…

…Selection of the reperfusion strategy Primary PCI as the preferred strategy Primary percutaneous coronary intervention (PPCI) is preferred to fibrinolysis when the anticipated interval from…

…hypotension and bradycardia. However, some patients exhibit a primary cardioinhibitory response with pronounced bradycardia. Most cardioinhibitory events are due to sinus bradycardia, though transient atrioventricular…

…onset, is of paramount importance. The primary concern in correcting hyponatremia is the prevention of osmotic demyelination syndrome (ODS), previously known as central pontine myelinolysis…

…the cooling process. Malignant hyperthermia Malignant hyperthermia may manifest under two primary circumstances: Due to a genetic mutation in the RYR1 receptor, resulting in persistent…

…Thromboembolism). There are genetic syndromes that result in the emergence of multiple myxomas. Papillary fibroelastoma Papillary fibroelastoma is benign primary tumors affecting adults. These tumors…

…impulse conduction. 2. Calcium Hypercalcemia Causes of hypercalcaemia Primary hyperparathyroidism and malignancies cause 90% of all cases of hypercalcemia. Less common causes are immobilization, sarcoidosis…

…The coronary arteries: a brief overview The two primary coronary arteries originate from the aortic bulb ( Figure 1 ): The right coronary artery ( RCA ) originates on…

…90–95% of individuals with hypertension have essential hypertension , also referred to as primary hypertension . Essential hypertension is defined as hypertension without an identifiable underlying…

…efficiency of the pumping function. The primary ECG manifestations of conduction defects are prolonged QRS complexes and altered QRS appearance. These concepts will be discussed…

…interval. The primary hazard lies in long QTc intervals because they induce a very unstable polymorphic ventricular tachycardia referred to as torsade de pointes . Abnormally…

…if the load becomes prolonged. However, most often the cause of the load is the primary problem. Among the causes are pulmonary embolism, pulmonary hypertension…

…the primary ischemic ECG changes. ST segment depressions in NSTE ACS are frequently accompanied by T wave inversions (or flat T waves), but the primary…

…Myocardial oxygen demand Myocardium can only function under aerobic conditions (oxygen is required for ATP synthesis [ATP is the primary energy source in all cells])…

…STEMI: time targets and choice of reperfusion Primary PCI is the method of choice if PCI can be performed within 120 minutes of the STEMI…

…second attempt). Vasoactive infusions Drug Dose range Primary effect Used in : : : : Noradrenaline 0.05–0.5 µg/kg/min α₁ — vasoconstriction Septic and distributive shock