Echocardiography Pulmonary (pulmonic) stenosis Pulmonary stenosis is virtually always a consequence of congenital heart disease. The stenosis can be fixed or dynamic, depending on the…

…responders. Left heart disease is the most common risk factor for PH. It produces postcapillary PH through elevation of left atrial and pulmonary venous pressure…

…heart disease Tetralogy of Fallot Marfan syndrome Takayasu's arteritis Iatrogenic (e.g complication of catheterization) Congenital dysplasia/aplasia of the pulmonary valve Idiopathic pulmonary…

…channelopathies, heritable aortopathies, selected congenital heart diseases, pulmonary arterial hypertension and thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an…

…3 Heart rate 100/min 1.5 Immobilisation ≥ 3 days or surgery in the last 4 weeks 1.5 Previous deep vein thrombosis or pulmonary…

…patient has a clinical heart failure syndrome and by determining the LVEF. Physical signs may be absent, particularly in early disease and in optimally treated…

…elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion [3] . Within this spectrum, Heart Failure with Reduced Ejection Fraction (HFrEF) is…

…pericarditis Coronary or large vessel arteritis Pulmonary arterial vasculopathy and pulmonary hypertension Arterial and venous thrombosis Valvular heart disease Cardiac dysrhythmias Arterial stiffness and endothelial…

…mellitus, chronic kidney disease (CKD), sedentary lifestyle, and atrial fibrillation (AF) [5] . Unlike HFrEF, where epicardial ischemic heart disease and myocardial infarction are primary drivers…

…occur in primary valvular disease. Increasing severity of mitral regurgitation is associated with worse outcomes. Pulmonary hypertension secondary to left heart disease may occur because…

…hypotension Heart rate and tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease…

…of COVID 19 relies on small samples of hospitalized patients. Most reports have suggested that comorbidities – e.g. cardiovascular disease, pulmonary disease, advanced age, smoking…

…venous pressure, pulmonary congestion, peripheral edema and body weight, often within days. However, diuretic treatment has not been shown formally to reduce heart failure mortality;…

…classification is clinically useful but should not be regarded as a series of completely discrete diseases. Heart failure extends across the full range of LVEF…

…kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease…

…therapy. Furthermore, acute heart failure and cardiogenic shock can present de novo in pregnant women without pre existing heart disease, such as in peripartum cardiomyopathy…

…48 hours Ongoing unstable angina Uncontrolled cardiac arrhythmia with hemodynamic compromise Active endocarditis Symptomatic severe aortic stenosis Decompensated heart failure Acute pulmonary embolism, pulmonary infarction…

…arrest with a separate category for cardiac etiologies. Cause Definition Medical cause Includes cardiac arrest caused by heart disease, other medical conditions (pulmonary embolism, bleeding…

…oxygen. Acute on chronic hypercapnic failure in obesity hypoventilation and neuromuscular disease. Hypercapnic failure in cardiogenic pulmonary oedema that does not improve with CPAP alone…

…unstable angina. Uncontrolled symptomatic arrhythmia. Symptomatic severe aortic stenosis. Decompensated heart failure. Acute pulmonary embolism or deep vein thrombosis. Acute myocarditis, pericarditis or endocarditis. Acute…

…chest discomfort requires a systematic differential diagnosis, as the syndrome associated with ischemic heart disease is broader than chest pain itself, encompassing symptoms like tightness…

…with total and cardiovascular mortality ( Curtis et al ). Among patients with coronary heart disease, left ventricular function is actually a stronger predictor of death than…

…prolapse DCM (dilated cardiomyopathy) Ischemic heart disease (coronary heart disease) Rheumatic valve disease Endocarditis Congenital mitral regurgitation Amyloidosis SLE Hypertrophic obstructive cardiomyopathy (HOCM) Rupture of…

…dyspnoea in a patient with COPD. Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered [1]. Do the following early:…

…is titrated slowly. Caution in acute heart failure and in obstructive airways disease Verapamil or diltiazem When a beta blocker is contraindicated, for example in…

…ischaemia or previous infarction Dyspnoea requires assessment of dynamic LV function, valve disease, pulmonary pressure, or haemodynamics Stress imaging is not recommended in patients undergoing…

…diastolic dysfunction Valvular heart disease Pulmonary hypertension Ischaemic heart disease Atrial arrhythmias Pericardial disease, including constriction Right ventricular dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies…

…Additionally, LAD may suggest underlying left heart disease in patients being evaluated for pulmonary hypertension [16]. Causes of Left and Right Axis Deviation Based on…

…pain (chest discomfort) HISTORY PARAMETER QUESTIONS COMMENTS Risk factors for the 5 serious etiologies Family history (focus on ischemic heart disease, aortic dissection, pulmonary embolism…

…congestive heart failure, congenital heart disease, diabetes mellitus (both type 1 and type 2), obesity, smoking, obstructive sleep apnea and chronic obstructive pulmonary disease (COPD…

…ectopic atrial rhythm Side effect of digoxin. Heart failure. Lung disease (COPD, pulmonary hypertension, etc). Ischemic heart disease (coronary artery disease). Structural heart disease, any…

…echocardiography. Causes of right ventricular hypertrophy Lung disease (with increased pulmonary vascular resistance), congenital heart disease (transposition of the great arteries, pulmonary valve stenosis, atrial…

…Carcinoid heart disease. Endocarditis (common in intravenous drug addicts). Myxomatous degeneration. Rheumatic heart disease. Dilatation of the right ventricle. Dilatation of the right atrium. Pulmonary…

…of diseases and medications may cause sinus tachycardia; e.g congestive heart failure, lung disease (e.g COPD), fever, infections, anemia, myocardial ischemia/infarction, pulmonary…

…Unprotected Left Main Disease : Increases complexity and risk. Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive Pulmonary Disease (COPD) : Associated with higher perioperative risk…

…an irregular or rapid heartbeat Dyspnoea and worsening pulmonary congestion Reduced exercise capacity Symptoms or signs of heart failure Haemodynamic instability Myocardial ischaemic symptoms or…

…medicine Procedurer Definition and Pathophysiology Cardiac tamponade is a life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular filling…

…Cardiac causes Systemic causes Heart failure Sepsis Myocarditis Chronic kidney disease Cardiomyopathy Stroke or subarachnoid haemorrhage Takotsubo syndrome Pulmonary embolism Recent coronary revascularization Infiltrative disease…

…Gonzalo; Baumgartner, Helmut et al. (2012): Guidelines on the management of valvular heart disease (version 2012). In European heart journal 33 (19), pp. 2451–2496…

…in turn results in pulmonary hypertension and pulmonary edema. Table 1. Causes of aortic regurgitation Bicuspid aortic valve Rheumatic heart disease Calcified aortic valves Idiopathic…

…as follows: Assessment of cardiovascular risk in screening. Detection of coronary artery disease (ischemic heart disease). Evaluation of coronary artery disease. Assessment of therapeutic response…

…gives a falsely high reading The cuff at heart level Measure in both arms at the first visit; a difference 15 mmHg suggests vascular disease…

…be taken at the next regular time. Use with caution in patients with asthma/chronic obstructive pulmonary disease (COPD). Dyspnea has been reported in patients…

…the disease early in the course. Hemodynamic effects of constrictive pericarditis Diastolic heart failure and right heart failure The rigid pericardium prevents all four heart…

…of the mitral valve orifice. There are many causes of mitral stenosis, the most common of which are rheumatic heart disease, congenital malformations, radiation complications…

…Other congenital anomalies include anomalous origin of a coronary artery from the pulmonary artery and anomalous origin of one coronary artery from the opposite aortic…

…exclude significant anatomical CAD with high sensitivity and a high negative predictive value, particularly when disease prevalence is low. It also identifies non obstructive plaque…

…trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive ventilation or intubation. Aortic disease An acute aortic dissection is a hypertensive…

…rupture causes abrupt severe MR. Its typical presentation is: Sudden severe dyspnoea. Acute pulmonary oedema. Hypotension. Progressive heart failure. Cardiogenic shock. Complete transection of a…

…rupture with tamponade, and less common causes such as severe pre existing valvular disease or excessive beta blocker or calcium channel blocker exposure. The incidence…

…holds true for cardiac arrests caused by chronic or acute ischemic heart disease, it is often not true in other circumstances (e.g. pulmonary embolism…

…changes occur during the first year of life. The electrocardiogram (ECG) evolves in parallel with the changing anatomy and physiology of the heart. ECG amplitudes…

…changes occur during the first year of life. The electrocardiogram (ECG) evolves in parallel with the changing anatomy and physiology of the heart. ECG amplitudes…

…Doses 5 μg/kg/min induces vasoconstriction, which dominates at dosease 15 μg/kg/min. Tachycardia Increased ventricular rate in AF Ventricular arrhythmias…

…Doses 5 μg/kg/min induces vasoconstriction, which dominates at dosease 15 μg/kg/min. Tachycardia Increased ventricular rate in AF Ventricular arrhythmias…

Cardiology Key points Levosimendan alleviates heart failure symptoms, increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of…

…of pulmonary embolism has increased in recent decades. Potential explanations for this trend include an ageing population, increased incidence and prevalence of cancer, heart failure…

…I and II. Heart axis deviation: right axis deviation (RAD) and left axis deviation (LAD) Causes of right axis deviation Normal in newborns. Right ventricular…

ECG Introduction to ECG interpretation The electrical axis of the heart Although often ignored, assessment of the electrical axis is an integral part of ECG…

…Nipride RTU ®, Nitropress ®. Indications Pulmonary edema, congestive heart failure. Angina pectoris. Hypertension, hypertensive crisis/emergency. Pulmonary hypertension. Blood pressure control. Mechanism of action…