…Objective evidence of myocardial ischaemia. Absence of obstructive coronary artery disease, defined as no stenosis exceeding 50% diameter reduction and/or an FFR 0.80…

…an atherosclerotic plaque may also release atherosclerotic debris downstream, causing microvascular embolization (i.e occluding smaller vessels downstream). The thrombosis causes occlusion of the artery…

Cardiology Principles of myocardial perfusion imaging Myocardial perfusion imaging (MPI) is a non invasive technique for detecting and quantifying coronary artery disease (CAD). It offers…

…associated fatty liver disease is also independently related to cardiovascular disease, particularly coronary artery disease. Hyperuricaemia and Endothelial Dysfunction Insulin resistance impairs renal tubular handling…

…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…

…the onset of myocardial infarction. This is utilized in clinical practice by detecting troponins in patients with suspected acute coronary syndromes. Several manufacturers have developed…

…release must therefore be considered throughout assessment. Coronary disease is most commonly related to atheromatous plaque producing progressive narrowing or obstruction of epicardial coronary arteries…

…restenosis (ISR) is recurrent narrowing within a previously implanted coronary stent. It represents a form of arterial hyperplastic disease arising after percutaneous coronary intervention (PCI)…

…The central pathophysiological concern in the emergency department is myocardial ischaemia caused by an acute coronary process. Myocardial injury leads to release of cardiac troponin…

…infarction. The degree of troponin elevation does not by itself establish the mechanism. Increased concentrations may result from acute coronary atherothrombosis, oxygen supply–demand imbalance…

…CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial…

…and Pathophysiological Basis High sensitivity cardiac troponin (hs cTn) assays detect circulating troponin released from injured cardiomyocytes at substantially lower concentrations than earlier generation assays…

…CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial…

…care or coronary care unit, and the operating theatre. Careful electrocardiographic and haemodynamic monitoring with ECG, a central venous catheter and an arterial line is…

…preparations: in practice within about 1 hour. Tablets and solid preparations: up to about 2 hours. Modified release preparations, anticholinergics, opioids and salicylate — where gastric…

…a dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release. In cardiac arrest with suspected hyperkalaemia, advanced life…

…a fixed dose is given without assessment, when a modified release preparation is started in an opioid naive patient, or when a conversion between drugs…

…around the clock for health care professionals. Contact the centre early in serious, unusual or unclear poisoning, with modified release preparations, mixed poisoning, pregnancy, children…

…plasma concentrations of the two peptides are not interchangeable. Natriuretic peptide concentrations reflect haemodynamic stress, but their release is not specific to left ventricular systolic…

…done wrongly. The two commonest errors are that an intramuscular injection in fact ends up subcutaneously in a patient with a high BMI, and that…

…modified release preparation before the daily requirement is known. Duplication. Check that the patient is not already on an opioid patch, a modified release tablet…

…if more than one hour has elapsed post ingestion unless the ingested substance has the propensity to form bezoars or is a sustained release formulation…

…from the active edge, not from the centre Include epidermis and dermis Bullous dermatosis Two biopsies: one from a fresh blister (routine), one from perilesional…

…pupillary reflex. Importantly, pupillary size and reactivity are influenced by factors beyond neural activity. Systemic catecholamines released or administered during resuscitation can affect pupil to