…multiple QT prolonging medications, and drug accumulation secondary to renal or hepatic impairment or the inhibition of cytochrome P450 metabolism [1]. Nonmodifiable risk factors encompass…

ECG Hypertrophy and dilatation ECG and clinical characteristics in right ventricular hypertrophy (RVH) Figure 1. ECG changes seen in left ventricular hypertrophy (LVH) and right…

…is characterized by a significant reorganization of the activation and recovery patterns within the left ventricle, resulting in a widened QRS complex and secondary ST…

…left ventricle is amplified. Secondary ST T changes in left sided leads Left ventricular hypertrophy is often accompanied by J point depression, downsloping ST segment…

…miscellaneous conditions Definition and pathophysiology Familial hypercholesterolaemia (FH) is an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early…

…and infarction ST segment depression due to acute myocardial ischemia ST segment depressions caused by ischemia are characterized by a horizontal or downsloping ST segment…

Arrhythmias and arrhythmology Emergency medicine Pharmacology & dosing Definition and Pathophysiology Bradycardia encompasses a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within…

…Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome characterized by the cardinal symptoms and signs of heart failure (HF) in the…

…ECG, clinical characteristics and management Pre excitation The atrioventricular node and bundle of His are normally the only communication between the atria and the ventricles…

…than by ejection fraction alone. Heart failure with preserved ejection fraction (HFpEF) is characterized by: Symptoms and/or signs of HF. A left ventricular ejection…

…The relationship between LDL C exposure and ASCVD risk is characterized by several principles: Lower LDL C is associated with lower ASCVD risk across the…

…underlying coronary atherosclerotic process. Their clinical effects therefore occur within the broader framework of guideline directed medical therapy and secondary prevention. PCI treats focal stenotic…

…the remaining ones are malignant. • Secondary cardiac tumours have spread to the heart by metastasis or invasion from surrounding tissue. Differential Diagnostics There are several…

…cardiomyopathy Takotsubo cardiomyopathy Tachycardia induced cardiomyopathy Non compaction cardiomyopathy Peripartum cardiomyopathy Cardiomyopathy secondary to valvular heart disease Long term prognosis varies markedly across these conditions…

…patient with primary adrenal insufficiency (Addison's disease), secondary adrenal insufficiency or long term corticosteroid treatment cannot increase their own cortisol production. Situation Action : : Fever…

…5% to 30% of patients taking these agents. The cough is characteristically nonproductive and dry. Patients may describe a persistent tickle or sensitivity in the…

…the sample was fasting or non fasting. The presence of ASCVD, peripheral arterial disease or aortic disease. Secondary causes, particularly diabetes, thyroid disease, kidney disease…

…receptors) and parasympathetic withdrawal. Sinus tachycardia secondary to disease and medications : A wide range of diseases and medications may cause sinus tachycardia; e.g congestive…

…expansion of contractile cells as compared with conduction cells. Therefore it is very common to observe secondary ST T changes, characterized by ST segment elevation

…Secondary ST T changes occur invariably in the presence of LBBB. The following ECG criteria and characteristics are used to diagnose LBBB: QRS duration ≥0…

…Figure 3. Characteristics of right and left bundle branch block in leads V1/V2 and V5/V6. Figure 4 shows morphological differences between LBBB and…

…that universally warrants acute intervention and long term secondary prevention strategies. By Morphology: Monomorphic VT (MMVT): Characterized by a uniform QRS morphology from beat to…

…there is no consensus regarding grading of tricuspid stenosis severity. Tricuspid stenosis is visually characterized by thickened leaflets, with reduced motion and potentially fused commisures…

Cardiology Endocrinology & metabolism Definition and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiological basis Secondary prevention after myocardial infarction (MI) encompasses long term interventions intended to reduce recurrent infarction…

…Unstable coronary artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity…

…and infarction Definition and Purpose Cardiac rehabilitation is a comprehensive, multidisciplinary secondary prevention intervention for patients with cardiovascular disease, including those recovering from myocardial infarction…

…secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic cardiovascular disease (ASCVD), coronary artery disease, cerebrovascular disease, or peripheral artery disease. Secondary…

…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…

…potassium, and resistant to suppression by sodium loading. It is the most common form of secondary hypertension. Aldosterone acts principally through the mineralocorticoid receptor (MR)…

…It identifies patients whose blood pressure remains uncontrolled despite intensive antihypertensive treatment and who therefore require assessment for pseudo resistance, secondary hypertension, treatment related contributors…

…which seeks to prevent the development of cardiovascular risk factors themselves, and from secondary prevention, which addresses patients with established disease to reduce recurrent events…

…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…

…hyperkalaemia, postural symptoms. Suspected secondary adrenal insufficiency in pituitary disease, after pituitary surgery or radiotherapy, or with suspected suppression of the HPA axis after long…

…cause, 4. prevent recurrence and secondary brain injury. The doses in the treatment ladder below follow the Swedish local sequence given in the original article…

…rate or decreasing blood pressure, making it a consideration for patients with low blood pressure secondary to a low cardiac output. Its primary clinical utility…

…not reverse coronary atherosclerosis. Long term benefit therefore depends on the integration of revascularisation with guideline directed medical therapy and secondary prevention. Clinical Presentation and…

…arrhythmias and therefore QT duration must always be assessed. QT prolongation may be congenital (due to genetic mutations) or acquired (secondary to medications, electrolyte disorders)…

…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…

…block causes substantial changes in left ventricular depolarization and repolarization, which result in secondary ST T changes. Such ST T changes may mimic (simulate) or…

…abnormal 24 hour rhythm should prompt investigation for sleep apnoea, renal disease and secondary hypertension, and lead to one dose being moved to the evening…

…ABI or follow up 0.41–0.90 Peripheral arterial disease, mild to moderate Secondary prevention, walking exercise ≤ 0.40 Severe ischaemia Urgent vascular surgical…

…to their indication. Do not routinely stop aspirin given as secondary prevention 8 Contact the endoscopist and the consultant on call early. In cirrhosis or…

…Patients with suggestive symptoms, signs or a medical history indicating possible secondary hypertension should undergo appropriate screening for an underlying secondary cause. Evaluation and physical…

…who were unable or unwilling to take statins. Approximately 70% were in secondary prevention and 30% in primary prevention; 23% were taking a small dose…

…rather than a replacement for, established secondary prevention treatment. Its potential role is greatest when cardiovascular risk remains high despite optimal or maximally tolerated guideline…

…sugars and meats. In secondary prevention, randomized trials in people with established coronary disease found fewer cardiovascular events with Mediterranean dietary interventions than with low…

…women without pre existing heart disease, such as in peripartum cardiomyopathy, or secondary to known cardiac conditions; in these patients, symptoms may be challenging to…

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

…on the provided context, the primary etiologies for axis deviations include: Causes of Right Axis Deviation: Pulmonary hypertension (primary or secondary) [9, 16] Severe pulmonary…

…disorders (calcium, potassium), tachycardia, increased sympathetic tone, drug side effects etc. Secondary ST T changes occur when abnormal depolarization causes abnormal repolarization . This is se

…at the top. Refer to Figure 1 . Patients with left ventricular hypertrophy may instead display normalization of secondary T wave inversions (lead V5, V6, aVL…

…renal replacement therapy. The study found no significant differences between the two treatment groups with respect to either the primary or secondary outcomes. Primary outcome…

…depolarization will consequently lead to abnormal repolarization. This explains the secondary ST T changes seen on premature ventricular complexes; the ST T vector will be…

…to 40 beats per minute and the rhythm is regular. There is always secondary ST T changes, meaning that the ST T segment is discordant …