…and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every patient with newly diagnosed…

…does not specify the loading dose. Efficacy and harms In secondary prevention trials involving patients with previous vascular disease, aspirin reduced the combined incidence of…

…Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity: Do not administer to patients with a…

…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…

…disease, or peripheral artery disease. Secondary prevention concerns patients with established vascular disease, in whom aspirin has a substantially more favourable benefit–risk profile. Aspirin…

…recovery patterns within the left ventricle, resulting in a widened QRS complex and secondary ST T wave abnormalities [7]. Diagnostic Criteria The diagnostic requirements for…

…and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS)…

…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)…

…that increase blood pressure; or An undiagnosed secondary cause of hypertension. White coat hypertension must be excluded with out of office measurements. Objective assessment of…

…of cardiovascular risk factors themselves, and from secondary prevention, which addresses patients with established disease to reduce recurrent events and mortality. Risk factor modification is…

…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…

…Stress dosing in known adrenal insufficiency A patient with primary adrenal insufficiency (Addison's disease), secondary adrenal insufficiency or long term corticosteroid treatment cannot increase…

…Suspected secondary adrenal insufficiency in pituitary disease, after pituitary surgery or radiotherapy, or with suspected suppression of the HPA axis after long term glucocorticoid treatment…

…Lathundar Definition and aims of treatment Convulsive status epilepticus in adults is present with: an ongoing generalised tonic clonic seizure lasting at least 5 minutes…

…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…

…dL ( 5.6 mmol/L) Triglyceride rich lipoproteins, remnant lipoproteins and insulin resistance are associated with atherosclerotic cardiovascular disease (ASCVD), particularly in peripheral arterial disease…

…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…

…refers to clinically significant atherosclerotic disease affecting two or more major epicardial coronary arteries. It frequently coexists with left main coronary artery disease, diabetes mellitus…

…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)…

Cardiology Clinical medicine Definition and cardiovascular rationale Smoking cessation is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible…

…Management Definition and Clinical Characteristics Torsades de pointes (TdP) represents a multifactorial clinical entity typically associated with drug induced long QT syndrome (DI LQTS) [1]…

…of the myocardium; in these cases, the tumor can debut with ventricular arrhythmias that result in asystole and sudden death. In echocardiography, tumour should be…

…of the left ventricle . Patients with DCM typically develop heart failure early in life and a family history of heart failure, ventricular arrhythmias or sudden…

…affects cardiovascular and total mortality. Left bundle branch block is more common in individuals with structural and ischemic heart disease. Assessment of ischemia on ECG…

…with increased sympathetic input (leading to stimulation of beta adrenergic receptors) and parasympathetic withdrawal. Sinus tachycardia secondary to disease and medications : A wide range of…

…display such secondary ST T changes; the absence of such changes should lead to suspicion of ischemia (if the patient has symptoms consistent with ischemia…

…are no absolute contraindications. Refrain or adapt in atrial fibrillation with a rapid and irregular ventricular rate (oscillometric measurement becomes unreliable), lymphoedema or a dialysis…

…mild to moderate Secondary prevention, walking exercise ≤ 0.40 Severe ischaemia Urgent vascular surgical assessment Exercise ABI. With a normal or borderline resting ABI but…

…as secondary prevention 8 Contact the endoscopist and the consultant on call early. In cirrhosis or suspected variceal bleeding, also contact a gastroenterologist with hepatology…

…with talking, laughing, or exertion. It is more common in women than in men and can last for years. ACE Inhibitor Induced Angioedema Angioedema secondary…

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

…level, producing atrioventricular (AV) or intraventricular blocks. Isolated sinus bradycardia in the early hours following infarction may be associated with hemodynamic compromise. More broadly, bradyarrhythmic…

…statin therapy reduced LDL C by approximately 16.5%; the reduction in a subgroup with diabetes was approximately 19.1%. The drug also lowers hsCRP…

…vascular lesions. The interleukin 1β pathway, with downstream effects involving interleukin 6 and C reactive protein, has been a major therapeutic target. This concept…

…In secondary prevention, randomized trials in people with established coronary disease found fewer cardiovascular events with Mediterranean dietary interventions than with low fat control diets…

…receptor endocytosis and produce an FH like phenotype. Individuals with a single pathogenic variant have heterozygous FH (HeFH). Biallelic pathogenic variants cause homozygous FH (HoFH…

…Increasing severity of mitral regurgitation is associated with worse outcomes. Pulmonary hypertension secondary to left heart disease may occur because elevated left sided filling pressures…

…Non HDL C and apoB are secondary targets or risk refining measures, particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance…

…as an agonist of both beta1 and beta2 adrenergic receptors, with variable effects on alpha receptors. Stimulation of beta receptors increases inotropy and chronotropy by…

…disease, and management should therefore address the entire arterial circulation. PAD is associated with increased cardiovascular morbidity and mortality, as well as limb complications. Atherosclerotic…

…The amplitude of the waveform recorded in any given lead correlates directly with the projection of the heart vector onto that specific lead vector [3…

…plateau phase. These two factors are the reason why the ST segment is flat and isoelectric (i.e in level with the baseline). Displacement of…

…to a mismatch between the expansion of contractile cells as compared with conduction cells. Therefore it is very common to observe secondary ST T changes…

…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…

…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…

…drivers, HFpEF is more frequently associated with coronary microvascular dysfunction, though epicardial coronary artery disease frequently coexists as a bystander or secondary contributor [8] . Pathophysiology…

…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…

…primary or secondary outcomes. Primary outcome events occurred in 49% of patients in the milrinone group and 54% in the dobutamine group, with a relative…

…secondary ST T abnormalities). Click to zoom. Atrioventricular reentrant (reentry) tachycardia (AVRT) Individuals with accessory pathways are at risk of developing atrioventricular reentrant tachycardia (AVRT…

…complexes are not preceded by P waves because the ectopic impulse originates in the ventricles and does not influence the atria (with exceptions discussed below)…

…ventricle in RBBB, repolarization is also abnormal, leading to secondary ST T changes, which appear on the ECG as discordant ST T segments. These ST…

…right bundle branch block (RBBB). Secondary ST T changes are common in V1–V3. The ST T segment is usually discordant to the QRS complex…

…may be delivered to both bundle branches and subsequently the entire ventricular myocardium normally. This may yield a ventricular rhythm with narrow QRS complexes. However…

…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…

…severity. Tricuspid stenosis is visually characterized by thickened leaflets, with reduced motion and potentially fused commisures. Continuous Doppler is used to assess the stenosis. Doppler…