…Primary hyperparathyroidism and malignancies cause 90% of all cases of hypercalcemia. Less common causes are immobilization, sarcoidosis, thyrotoxicosis, familial hypocalciuric hypercalcemia, Addison's disease, renal…

…factors and relevant comorbidities Evidence of hypertension mediated organ damage Existing cardiac, cerebrovascular, or renal disease The possibility of a secondary cause The medical and…

…pathophysiological basis Secondary prevention after myocardial infarction (MI) encompasses long term interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic…

…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…

…centre of secondary cardiovascular prevention in which exercise, lifestyle intervention, education, and guideline directed medical therapy are integrated. Rationale and Pathophysiological Basis Survivors of STEMI…

…pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention…

…widened QRS complex and secondary ST T wave abnormalities [7]. Diagnostic Criteria The diagnostic requirements for LBBB vary by the stringency of the criteria applied…

…syndromes (ACS). Its principal therapeutic objective is reduction of low density lipoprotein cholesterol (LDL C), the primary lipid target in contemporary secondary prevention. Statins inhibit…

…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)…

…likelihood of secondary hypertension and with substantially greater cardiovascular risk than hypertension controlled with treatment. Reported risks of myocardial infarction, stroke, end stage renal disease…

…It differs from primordial prevention, which seeks to prevent the development of cardiovascular risk factors themselves, and from secondary prevention, which addresses patients with established…

…secondary prevention of atherosclerotic cardiovascular disease, both at the population and individual levels. Several prediction models have been developed and validated for the prediction of…

…apply to the anti inflammatory effect. They say nothing about the mineralocorticoid effect or about suppression of the HPA axis, where a long half life…

…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…

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

…of heart failure, digoxin improves hemodynamics without increasing heart rate or decreasing blood pressure, making it a consideration for patients with low blood pressure secondary…

…Secondary causes, particularly diabetes, thyroid disease, kidney disease, alcohol excess, dietary factors and relevant medications. Cardiovascular risk category and the adequacy of LDL C lowering…

…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…

…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…

…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)…

…endpoint. The cardiovascular benefits of cessation extend across primary and secondary prevention. Observational evidence indicates that cessation lowers the risk of peripheral artery disease, myocardial…

…the co administration of multiple QT prolonging medications, and drug accumulation secondary to renal or hepatic impairment or the inhibition of cytochrome P450 metabolism [1…

…tumors are secondary, and the primary cardiac tumors, generally, are benign. Primary and secondary cardiac tumors • Primary cardiac tumors , which constitute a minority of cardiac…

…cause of the dilation. The only exception to this rule is ventricular dilation secondary to non compaction cardiomyopathy, which confers only slightly elevated risk of…

…which result in secondary ST T changes. Such ST T changes may mimic (simulate) or mask ischemia. Simulation of ischemia manifests as ST segment elevations…

…the condition may hamper the quality of life substantially. The management of sinus tachycardia is aimed at finding secondary causes that can be treated or…

…referred to as secondary ST T changes. It is actually expected that these conditions display such secondary ST T changes; the absence of such changes…

…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…

…brachial index (TBI). The digital arteries rarely calcify, which makes toe pressure the method of choice in diabetes and renal failure. A normal TBI is ≥

…the renal function and the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not routinely stop aspirin given as secondary…

…Inhibitor Induced Angioedema Angioedema secondary to ACE inhibitor therapy occurs in approximately 1% of patients. It manifests as localized, transient swelling of the subcutaneous or…

…conventional hypertension threshold. The traditional diagnostic threshold of 140/90 mmHg derives from epidemiological observations associating pressures above this level with increased mortality. Contemporary management…

…or secondary arrhythmias result from the slow rate. In the setting of bradyarrhythmic or asystolic arrest, management priorities shift to establishing control of cardiorespiratory status…

…to take statins. Approximately 70% were in secondary prevention and 30% in primary prevention; 23% were taking a small dose of a statin, defined as…

…coronary syndrome. The available evidence supports consideration of low dose colchicine as an adjunct to, rather than a replacement for, established secondary prevention treatment. Its…

Cardiology Clinical medicine Definition and Pathophysiology Dietary patterns are the overall combinations of foods habitually consumed rather than isolated nutrients considered independently. For cardiometabolic health…

…of myocardial infarction or raised cholesterol among relatives. The presence of tendon xanthomas, corneal arcus and xanthelasma. Potential secondary causes of hypercholesterolaemia. The likelihood of…

…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…

…C = total cholesterol − HDL C Apolipoprotein B (apoB) reflects the concentration of circulating atherogenic particles because each apoB containing particle carries one apoB molecule…

…peripartum cardiomyopathy, or secondary to known cardiac conditions; in these patients, symptoms may be challenging to differentiate from normal physiological changes of pregnancy. Evaluation and…

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

…primary or secondary) [9, 16] Severe pulmonary stenosis [8] Right ventricular hypertrophy [8, 17] Pulmonary embolism, which may manifest as a rightward shift of the…

…in the myocardium. The electrical potential difference exists between ischemic and normal myocardium and it results in displacement of the ST segment. The ST segment…

…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…

…V2) indicate that the vector of the left ventricle is amplified. Secondary ST T changes in left sided leads Left ventricular hypertrophy is often accompanied…

…as a bystander or secondary contributor [8] . Pathophysiology and mechanisms The pathophysiological paradigm of HFpEF has shifted dramatically from the historical concept of isolated "diastolic…

…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…

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

…pre excitation causes secondary ST T changes. This is due to the fact that pre excitation leads to abnormal depolarization of the ventricles and this…

…because of the stronger ventricular contractions caused by the increased filling. Ventricular premature complexes are not preceded by P waves because the ectopic impulse originates…

…and rightward. Due to the abnormal depolarization sequence of the right ventricle in RBBB, repolarization is also abnormal, leading to secondary ST T changes, which…

…LVH) and right ventricular hypertrophy (RVH). The electrical vector of the left ventricle is enhanced in LVH, which results in large R waves in left…

…a ventricular origin. The ventricular rate is between 20 to 40 beats per minute and the rhythm is regular. There is always secondary ST T…

…to hemodynamic collapse [4] . Sustained VT is a medical emergency that universally warrants acute intervention and long term secondary prevention strategies. By Morphology: Monomorphic VT …

…causes right atrial dilation. Vena cava inferior may also dilate secondarily. Principles of management Medical therapies do not alter disease progression. Diuretics may be used…