…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…

…injury. Myocardial injury Myocardial injury is defined by at least one cardiac troponin (cTn) concentration above the assay specific 99th percentile upper reference limit (URL)…

…familiar to every electrophysiologist, is that LVEF is both insensitive and non specific for SCD. Most people who die suddenly never had an ejection fraction…

…Cutoff ≤ 0.80. Deepest outcome trial evidence base of any physiological index; lesion specific and largely independent of resting hemodynamics; guideline reference standard. Requires pressure…

…Female specific and female predominant risk factors Risk assessment should include reproductive and pregnancy related history. Female specific or female predominant factors associated with later…

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…

…Criteria for ST Elevation Myocardial Infarction (STEMI) The diagnosis of STEMI relies on specific electrocardiographic thresholds for ST segment elevation measured at the J point…

…reserve (FFR) is an invasive, lesion specific physiological index used to estimate the functional significance of an epicardial coronary stenosis. It is defined during maximal…

…made in the same systematic way as in adults, but against the age specific reference values below. Method of interpretation Heart rate Heart rhythm The…

…torsade de pointes. This condition is primarily attributed to specific genetic mutations: loss of function mutations in KCNQ1 (LQT1) and KCNH2 (LQT2), and gain of…

…torsade de pointes. This condition is primarily attributed to specific genetic mutations: loss of function mutations in KCNQ1 (LQT1) and KCNH2 (LQT2), and gain of…

…risk of type 2 diabetes, metabolic syndrome and specific cancers. BMI and cardiovascular outcomes High BMI is associated with several health conditions: Type 2 diabetes…

…Despite their proven morbidity and mortality benefits, their use is limited by specific adverse effects. Most of these adverse events are related to the suppression…

…electrocardiogram (ECG), which predisposes the myocardium to a specific form of polymorphic ventricular tachycardia (VT) known as torsades de pointes (TdP). Drug induced LQTS and…

…discouraged. However, it retains a specific niche in contemporary cardiovascular pharmacotherapy. The pharmacologic foundation of digoxin lies in its inhibition of the Na+ K+ ATPase…

…Myocardial injury Myocardial injury is a biochemical diagnosis defined by at least one cardiac troponin value above the assay specific 99th percentile upper reference limit…

…the interventions available in BLS, the number needed to treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy…

…There are cardiac specific isoforms of troponin and these are abbreviated cTnI, cTnT, and cTnC. The isoforms cTnI and cTnT are specific to cardiac muscle…

…and subject preparations. We will also discuss the relevance of withholding specific cardioactive medications during exercise testing (exercise ECG). Indications for exercise stress test Indications…

…and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and HHS are dynamic…

…responds to further cholinesterase inhibition. The test has a sensitivity of around 60 % and is not specific: motor neurone disease, myopathies and Lambert–Eaton syndrome…

…blocker, a calcium channel blocker or digitalis, while awaiting the antidote and specific treatment. Bradyasystole during and after cardiac arrest with persisting electrical activity. Overdrive…

…intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis and can also be seen when the bleeding is slow or has stopped. The…

…de pointes, a specific form of polymorphic ventricular tachycardia characterized by irregular (polymorphic) QRS complexes that appear to twist around the isoelectric baseline. The risk…

…It integrates multiple variables, including the number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions (CTOs), calcification, and thrombus presence…

…Requires detailed clinical and angiographic data. Calculation can be complex without dedicated software. May not account for all patient specific factors (e.g., frailty, comorbidities)…

…describes approximately a four fold greater risk. This difference informs the use of sex specific surveillance and repair thresholds. Clinical Presentation and Symptoms Most AAAs…

…Clinical Presentation and Symptoms The source material does not provide specific information on the clinical presentation and symptoms of the underlying conditions for which ACE…

…Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific risk assessment or risk categorization is applicable Moderate or severe chronic kidney disease…

…unrecognized inflammatory disease. Epidemiology and disease specific patterns Patients with inflammatory rheumatic disease have a higher cardiovascular risk than the general population. This excess risk…

…Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated…

…also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The association is mediated by both traditional and kidney specific pathways. Diabetes…

…by itself, establish the presence or haemodynamic significance of a specific stenosis. Clinical Role and Indications CAC scoring is principally a risk stratification tool for…

…ACS). Cardiac troponin is a marker of myocardial injury, not a disease specific marker of myocardial infarction (MI). MI requires both: Acute myocardial injury, demonstrated…

…Natriuretic peptide concentrations reflect haemodynamic stress, but their release is not specific to left ventricular systolic dysfunction. Levels may also rise with: Left ventricular diastolic…

…indicative of obesity or excess abdominal adiposity. Ethnic specific thresholds are lower or otherwise modified in some populations. Cardiometabolic mechanisms Visceral and ectopic fat are…

…to plasmin. Fibrin specific agents act preferentially when fibrin is present, whereas streptokinase is not fibrin specific and produces more extensive fibrinogen depletion. Successful fibrinolysis…

…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]…

…TdP is drug dependent, ranging between 1% and 8% for Class III antiarrhythmic agents depending on the specific drug and dosage [1]. Acute Management and…

…dyslipidaemia, obesity, smoking and other conventional risk factors, together with diabetes specific vascular and metabolic abnormalities. Diabetes is associated with inflammation, thrombosis and accelerated atherosclerosis…

…and nausea. Patients may also experience lightheadedness and palpitations upon assuming an upright posture. Specific triggers are well recognized and include: Provoked fear, pain, anxiety…

…systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical cul de sac [19] …

…induce cardiac arrest or cause profound cardiopulmonary depression. Table 1 delineates substances for which specific antidotes are available. The detrimental effects of these substances can…

…a correlation between the severity of electrolyte imbalance and the visible ECG changes. Specific electrolyte disorders 1. Sodium Increased (hypernatremia) and decreased (hyponatremia) sodium levels…

…stenosis, decompensated heart failure, and uncontrolled arrhythmias. Pharmacologic stress agents have specific contraindications: Adenosine, Dipyridamole, Regadenoson : Should be avoided in patients with active bronchospasm, severe…

…In cardiac arrest, non specific ST T changes are very common. Non specific ST depressions, T wave inversions (negative T waves) do not affect the…

…of arrhythmias) is presented in this chapter, followed by in depth discussions of specific arrhythmias in subsequent chapters. Cardiac arrhythmias can be subdivided into the…

…region of interest. The difference between zooming in and shifting focus is that the zoom encloses a specific region of the image, whereas shifting focus…

…for pathological R wave progression is considerably lower than pathological Q waves and guidelines do not state any ECG criteria specific to R wave progression…

…For most pathological conditions, there are specific guidelines (see links below). This chapter presents recommendations for conducting a standard transthoracic echocardiographic (TTE) examination and it…

…flow. These imaging modalities are highly sensitive and specific in evaluating perfusion and also play a role in determining the viability of compromised myocardial tissue…

…the structure reflecting the sound wave). The pulsed wave Doppler can analyze sound waves reflected from a specific location. This is the main advantage of…

…either of the following three structures (discussed in detail in Chapter 1): Specific clusters of atrial myocardium : There are clusters of atrial myocardium that possess…

…to be the cause of the ST segment depression. The horizontal ST segment depression is more specific than the downsloping depression. Refer to Figure 1 …

…The volume (V) that passes a specific segment is the product of the flow (Q) and time (t): V = Q · t V = volume…

…particularly at night. Symptom–rhythm correlation in non specific complaints. The choice of recording is governed by the frequency of symptoms: Symptom interval Method : : Daily…

…High sensitivity troponin T < 14 ng/L The decision thresholds are assay specific — follow the local 0/1 hour protocol NT proBNP < 125…

…not exclude delirium, however, and an abnormal result is not specific to delirium. Symptoms are often worse in the evening and at night, but diurnal…

…values and differential diagnoses Prolonged QRS duration: left bundle branch block. Right bundle branch block. Non specific intraventricular conduction delay. Hyperkalaemia. Class I antiarrhythmic drugs…

…and subsequent fall in cardiac specific troponin attributable to myocardial ischaemia. UA presents with compatible ischaemic symptoms but without cardiac specific troponin elevation above the…