…dysfunction Dyslipidaemia A prothrombotic state Albuminuria and declining estimated glomerular filtration rate Development of type 2 diabetes mellitus Atherosclerotic cardiovascular events HF and atrial fibrillation…

…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…

…by an abnormal prolongation of the QT interval on the surface electrocardiogram (ECG), which predisposes the myocardium to a specific form of polymorphic ventricular tachycardia…

…are components of the myocardial contractile apparatus and are expressed predominantly in cardiac muscle. Troponin I is highly specific for myocardial injury. Interpretation of troponin…

…examination The use of echocardiography has increased dramatically during the past few decades. Advances in echocardiography have been propelled by breakthroughs in engineering, software development…

…relationship between triglyceride concentrations and aortic disease is less clearly defined, although triglycerides may contribute to the development and progression of aortic pathology. Severe HTG…

…and guidelines do not state any ECG criteria specific to R wave progression. Figure 1. Pathological R wave progression is indicative of previous myocardial infarction…

…Female specific or female predominant factors associated with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational…

…impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated with a greater likelihood of cure. When to investigate…

…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…

…but against the age specific reference values below. Method of interpretation Heart rate Heart rhythm The P wave The PR interval The QRS complex The…

…reducing arrhythmic events, contingent upon the specific mutation present. For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope…

…reducing arrhythmic events, contingent upon the specific mutation present. For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope…

…and reliable screening tool for body composition, risk of type 2 diabetes, metabolic syndrome and specific cancers. BMI and cardiovascular outcomes High BMI is associated…

…alternative etiologies are excluded by diagnostic testing or failed therapeutic trials. If alternative causes of cough are suspected, specific diagnostic pathways may be pursued. Spirometry

…of more efficacious agents with wider therapeutic to toxic windows, and its routine use in adult patients is generally discouraged. However, it retains a specific…

…to treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy of these interventions is much lower or uncertain…

…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…

…Always follow the local protocol for exact infusion rates, electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises…

…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…

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

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

…II Anatomical SYNTAX Score : Derived from the original SYNTAX Score, which evaluates the complexity of coronary lesions. Clinical Variables : Age : Older patients have a higher…

…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…

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

…digitalis excess. Biomarkers and Laboratory Findings The source material does not provide information on biomarkers or laboratory findings specific to the evaluation of bradycardia. Treatment…

Cardiology Definition and purpose Cardiovascular risk assessment estimates an individual’s probability of experiencing cardiovascular disease (CVD) over a defined period. SCORE2 and SCORE2 Older…

…and may be the first clinically important manifestation of an otherwise unrecognized inflammatory disease. Epidemiology and disease specific patterns Patients with inflammatory rheumatic disease have…

…an acute coronary process. Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce…

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

…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…

…Initial hs cTn measurement Continuous cardiac monitoring The source material does not provide a detailed list of physical examination findings or a specific examination sequence…

…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…

…is therefore the central priority of STEMI systems of care. Fibrinolysis promotes thrombus dissolution by converting plasminogen to plasmin. Fibrin specific agents act preferentially when…

…lead correlates directly with the projection of the heart vector onto that specific lead vector [3]. When the direction of cardiac activation is parallel to…

…Myocardial ischemia and infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings…

…III antiarrhythmic agents depending on the specific drug and dosage [1]. Acute Management and Treatment Alternatives The management of TdP and related malignant ventricular arrhythmias…

…is mediated by the combined effects of hyperglycaemia, hypertension, dyslipidaemia, obesity, smoking and other conventional risk factors, together with diabetes specific vascular and metabolic abnormalities…

Arrhythmias and arrhythmology Cardiology Definition and Pathophysiology Vasovagal syncope represents the most common form of neurally mediated syncope (NMS), a disorder of autonomic reflexes. It…

…loss of organized atrial systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical…

…Table 1 delineates substances for which specific antidotes are available. The detrimental effects of these substances can potentially be reversed if interventions are promptly instituted…

…of serious arrhythmias. This is possible because there is a correlation between the severity of electrolyte imbalance and the visible ECG changes. Specific electrolyte disorders…

…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…

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

…acquire an understanding of the overarching concepts. Arrhythmogenesis (mechanisms of arrhythmias) is presented in this chapter, followed by in depth discussions of specific arrhythmias in…

…multiple controls that each represent a specific depth in the image (Figure 1). The bottom control adjusts gain at the bottom of the image etc …

…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…

…distance of the reflector ( i.e the structure reflecting the sound wave). The pulsed wave Doppler can analyze sound waves reflected from a specific location…

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

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

…product of area (a) of the cylinder and the velocity (v) of the fluid (i.e blood). The volume (V) that passes a specific segment…

…Evaluation of antiarrhythmic treatment or pacemaker function. Suspected bradyarrhythmia or pauses, particularly at night. Symptom–rhythm correlation in non specific complaints. The choice of recording…

…a risk of pancreatitis Cardiac markers and coagulation Test Reference Comment : : : High sensitivity troponin T < 14 ng/L The decision thresholds are assay specific …

…to recite the months of the year backwards. A normal result does not exclude delirium, however, and an abnormal result is not specific to delirium…

…in the same order every time, reduces the risk of missing abnormalities. The eight steps below go through the rhythm and then the waveforms one…

…the difference in R wave amplitude, note the slurred terminal portion of the R wave in the high risk morphology, which replaces the sharp negative…

…specific troponin elevation above the 99th percentile. The clinical presentation should not be interpreted in isolation. The initial diagnosis and triage depend on integration of…