…respiratory disorders, notably obstructive sleep apnoea (OSA) and obesity hypoventilation syndrome, which further increase cardiovascular burden. Obesity may be a particularly important cause of HF…

ECG Myocardial ischemia and infarction Lathundar ECG Criteria for ST Elevation Myocardial Infarction (STEMI) The diagnosis of STEMI relies on specific electrocardiographic thresholds for ST…

…the myocardium to a specific form of polymorphic ventricular tachycardia (VT) known as torsades de pointes (TdP). Drug induced LQTS and TdP represent a multifactorial…

…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…

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

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

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

…reproductive and pregnancy related history. Female specific or female predominant factors associated with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of…

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

…ischemia and infarction Definition and pathophysiology Fractional flow reserve (FFR) is an invasive, lesion specific physiological index used to estimate the functional significance of an…

…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…

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

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

…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…

…and post myocardial infarction (MI) care. Despite their proven morbidity and mortality benefits, their use is limited by specific adverse effects. Most of these adverse…

…evaluation of patients receiving digoxin reveals specific electrophysiologic profiles. Digoxin's autonomic actions largely slow the sinus node discharge rate, shorten atrial refractoriness, and prolong…

…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…

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

…response and by repeated laboratory measurements, not by the values on admission alone. Diagnosis Current diagnostic criteria According to the international consensus report of 2024…

…The test has a sensitivity of around 60 % and is not specific: motor neurone disease, myopathies and Lambert–Eaton syndrome may also give a positive…

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

…the last dose, the renal function and the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not routinely stop aspirin…

…interval can cause serious arrhythmias and sudden cardiac death. QT prolongation can precipitate torsades de pointes, a specific form of polymorphic ventricular tachycardia characterized by…

…number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions (CTOs), calcification, and thrombus presence. These factors are weighted and summed…

…designed to improve the prediction of long term outcomes after revascularization. It incorporates both anatomical (from the original SYNTAX Score) and clinical variables (e.g…

…This difference informs the use of sex specific surveillance and repair thresholds. Clinical Presentation and Symptoms Most AAAs are asymptomatic and are identified either during…

…does not provide specific information on the clinical presentation and symptoms of the underlying conditions for which ACE inhibitors are prescribed. Evaluation and Physical Examination…

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

…adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast…

…by conventional risk scores and may be the first clinically important manifestation of an otherwise unrecognized inflammatory disease. Epidemiology and disease specific patterns Patients with…

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

…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…

…establish the presence or haemodynamic significance of a specific stenosis. Clinical Role and Indications CAC scoring is principally a risk stratification tool for individuals without…

…assay specific 99th percentile upper reference limit; and Evidence that the injury is caused by myocardial ischaemia. Accordingly, acute troponin elevation without evidence of ischaemia…

…NT proBNP) are circulating markers of myocardial wall stress. They are released principally by ventricular cardiomyocytes in response to increased transmural stress and ventricular stretch…

…not fibrin specific and produces more extensive fibrinogen depletion. Successful fibrinolysis is generally accompanied by relief of ischaemic symptoms, at least 50% resolution of ST…

…and the resultant vector sum determines the mean electrical axis [3]. A frontal plane axis directed toward the positive pole of lead I is designated…

…because myocardial injury may occur without myocardial ischaemia. Non ischaemic myocardial injury may accompany numerous cardiac and systemic disorders, including: Cardiac causes Systemic causes Heart…

…Evaluation of Treatment and Alternatives for Drug Failure The provided context does not contain specific information regarding the formal criteria for evaluating the success of…

…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…

…form of neurally mediated syncope (NMS), a disorder of autonomic reflexes. It typically occurs after attaining an upright posture or following painful stimuli and emotional…

…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…

…Administer the specific antidote promptly upon suspicion of poisoning. Decontamination Disrobe the patient of any attire possibly contaminated with the toxicant. Irrigate skin and eyes…

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

…agents have specific contraindications: Adenosine, Dipyridamole, Regadenoson : Should be avoided in patients with active bronchospasm, severe hypotension, or high degree AV block. Caffeine and other…

…show any benefit of urgent angiography. ST elevation in acute transmural myocardial ischemia is discussed in the chapter ST elevations in ischemia and differential diagnoses…

Arrhythmias and arrhythmology ECG Mechanisms of cardiac arrhythmias: from automaticity to re entry This section introduces the most common arrhythmias encountered in clinical practice, beginning…

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

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

…CW Doppler sends and analyses ultrasound continuously. Sample volume (SV) The major advantage of pulsed wave Doppler is the ability to specify where (along the…

…1): Specific clusters of atrial myocardium : There are clusters of atrial myocardium that possess automaticity and thus pacemaker function. The intrinsic rate of depolarization in…

…American and European guidelines assert that the ST segment must be either downsloping or horizontal. Otherwise, ischemia is unlikely to be the cause of the…

…velocity (v) of the fluid (i.e blood). The volume (V) that passes a specific segment is the product of the flow (Q) and time …

…The set up and the instructions decide whether the investigation will be usable. Ambulatory blood pressure monitoring (ABPM) Indications Confirmation of newly detected hypertension — recommended…

…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…

…35 mm. Q waves: pathological Q waves (≥ 0.03 s and/or an amplitude ≥ 25 % of the R wave amplitude in the same lead, in…

…effective, terminating well over 99% of the ventricular arrhythmias they detect. It lies instead in patient selection. Because implantation entails appreciable cost and procedural risk…

…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…