…hypertensive emergency, heart failure, and end stage renal disease, may produce elevated troponin concentrations. The probability of MI increases continuously as the absolute hs cTn…

…thickness of the pericardium can be measured and in most cases, a thickening is noted. Table 1 presents the similarities and differences between restrictive cardiomyopathy…

…Acute kidney injury (KDIGO) Stage Creatinine Urine output : : : 1 A rise ≥ 26 µmol/L in 48 h, or 1.5–1.9 × the baseline <…

…assumes a steady state. Dosing and clinical decisions should therefore be based on the whole course, not on a single eGFR. Step 1: confirm the…

…eGFR of 15 mL/min/1.73 m², cardiovascular mortality risk may be as much as three times higher than in individuals without comparable renal…

…treatment. Reported risks of myocardial infarction, stroke, end stage renal disease, and death may be two to six fold higher in affected adults. True, apparent…

…from atherosclerotic type 1 MI. It is an infrequent cause of ACS overall but represents a substantial proportion of ACS presentations in young and middle…

…fundamental pathophysiological substrate for acute coronary syndromes (ACS), including ST Elevation Myocardial Infarction (STEMI) [1] . Historically viewed as a simple plumbing problem characterized by the…

…airway algorithm is activated in unexpectedly difficult laryngoscopy, difficult bag mask ventilation or failed intubation — and already at the planning stage when the MACOCHA score…

…coexistence of defined clinical and laboratory components; the diagnostic criteria themselves are not reproduced in the available source material. Waist circumference is particularly important because…

…mosm/kg or total osmolality 320 mosm/kg Typical patient Often type 1 diabetes, but also occurs in type 2 diabetes Usually type 2 diabetes…

…sodium. Chronic or minimally symptomatic hyponatraemia must be corrected in a controlled fashion, since too rapid a rise can cause osmotic demyelination syndrome [1,2]…

…non variceal bleeding [1,2]. Upper gastrointestinal bleeding can present as haematemesis, coffee ground vomiting or melaena. Haematochezia can occur in massive upper bleeding with…

…GFR in individuals with near normal or mildly reduced kidney function (eGFR 60 mL/min/1.73 m²), potentially leading to misclassification of CKD stages…

…are potentially hazardous and may precipitate cardiac arrest. The classification of hyperthermia is delineated in Table 1 below. Severity Clinical presentation Treatment Mild hyperthermia Thirst…

…chronic, systemic proinflammatory state. This circulating inflammation leads to coronary microvascular endothelial dysfunction, characterized by the upregulation of adhesion molecules (e.g., VCAM 1) a

…R wave progression implies that the R wave amplitude increases gradually from V1 to V5 and then diminishes again in V6. Refer to Figure 1 …

…explained by the fact that these cells start leaking sodium (Na + ) into the cell as soon as they return to their resting state (Figure 1)…

…and an increased transfusion requirement. Pregnancy, medication and arrhythmia affect its interpretation. The shock index must never replace clinical assessment [1]. In trauma, the AB

…to 1.5 µg/mL, though greater arrhythmia suppression may occur up to 3.5 µg/mL at the cost of increased toxicity risk. In…

…vector typically shifts in the direction of the outer epicardial layers, producing ST elevations over the ischemic zone [15]. In the earliest stages of ischemia…

…the "VASc" nomenclature but clarify that female sex functions as a "risk modifier" rather than a primary driver of anticoagulation decisions [1] . In both paradigms…

…a state of myocardial remission rather than true recovery. Data from the TRED HF trial demonstrated that withdrawal of guideline directed medical therapy (GDMT) in…

…these stages is supported by a wide range of experimental and clinical studies. The electrical phase and circulatory phase are explained by cellular changes in…

…or underlying channelopathies (e.g., Torsades de Pointes in Long QT Syndrome) [1] . Underlying Etiologies The etiology of VT is broadly dichotomized into structural heart…

…assay specific — follow the local 0/1 hour protocol NT proBNP < 125 ng/L (< 300 in acute dyspnoea) A normal value effectively excludes…

…mmol/L. This combination carries a high mortality [1,2]. Give antibiotics immediately and aim for administration within one hour in septic shock, or when…

…thrombus, and implanted stents. The principal modalities used in the catheterization laboratory are intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Unlike coronary angiography, which…

…Type 2 myocardial infarction (MI) is defined as an ischaemic myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand…

…elevated risk of developing aortic stenosis. The prevalence of bicuspid aortic valves is 1% to 2% in most Western populations. Individuals with bicuspid aortic valves…

…octopus trap). Refer to Figure 1 and Figure 2. Figure 1. Echocardiogram showing takotsubo cardiomyopathy in acute phase (A) and resolution phase (B). Note the…

…the baseline. 2. Jp is ≥0.1 mV in 2 or more contiguous leads of the 12 lead ECG, excluding leads V1 to V3. 3…

…mmHg ≤15 mmHg ≤2 Wood units The source material also presents a CpcPH threshold of PVR ≥3 Wood units in an overlapping clinical classification table…

…qualitative CPC (Cerebral Performance Category) score. The scale is depicted in Table 1. CPC 1 No neurological disability. Good cerebral function without any significant issues…

…while cardiomyocyte swelling, interstitial oedema and tissue inflammation produce extravascular compression. In the most severe form, termed no reflow, structural and functional microvascular impairment persists…

…intervention (PCI). Contraindications Prasugrel should not be used in the following situations: Hypersensitivity to the active substance or any of the excipients. Active pathological bleeding…

…follow up and appropriate therapy. In this setting, the risk of sudden death and end stage heart failure is high, and assessment for advanced therapies…

…weight gain, peripheral edema, early satiety, abdominal distension and, in some patients, bendopnea. Congestion may also aggravate functional mitral regurgitation, ventricular dilatation, myocardial wall stress…

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

…may produce a transient mismatch between myocardial oxygen demand and coronary blood supply, resulting in myocardial hypoperfusion or ischaemia. Ischaemia is commonly precipitated by exertion…

Myocardial ischemia and infarction Definition and pathophysiology In acute coronary syndrome (ACS) with multivessel coronary artery disease (MVD), revascularization may be directed exclusively at the…

…encephalopathy, acute heart failure, disseminated intravascular coagulation, and abrupt deterioration in renal function. By contrast, hypertensive urgency describes severe hypertension without clinical evidence of acute…

…contrast, chronic hypoperfusion may result in hibernating myocardium: a persistently dysfunctional but potentially recoverable state. The chronically dysfunctional myocardium in ischemic cardiomyopathy is therefore heterogeneous…

…to apolipoprotein(a). The length of apolipoprotein(a) varies because of genetically determined differences in the number of kringle IV type 2 repeats. Lp(a)…

…of the most comprehensive blogs in practical ECG interpretation. Taught by professor Smith, any reader is guaranteed to quickly acquire state of the art knowledge…

…ischemia at later stages, when functional or electrical alterations are evident. Subjective symptoms (i.e. chest pain) appear as the last event in the cascade…

…markers of myocardial wall stress. They are released principally by ventricular cardiomyocytes in response to increased transmural stress and ventricular stretch. Atrial natriuretic peptide is…

…HF), atrial fibrillation and cardiovascular events. In clinical practice, obesity is conventionally defined by a body mass index (BMI) of ≥30 kg/m2. Severe obesity…

…and class III antiarrhythmic effects. The drug comprises both d and l isomers, which share similar efficacy in prolonging repolarization. However, the l isomer is…

…of consciousness, a confusional state, profound weakness, the appearance of an arrhythmia, evidence of peripheral embolism, or an unexplained drop in arterial pressure. Silent or…

…useful tool for detecting hypertrophy/dilatation but echocardiography and magnetic resonance imaging (cardiac MRI) are superior to the ECG in terms of sensitivity and specificity…

…vegetative state, or brain death. The cause of brain injuries is anoxic cell death, continued dysfunction in cerebral blood flow (autoregulation) after ROSC and cerebral…

ECG Exercise stress test Exercise stress testing in patients with previous acute coronary syndromes (myocardial infarction), women, elderly and revascularized individuals Clinicians should be familiar…