…pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months and have health implications…

…Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced…

…least 12 hours Use whichever criterion gives the higher stage. A patient can thus be stage 3 by urine output despite a less marked rise…

…bag mask ventilation or failed intubation — and already at the planning stage when the MACOCHA score or the LEMON assessment indicates that difficulties are likely…

…coronary circulation and may involve multiple vessels. Pregnancy associated SCAD can occur at any stage of pregnancy or after delivery, although more than 70% of…

…mediated fibroproliferative response to endothelial injury [2] . The process initiates with endothelial dysfunction, a state provoked by systemic risk factors such as hypertension, hyperglycemia, smoking…

…kg. Renal impairment No dose adjustment is required, including for patients with end stage renal disease. Limited experience exists for patients with impaired renal function…

…The 3 phase model of sudden cardiac arrest. According to Weisfeldt et al (2002) . The existence of these stages is supported by a wide range…

…does not produce the same sustained shift of water [3]. Severity of DKA The classification helps in choosing the level of care. The clinical state…

Echocardiography Aortic stenosis The aortic valve area is normally 3.0 to 4.0 cm 2 . Aortic stenosis is a progressive disease that leads to…

…first pass extraction. Following a single oral dose, plasma concentrations peak within 3 to 6 hours. The agent undergoes extensive hepatic metabolism, yielding desethylamiodarone as…

…cardiovascular societies, defines HF as a clinical syndrome corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion [3] . Within…

…poisoning, stroke, meningitis and a postictal state. 3. Check a repeat plasma sodium if the result is unexpected or does not fit the clinical picture…

…See the renal parameters for the eGFR stages and albuminuria. Inflammation and infection Test Reference Comment : : : CRP < 3 mg/L Rises within 6–8…

…bleeding is weaker [2,3,4]. Do the following immediately: 1. Call for help using the words massive haemorrhage , and state the patient's location…

…body's capacity for heat elimination. Hyperthermia can induce an inflammatory state similar to the Systemic Inflammatory Response Syndrome (SIRS). Body temperatures surpassing 40°C (104°F…

…trajectory, and risk of relapse upon GDMT withdrawal are fundamentally distinct from true, incident HFpEF [3] . Hemodynamically, the gold standard definition of HFpEF relies on…

…1] [2] . This exhaustive review provides a comprehensive synthesis of the current state of VT management for the practicing cardiologist. It meticulously details the classification…

…three hours. The evidence for an absolute one hour requirement is clearest in septic shock and less certain in sepsis without shock [3,4]. The…

…peripheral cannulae. Consider an arterial line if the patient is unstable or frequent blood gases are needed 3 Blood grouping and cross matching. Order red…

…occult lesions, and optimize percutaneous coronary intervention (PCI). Imaging can therefore influence several stages of intervention: lesion preparation; selection of stent diameter and length; identification…

…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…

…and create a highly prothrombotic endothelial surface. Furthermore, AF induces a systemic hypercoagulable state, characterized by elevated biomarkers such as D dimer, von Willebrand factor…

…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)…

…stabilized. This usually takes 2 to 3 days and the patient must not have experienced chest pain during the last 12 hours before exercise. Patients…

…repolarization in ECG (A) is characterized by upward concavity of the ST segment and positive T waves. In ECG (B) they state something similar. Unfortunately…

…with each dose adjustment, typically waiting 2 to 3 days to attain a steady state concentration before further adjusting the dose. Electrophysiology Sotalol prolongs the…

Echocardiography Constrictive pericarditis: the end stage of pericardial inflammation Constrictive pericarditis is the result of chronic inflammation of the pericardium. In principle, all causes of…

…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…

…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…

…despite restoration of epicardial flow. The electrocardiographic appearance depends on several interacting factors: The stage of the ischaemic process: acute, evolving or chronic The severity…

…therapy. In this setting, the risk of sudden death and end stage heart failure is high, and assessment for advanced therapies may be required. Evaluation…

…This distinction provides a practical framework for selecting treatment: Clinical state Principal management approach Congestion without hypoperfusion Intravenous loop diuretic therapy Congestion with hypoperfusion Loop…

…metabolic dysfunction associated steatohepatitis, which has a more prominent inflammatory component and may progress to cirrhosis and end stage liver disease. Metabolic dysfunction associated fatty…

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…

…kidney function (eGFR 60 mL/min/1.73 m²), potentially leading to misclassification of CKD stages. Population Specificity: The equation was derived from a study…

…not exclude a coronary cause of symptoms. CCS is a clinical syndrome rather than a permanently stable state. Patients may remain stable for prolonged periods…

…aims to treat all lesions producing myocardial ischaemia, either during the same procedure or through staged intervention. The rationale for complete revascularization is that untreated…

…outer epicardial layers, producing ST elevations over the ischemic zone [15]. In the earliest stages of ischemia, this may manifest as tall, positive hyperacute T…

…anxiety, or distress have transient BP elevation that improves when the precipitating state resolves. The distinction is therefore not based on the BP value alone…

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

… progression of calcific aortic stenosis; enhancement of a prothrombotic state. Its atherogenic and inflammatory effects may be mediated partly by oxidized phospholipids carried on the…

…Taught by professor Smith, any reader is guaranteed to quickly acquire state of the art knowledge and practical training. Professor Smith published a book as…

…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…

…ECG) become apparent. In contrast, modalities like echocardiography and ECG typically identify ischemia at later stages, when functional or electrical alterations are evident. Subjective symptoms…

…not a neprilysin substrate, it remains more closely related to the clinical state during treatment with an angiotensin receptor–neprilysin inhibitor. Clinical Applications Natriuretic peptides…

…systemic inflammation Insulin resistance Abnormal adipokine signalling Endothelial dysfunction Dyslipidaemia A prothrombotic state Albuminuria and declining estimated glomerular filtration rate Development of type 2 diabetes…

…less common presentations, with or without pain, include sudden loss of consciousness, a confusional state, profound weakness, the appearance of an arrhythmia, evidence of peripheral…

…chest pain and troponin elevation. The clinical manifestation is typically driven by an acute stressor superimposed on the patient's baseline cardiovascular state. For instance…

…stronger electrical potentials. However, severe dilatation (late stages) is usually associated with poor ventricular function and lower QRS amplitudes. Hypertrophy and dilatation may coexist. Moreover…

…stroke, cognitive dysfunction, Parkinsonism, vegetative state, or brain death. The cause of brain injuries is anoxic cell death, continued dysfunction in cerebral blood flow (autoregulation…

…hypoxia before cell death begins. It appears that neurons are unable to transition into a similar state with downregulated metabolism, which is presumed to explain…

…been issued by the European Society for Cardiology: Lyon et al: Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on…