…reveals calcification of the pericardium. With MRI or CT, the thickness of the pericardium can be measured and in most cases, a thickening is noted…

…and/or inotropes are reserved for low output and hemodynamic instability. Evaluation and physical examination The objective of decongestion is clinical euvolemia rather than an…

…abdominal, or visceral, adipose tissue is more closely related to insulin resistance and the risk of diabetes and cardiovascular disease than total adiposity alone. The…

…Stage Creatinine Urine output : : : 1 1.5 to 1.9 times baseline, or a rise of at least 26.5 µmol/L Below 0.5…

…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…

…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…

…any stage of pregnancy or after delivery, although more than 70% of cases occur early postpartum, most frequently during the first week. It is the…

…at the planning stage when the MACOCHA score or the LEMON assessment indicates that difficulties are likely. Contraindications The laryngeal mask is a compromise and…

…with PCI can increase the risk of thrombosis, myocardial infarction, or death. Treatment for up to 12 months is recommended unless clinically indicated to discontinue…

…Their greater analytical sensitivity improves diagnostic accuracy and negative predictive value in patients with suspected acute coronary syndrome (ACS). Cardiac troponin is a marker of…

…it sets the anatomical and biochemical stage for sudden, life threatening acute coronary syndromes when the structural stability of the plaque is acutely compromised [7]…

…precipitating factor is identifiable in up to one half of cases. Reported precipitants include vigorous physical activity, emotional stress, and an intercurrent medical or surgical…

…resistance or contribute directly to persistent hypertension. Resistant hypertension is associated with a higher likelihood of secondary hypertension and with substantially greater cardiovascular risk than…

…cancer related disease and cardiac amyloidosis among the relevant clinical settings or comorbidities. HFrEF is distinguished from heart failure with mildly reduced ejection fraction (HFmrEF…

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

…high glucose value is no longer required [1]. Diabetic ketoacidosis, DKA Hyperosmolar hyperglycaemic state, HHS : : : Glucose Plasma glucose ≥ 11.1 mmol/L or previously known…

…of cardiac arrest Neurological injuries may cause coma, seizures (myoclonus), stroke, cognitive dysfunction, Parkinsonism, vegetative state, or brain death. The cause of brain injuries is…

…is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency. Sustained hypoperfusion reduces oxygen and nutrient delivery and, when severe or…

…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…

…the ECG as increased amplitudes of the QRS complexes. The explanation is straightforward: myocardial muscle mass is increased and therefore it generates greater electrical potentials…

…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…

…a large change in TSH. During acute illness the TSH can be falsely low or high in the absence of thyroid disease; repeat it once…

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

…shock index is calculated as the heart rate divided by the systolic blood pressure. A value of around 0.9 to 1.0 or higher…

…upon administration of halogenated anesthetic agents. As an idiosyncratic response to substances such as MDMA (ecstasy) or amphetamines. In either scenario, there is sustained muscle…

…Other leads Greater than or equal to 1 mm These criteria for the other leads apply in the absence of left ventricular hypertrophy or left…

…with a subsequent measurement of 40% [14] . This distinction is paramount for practicing cardiologists: HFimpEF represents a state of myocardial remission rather than true recovery…

…CCS is a clinical syndrome rather than a permanently stable state. Patients may remain stable for prolonged periods, but chronic coronary disease can progress or…

…ridge is not seen in STEMI and suggests pericarditis instead. Pain is not uniformly present. The proportion of painless or silent STEMIs is greater in…

…hypercoagulable state, characterized by elevated biomarkers such as D dimer, von Willebrand factor, and increased thrombin generation. The clinical consequence of this triad is severe…

…normal cardiac function, but rather to a state where stroke volume is maintained only at the expense of pathologically elevated filling pressures. Epidemiology and risk…

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

…perfusion and the signs of shock 2 Two large bore peripheral cannulae. Consider an arterial line if the patient is unstable or frequent blood gases…

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

…with HFpEF, acute hypertension is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive ventilation or intubation. Aortic disease…

…prevalence of structural heart disease in this population. Obesity is associated with lower than expected BNP and NT proBNP concentrations despite comparable or greater ventricular…

…of LDL, and elevated Lp(a) may confer greater risk per particle or unit of cholesterol than LDL cholesterol. Clinical implications High Lp(a) is…

…outcomes than BMI, particularly in women. For European populations, waist circumference above 94 cm in men or 80 cm in women is considered indicative of…

…blood flow rather than pulmonary vascular disease. This state is termed unclassified PH. Potential explanations include congenital heart disease, liver disease, airway or lung disease…

…plateau phase of the action potential. This action potential prolongation exhibits reverse use dependence, meaning the repolarization time is extended to a greater degree at…

…baseline cardiovascular state. For instance, a patient with stable CAD may present with clinical manifestations of myocardial ischaemia following an acute gastrointestinal bleed or a…

…wave or R wave. Fragmented QRS complexes are indications of previous myocardial infarction. There are imaging studies demonstrating that QRS fragmentation is more common than…

…events in observational studies. OCT OCT uses near infrared light rather than ultrasound. Its resolution is substantially higher than that of IVUS, approximately 5–20…

…Most cases (70%) of takotsubo cardiomyopathy occur in situations with extreme stress, such as car accidents, gun violence, threats, or any situation in which the…

…stroke, meningitis and a postictal state. 3. Check a repeat plasma sodium if the result is unexpected or does not fit the clinical picture. 4…

…1 to 2 hours. Oral onset is delayed, typically requiring 2 to 3 days, and often 1 to 3 weeks or occasionally longer; loading doses…

…of coexisting coronary disease. Renal function, bleeding risk, comorbidities, frailty, and anticipated adherence to antithrombotic treatment. Whether the patient is suitable for PCI, CABG, or…

…20% of LV mass. Conversely, a greater burden of nonviable or scarred myocardium is associated with less improvement in LVEF. Nevertheless, improvement in LVEF is…

…and ventricular myocardium. Propagation of the action potential is possible because all cardiac cells are electrically interconnected by gap junctions (Figure 1) . Gap junctions are…

…at various stages before and after revascularization procedures (PCI or coronary artery bypass grafting [CABG]). Stress testing is used to establish the diagnosis of ischemic…

…duration of cardiac arrest is relatively short (or there is high quality CPR). The longer the duration of cardiac arrest, the greater the likelihood of…

…generate greater pressure, thereby overcoming the resistance in the stenosis and maintaining adequate stroke volumes. Thus, ventricular hypertrophy is a compensatory mechanism, the purpose of…

…acetate for hypotension or hypoperfusion, usually 500 mL as a rapid bolus, and a smaller bolus where the risk of fluid overload is high 0…