…results from long QT syndrome (LQTS). TdP occurs exclusively in individuals with LQTS (congenital or acquired). The VT is polymorphic with a gradual alteration in…

…results from long QT syndrome (LQTS). TdP occurs exclusively in individuals with LQTS (congenital or acquired). The VT is polymorphic with a gradual alteration in…

…initial description in 1992 as a syndrome of right bundle branch block, ST segment elevation, and sudden cardiac death (SCD), Brugada syndrome (BrS) has evolved…

Cardiology Endocrinology & metabolism Definition and Pathophysiology Metabolic syndrome is a clustering of cardiometabolic abnormalities centred on abdominal adiposity, insulin resistance, dyslipidaemia, elevated blood pressure and…

Info A comprehensive list of conditions and drugs that may prolong the QT interval, and cause torsade de pointes (TdP) and long QT syndrome (LQTS…

Cardiology Emergency medicine Surgery & trauma Definition and Pathophysiology Aortic dissection is a major form of acute aortic syndrome (AAS), alongside intramural haematoma, penetrating atherosclerotic ulcer…

Emergency medicine Myocardial ischemia and infarction Definition and pathophysiology Acute coronary syndrome (ACS) comprises a spectrum of clinical presentations caused by suspected acute myocardial ischaemia…

…the presence of non obstructive epicardial arteries does not exclude a coronary cause of symptoms. CCS is a clinical syndrome rather than a permanently stable…

…elderly, or patients with diabetes [4]. Associated Findings: The sudden onset of symptoms coupled with diaphoresis should always raise concern for a cardiovascular cause [4]…

…symptoms are severe, refractory to guideline directed medical therapy, occur at a low level of exertion, or are associated with high event risk. The apparent…

…presents a classification of acute coronary syndromes and myocardial infarctions. The reader should study this chart carefully. Figure 1. Flowchart showing the natural course of…

…heart syndrome) is a rather peculiar and certainly acute condition. Much research has been devoted to it in recent years. Most cases (70%) of takotsubo…

…is 1–2 weeks after AMI, although descriptions of the syndrome include a broader interval of approximately 1–8 weeks. The pathogenesis is presumed to…

…of the following symptoms: Syncope, pre syncope Ventricular tachycardia Ventricular fibrillation Cardiac arrest with or without sudden cardiac death Hence, the Brugada syndrome is a…

…ischaemia, heart failure, electrical instability or a large area of myocardium at risk. Over 48 hours: urgent PCI is still indicated with continuing ischaemia, shock…

…of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines the need for ventilatory support . At the same time, exacerbation is a…

…and cardiogenic shock. Patient related and procedural risk factors The risk of adverse events is increased by: advanced age; diabetes mellitus; chronic kidney disease or…

…spectrum of non ST elevation acute coronary syndrome (NSTE ACS). The clinical spectrum includes patients with a confirmed NSTEMI, patients with a working diagnosis of…

…syndrome, de Winter's sign, widespread ST segment depressions) that point to the left anterior descending artery (LAD) as the culprit. The coronary arteries: a…

…The pathophysiological explanation for this may be a general degeneration of the atrial conduction system. Individuals with atrial fibrillation and bradycardia have bradycardia–tachycardia syndrome…

…sick sinus syndrome . Causes of sinus node dysfunction The causes have been discussed in each respective article. A rehearsal follows. Reversible causes of sinus node…

…as a result of stunning. The systemic response to reperfusion and ischemia causes a state similar to SIRS (systemic inflammatory response syndrome) with risk of…

…Continous medical discussion: the ECG blog Infectious diseases Cardiovascular effects of COVID 19 Coronavirus disease 2019 (COVID 19) has caused a global public health crisis…

…4b and 4c fulfil the criteria for type 1 MI because they represent coronary atherothrombotic events in the setting of a stent thrombosis or restenosis…

…a single lesion. Consequently, local revascularization must be accompanied by systemic treatment aimed at stabilizing the broader atherosclerotic disease. Pathophysiology Mechanisms of acute coronary syndrome…

…and syndrome: from ECG criteria to management Although the early repolarization pattern has been recognized for almost 50 years, it is still one of the…

…interval must always be assessed when interpreting the ECG. Long QT syndrome (LQTS) is manifest when a long QT interval induces ventricular arrhythmias. Figure 1…

…Denmark, Netherlands and United Kingdom reported a novel ECG syndrome characterized by widespread ST segment depressions and an increased risk of sudden cardiac arrest. They…

…and Wolff Parkinson White (WPW) syndrome: ECG, clinical characteristics and management Pre excitation The atrioventricular node and bundle of His are normally the only communication…

…ECG examples of each condition are presented below. The ECG in Brugada syndrome Brugada syndrome is a rare channelopathy (an electrical disorder caused by mutations…

…infarction rates. Clinical presentation and symptoms The clinical presentation is determined primarily by the ACS syndrome and the haemodynamic consequences of the culprit lesion. Patients…

…STE ACS (ST Elevation Acute Coronary Syndrome) : STE ACS occurs when plaque rupture, and the ensuing atherothrombosis, causes a complete occlusion of the coronary artery…

…The 2015 European Society of Cardiology (ESC) guidelines advocate for ICD implantation in high risk LQTS patients, emphasizing a comprehensive risk assessment that includes genetic…

…The 2015 European Society of Cardiology (ESC) guidelines advocate for ICD implantation in high risk LQTS patients, emphasizing a comprehensive risk assessment that includes genetic…

…pathophysiology Congestion is a central expression of the heart failure syndrome and reflects excessive retention of sodium and water, with expansion of both the intravascular…

…kidney injury, AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine value alone but by the course, urine…

Cardiology Myocardial ischemia and infarction Definition and Pathophysiology Refractory angina is a chronic syndrome of persistent ischaemic symptoms despite the exhaustion of conventional therapeutic options…

…STE ACS (ST Elevation Acute Coronary Syndrome) : STE ACS occurs when plaque rupture, and the ensuing atherothrombosis, causes a complete occlusion of the coronary artery…

…Assessment of chronotropic function and pacemaker settings. Preoperative functional assessment before major surgery. At a low pre test probability most positive results are false positives…

[calc_aorta] Sinus of Valsalva (SOV) and Aortic Root Assessment The sinus of Valsalva diameter (SOVd) is a critical measurement in evaluating aortic root morphology…

…or treatment with another adenosine diphosphate (ADP) receptor inhibitor for patients who had coronary syndrome and are at high risk of developing a new event…

ECG Introduction The traditional classification of acute coronary syndromes (ACS) into ST segment elevation myocardial infarction (STEMI), non STEMI (NSTEMI), and unstable angina (UA) has…

Echocardiography Definition and types of cardiomyopathies Cardiomyopathy implies that the myocardium is structurally and functionally altered, and the pathological changes are not explained by coronary…

…MI) survivors, the contemporary risk factor profile is increasingly driven by the global epidemics of obesity, diabetes mellitus, and metabolic syndrome [58] . Hypertension and coronary…

…regurgitation Chronic mitral regurgitation causes a gradual volume and pressure overload, such that LVEDP and LAP rise slowly. This leads to compensatory dilatation of chambers…

…the characteristic clinical syndrome of breathlessness, fatigue and oedema. The underlying mechanisms are not uniform across the HFmrEF population. Some patients have a pathophysiological profile…

…work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury, anaphylaxis, deep neck infection, an expanding haematoma, facial trauma. An anticipated course requiring a…

…Heart failure, pulmonary oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic…

…as it serves as a quick, low cost, and reliable screening tool for body composition, risk of type 2 diabetes, metabolic syndrome and specific cancers…

…QT syndrome (LQTS) is characterised by an abnormal prolongation of the QT interval on the surface electrocardiogram (ECG), which predisposes the myocardium to a specific…

Cardiology Pharmacology & dosing Definition and pathophysiology Heart failure is a clinical syndrome in which the heart cannot provide blood flow commensurate with the body’s…

…blood at a rate appropriate to tissue requirements unless filling pressures are elevated. The syndrome is therefore defined by symptoms and signs of congestion or…

…syndrome or symptomatic bradycardia in the absence of a pacemaker. Hypersensitivity to adenosine. Administration Normal route : Peripheral intravenous (IV). Alternative route : Central venous administration of…

…flecainide Cardioversion of atrial fibrillation in patients without structural heart disease (reduced left ventricular function is considered a structural heart disease). AVNRT, AVRT (WPW syndrome)…

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

…70% of all cases had no myocardial disease or acute coronary syndrome. Indeed, the majority of the victims were healthy and tragically killed by a…

…Carcinoid syndrome is a paraneoplastic syndrome that occurs due to carcinomas secreting kallikrein and serotonin. In the heart, this can lead to thickening of the…

…coagulopathy. Severe uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit and risk. An inability to attend for sampling and follow up — relative…

…CCS. General strategy For most patients, initial therapy consists of a beta blocker and/or a calcium channel blocker (CCB). If symptoms remain inadequately controlled…

…is a life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular filling. It generally results from accumulation of pericardial…