…metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia…

…cardiomyopathies, and severe valvular heart disease. Type 2 MI and non ischaemic myocardial injury may coexist, and certain disease entities can span both categories; for…

…non haemorrhagic stroke Renal, mesenteric or lower limb ischaemia Paraplegia or paraparesis Persistent or recurrent pain Hypertension that remains uncontrolled despite optimal therapy Acute type…

…typically platelet rich and less occlusive, often presenting clinically as Non ST Elevation Myocardial Infarction (NSTEMI) rather than STEMI [4] . Calcified Nodules: A less common…

Cardiology Pharmacology & dosing Definition and pharmacological basis Ezetimibe is a non statin lipid lowering agent that inhibits the Niemann–Pick C1 like 1 (NPC1L1) transporter…

…including: Unstable angina (UA) Non ST elevation myocardial infarction (NSTEMI) ST elevation myocardial infarction (STEMI) This applies to patients undergoing either primary or delayed percutaneous…

…the most favourable patterns generally contain more minimally processed, fibre rich and bioactive foods, including fruits, non starchy vegetables, beans, whole grains, nuts and seeds…

…risk factors, type of symptoms etc. Chest pain is one of the most nuanced symptoms in clinical practice and it is fundamental to be able…

…heart failure. There are six main types of cardiomyopathy: Hypertrophic cardiomyopathy (HCM) — This type of cardiomyopathy is characterized by pronounced hypertrophy of the myocardium. It…

…ECG and haemodynamics. Do not wait for troponin. If clinical suspicion persists despite an initially non diagnostic ECG, the ECG must be repeated, particularly with…

…local stroke protocol and immediate contact with the on call stroke consultant or the thrombectomy centre take precedence where there is a discrepancy or uncertainty…

…are introduced, although the effect on 24 hour mortality is uncertain and the evidence for non traumatic bleeding is weaker [2,3,4]. Do the…

…or neuropathic pain, in chronic non cancer pain, or in headache. A failure to improve function is a reason to taper off, not to increase…

…Dofetilide, Ibutilide, Sotalol Class IV Non dihydropyridine L type Ca 2+ channel blockers Diltiazem, Verapamil Singh–Vaughan Williams classification of antiarrhythmic drugs. Bold text indicates…

…Definition and therapeutic rationale Inclisiran is a liver directed small interfering RNA (siRNA) designed to reduce production of proprotein convertase subtilisin/kexin type 9 (PCSK9)…

…Dofetilide, Ibutilide, Sotalol Class IV Non dihydropyridine L type Ca 2+ channel blockers Diltiazem, Verapamil Singh–Vaughan Williams classification of antiarrhythmic drugs. Bold text indicates…

…population is 1.0% to 1.5%. The crude prevalence is lower in non Western countries, primarily due to the younger age composition in those…

…Yet, in a significant number of cases, the rhythm is non shockable, as seen in certain causes of cardiac arrest (e.g. pulmonary embolism) or…

…shock, obstruction or advanced renal injury. Conversely, significant AKI may be non oliguric, particularly after nephrotoxins, sepsis or diuretic treatment [4]. An automatically reported eGFR…

…each time Always, once per patient if no valid result exists Type and screen (BAS test) Blood group confirmation and antibody screening. If the screen…

…The laryngeal mask is a compromise and does not protect the airway completely. Relative contraindications: A high risk of aspiration: a non fasted patient, ileus…

…must never delay it. Indications Suspected meningitis or encephalitis. Suspected subarachnoid haemorrhage with a normal or non diagnostic CT. Suspected neuroborreliosis, neurosyphilis or another CNS…

…4 mm punch from a lesion less than 48 hours old Also take a biopsy for immunofluorescence Panniculitis Excision or a deep punch down into…

…ACL reduces hepatic cholesterol synthesis and produces reductions in LDL C, non high density lipoprotein cholesterol, apolipoprotein B and high sensitivity C reactive protein (hsCRP…

…Clinical context and patient selection Acute coronary syndrome ACS includes ST segment elevation myocardial infarction (STEMI), non ST elevation myocardial infarction (NSTEMI), and unstable angina…

…syndrome (CCS). Whether and how PCI was performed. The need for non cardiac surgery. The presence of an indication for oral anticoagulation (OAC). Clinical context…

…distinction is important in premature coronary disease, hypertension, type 2 diabetes and hyperlipidaemia, which are usually polygenic conditions, although family history remains clinically useful for…

…The Fourth Universal Definition classifies MI into five distinct subtypes based on pathophysiology and clinical context: Type 1 MI: Caused by atherothrombotic coronary artery disease…

…sudden cardiac death. SCAD differs pathogenetically from atherosclerotic type 1 MI. It is an infrequent cause of ACS overall but represents a substantial proportion of…

…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…

…to a single lesion or process. Although Type 1 MI and acute coronary syndromes are commonly related to atherothrombotic events, myocardial ischaemia may also result…

…to 30 beats per minute. Sinus pause <3 seconds. Sinoatrial block Junctional rhythm First degree AV block Second degree AV block Mobitz type 1 (Wenckebach…

…the left ventricle. This type of bradycardia is due to diminished automaticity (pacemaker function) in the sinoatrial node or conduction defects (e.g. second degree…

…particularly ascending or type A aortic dissection Myocardial free wall rupture after infarction Anticoagulant associated bleeding Renal failure Systemic inflammatory disease Catheter based electrophysiological and…

…of the lumen. Assessment of total coronary disease burden, including non obstructive plaque, therefore contributes prognostic information beyond identification of focal severe stenoses. Coronary anomalies…

…severe hypertension. The decision to lower BP in acute stroke requires attention to the type of stroke and the possibility of thrombolytic treatment. Cardiac and…

…redistribution of blood from non ischemic to ischemic myocardium (i.e an increase in blood flow in the ischemic area!) [2]. Take home message: in…

…BMI (kg/m2) Obesity class Disease risk Underweight <18.5 — — Healthy weight 18.5–24.9 — — Overweight 25.0–29.9 — Increased Obesity 30.0…

…artery (LMCA) departs from the left coronary cusp (LCC). NCC = non coronary cusp. Natural course and prognosis in aortic stenosis Aortic stenosis is generally…

…conceal sarcopenia), in oedema and ascites, and in people under 18 years of age, where iso BMI or percentile charts should be used. Waist circumference…

…Contraindications Cautery: Type Contraindication : : Absolute The source of bleeding cannot be identified Relative A pacemaker or ICD when monopolar electrocautery is used Relative A cochlear…

…pain. Preparation and equipment Doppler for the ankle brachial index, blood pressure cuff. Lukewarm tap water or saline for cleansing, swabs. Sharp spoon (curette), ring…

Cardiology Endocrinology & metabolism Definition and Pathophysiology Type 2 diabetes mellitus (T2DM) is a major cardiovascular risk condition. It is associated with a two to four…

…Mobitz type 1 block is characterized by a gradual prolongation of the PR interval over a few heart cycles until an atrial impulse is completely…

Visual assessment of regional wall motion (left ventricle) TYPE OF MOTION DEFINITION WALL MOTION SCORE Normal Normal thickening (typically 30% thickening from end diastole to…

Cardiology Clinical chemistry & laboratory medicine Definition and Pathophysiology B type natriuretic peptide (BNP) and N terminal pro BNP (NT proBNP) are circulating markers of myocardial…

Cardiology Pharmacology & dosing Definition and Pathophysiology Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a hepatic protein that regulates the availability of the low density…

…shift. For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed, with clinicians focusing primarily on hemoglobin A1c (HbA1c) reduction, blood…

Echocardiography Cardiomyopathy caused by tachycardia A prolonged tachycardia can cause cardiomyopathy with left ventricular dilation. This type of cardiomyopathy, referred to as tachycardia induced cardiomyopathy …

…examination must be preceded by information about each step, take place with the patient's ongoing consent, and be able to be stopped at any…

…emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint or absent. Take cultures immediately, but never let sampling, imaging…

…based on height and weight. It is calculated by dividing body weight in kilograms by the square of height in meters. BMI is relevant for…

…Rapidly inactivated by esterases. Effects • Clevidipine is a dihydropyridine L type calcium channel blocker. Clevidipine is highly selective for vascular smooth muscle cells and has…

…are important differences. These differences are largely explained by the dramatic physiological and anatomical changes that take place during infancy and childhood. The most dramatic…

…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)…

…Type 4a MI after PCI In a patient with normal baseline cTn, type 4a MI is defined by: cTn greater than 5 times the 99th…

… A: Mobitz Type II 2nd AV block B: Prolonged QT interval (QTc ≥ 480 ms for females) C: Incomplete Right Bundle Branch Block (rSR' pattern in…

…pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose lowering in type 2 diabetes mellitus (T2DM)…

…It is a PCI related myocardial infarction when angiography or autopsy documents thrombosis and the diagnostic criteria used for type 1 myocardial infarction are fulfilled…

…by a repolarization (recovery). The action potential occurs in all cardiac cells but its appearance varies depending on cell type. During de and repolarization ions…