Cardiology Respiratory medicine Definition and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise…

…outcomes. Preserving right ventricular function is therefore an important therapeutic objective. Exercise intolerance Exercise limitation is multifactorial. In addition to elevated exercise induced filling pressures…

…Patient preferences, local expertise and operator or institutional experience Assessment of coronary complexity The SYNTAX score is used to characterize coronary anatomical complexity. It incorporates…

…required in asymptomatic patients. Before drug treatment, recommended or suggested measures include: reassurance; exercise training; volume expansion; avoidance of cardiac stimulants. Beta blockers have been…

…therapeutic rationale for disease modifying treatment is to reduce mortality, prevent recurrent hospitalization for worsening heart failure, and improve symptoms, functional capacity and quality of…

…pressure are common in later life. These changes contribute to the complexity of defining an appropriate treatment target, particularly when a lower DBP, orthostatic hypotension…

…or selectively after initial medical treatment. The presence of ST segment changes or a positive troponin assay identifies patients in whom an invasive strategy is…

…Evaluation of coronary artery disease. Assessment of therapeutic response. Exercise testing can be used to evaluate the effect of medications or interventions such as PCI…

…commonly coexist and should be considered part of the clinical cardiovascular phenotype. Weight reduction and increased physical activity can improve metabolic control and exercise capacity…

…fibrillation, particularly when other therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across multiple organ systems…

…a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the treatment is safe…

…may occur relatively soon after treatment is initiated. Reported increases include: Approximately 43% increase in major bleeding in a meta analysis of primary prevention trials…

…increasing the dose of a single drug. They may also permit lower doses of each component, potentially limiting adverse effects and facilitating adherence. Treatment response…

…should be considered within a stepwise, target based lipid lowering strategy: Dietary and lifestyle interventions form the foundation of treatment. Statins are the preferred first…

…Response to treatment should be reviewed after initiation and after each adjustment. Persistent symptoms despite appropriately titrated medical therapy should prompt consideration of coronary angiography…

…variable rather than a therapeutic objective. LDL C as the primary treatment target Current lipid management frameworks place LDL C at the centre of treatment…

…The increasing prevalence of refractory angina reflects population ageing and improved survival among patients with CAD following advances in anti ischaemic treatment and coronary revascularization…

…major therapeutic target. This concept is clinically relevant because cardiovascular risk may persist despite appropriate lipid lowering and other guideline directed therapies. Anti inflammatory treatment…

…and acute coronary syndromes (ACS). Its principal therapeutic objective is reduction of low density lipoprotein cholesterol (LDL C), the primary lipid target in contemporary secondary…

…Treatment should begin as soon as possible, with a target of less than 10 minutes from STEMI diagnosis to the fibrinolytic bolus. In suitable systems…

…and permanent—and is not determined solely by the apparent frequency or duration of documented episodes. The central therapeutic objective is prevention of thromboembolic complications…

…on practical diagnostic and therapeutic considerations, with recommendations aligned with current guidelines from both the American Heart Association (AHA) and American College of Cardiology (ACC…

…pain or restricted movement (therapeutic aspiration). Intra articular corticosteroid injection in verified inflammatory or osteoarthritis related joint disease. Contraindications Infection of the skin or soft…

…treatment or marked coagulopathy. A platelet count below 50 × 10⁹/L is often quoted as the threshold, but the threshold varies between regions. Infection of…

…unit. Assessment of the effect of adenosine, which can be given during the recording and unmask the atrial activity. The investigation is diagnostic, not therapeutic…

…pancreatic ascites. Therapeutic paracentesis: Tense ascites with abdominal discomfort, early satiety or respiratory compromise. Diuretic refractory or diuretic intolerant ascites, as recurrent treatment. Contraindications There…

…Choose a point with at least 15 mm depth of fluid throughout the respiratory cycle and where the lung does not come up against the…

…Cleviprex ® Indications Hypertension and hypertensive emergency. Treatment of postoperative hypertension. Mechanism of action Ultra short acting calcium channel blocker (CCB). Half life: 5 minutes…

…Common therapeutic dose: 4 6 mg/h. Clevidipine is administered in lipid emulsion (containing soy, egg), of which the maximum dose per 24 hours is…

…A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation. 2000 Oct…

…A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation. 2000 Oct…

…between treatment benefit and harm. Prevention in the very elderly therefore extends beyond reducing myocardial infarction, stroke, heart failure, or cardiovascular death. Preservation of mobility…

…investigation should be undertaken when its diagnostic or therapeutic consequences are likely to outweigh procedural risks. This balance forms part of shared clinical decision making…

…clearance of circulating LDL cholesterol (LDL C). Increased PCSK9 activity therefore contributes to higher LDL C concentrations. The genetic evidence provides the rationale for therapeutic…

…coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to chronic limb threat

…Life Support (ECLS) encompasses several extracorporeal systems designed to assist in cases of cardiac or respiratory failure by means of an extracorporeal pump and oxygenator…

…Common therapeutic dose: 4 6 mg/h. Clevidipine is administered in lipid emulsion (containing soy, egg), of which the maximum dose per 24 hours is…

…to elective cardioversion. It does not apply in haemodynamic instability. Digitalis toxicity — a risk of refractory ventricular arrhythmias. Therapeutic digoxin levels, by contrast, are no…

…are the first line treatment for reducing arrhythmic risk across all LQTS genotypes. These medications mitigate adrenergic stimulation, thereby decreasing the likelihood of arrhythmia onset…

…are the first line treatment for reducing arrhythmic risk across all LQTS genotypes. These medications mitigate adrenergic stimulation, thereby decreasing the likelihood of arrhythmia onset…

…phenytoin binding to plasma albumin, but the therapeutic effect remains unchanged. Sulfonylureas: Salicylates may potentiate the hypoglycemic effect of sulfonylureas, possibly due to reduced binding…

…Fibrillation) Bleeding Risk Score is a clinical tool designed to estimate the risk of major bleeding in patients with atrial fibrillation (AF) undergoing anticoagulation therapy…

…lacking; the diagnosis is suspected when alternative etiologies are excluded by diagnostic testing or failed therapeutic trials. If alternative causes of cough are suspected, specific…

…in patients with renal disease; neither amiodarone nor desethylamiodarone is dialyzable. The volume of distribution is large, averaging 60 L/kg, and the drug is…

…radial access. Radial access has also been associated with lower overall major adverse cardiac events and mortality in pooled analyses of randomized trials. Femoral access…

…a period of DAPT. The therapeutic objective is to reduce coronary thrombotic events without exposing the patient to disproportionate bleeding risk. Shortening treatment may reduce…

…with manifest clinical disease are at high risk of progression and generally require all appropriate evidence based measures, including drug treatment and therapeutic lifestyle change…

…contexts [4]. Reduction of Sympathetic Drive Modulating autonomic tone is a pivotal therapeutic target [4]: Beta Blockers : Administered to reduce adrenergic stimulation [4]. Sedation and…

…colleagues in 2018. This approach seeks to anchor diagnostic and therapeutic decisions in the presence or absence of an acute coronary occlusion, rather than rigid…

…renal insufficiency, therapeutic interventions with tamoxifen or lithium, thiazide administration, and over supplementation of calcium and vitamin D. ECG in hypercalcemia Typical ECG changes: Shortened…

…compressions. For traumatic tamponades, thoracotomy remains the primary therapeutic intervention. Ideally, it should be performed within 15 minutes of the onset of collapse. Pericardiocentesis , performed…

…due to digoxin treatment. Adverse effects of digoxin The incidence of adverse drug reactions is high, owing to the narrow therapeutic index of the drug…

…as individually appropriate. 3 Important study: Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock (N Engl J Med 2021; 385:516 525…

…normal hearts, a division that profoundly influences prognosis and therapeutic decision making. Structural Heart Disease (SHD): Accounting for approximately 90% of all VT presentations, SHD…