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…

…and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures. Both can improve coronary flow, exercise…

…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…

…Treatment decisions should not be based on age alone. Assessment should include: Degree of frailty, preferably using validated clinical tests Ability to perform activities of…

…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…

…all cause mortality. The excess risk is mediated by the combined effects of hyperglycaemia, hypertension, dyslipidaemia, obesity, smoking and other conventional risk factors, together with…

…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…

…aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The…

…Combinations Fixed dose, single pill combinations are preferred whenever combination treatment is used. The number of prescribed tablets is directly related to adherence, and simplifying…

…reduction of approximately 50.5% when inclisiran was added to maximally tolerated statin therapy, with or without other lipid lowering treatment. The durability of the…

…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…

…wave. The whole value of the investigation lies in the ratio between the number of atrial and ventricular complexes — more atrial than ventricular complexes, the…

…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…

…measurements permit assessment of the physiological significance of selected stenoses using fractional flow reserve (FFR) and instantaneous wave free ratio (iFR). Other invasive techniques can…

…availability of hepatic LDL receptors and thereby enhances LDL C removal from plasma. Two principal therapeutic strategies have emerged: Inhibition of circulating PCSK9 activity , using…

…and cardiovascular rationale Smoking cessation is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible, other inhaled nicotine products…

…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…

…acetylsalicylic acid at the first sign of skin rash, mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit…

…6% High risk 5 or more 5.8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist…

…and other tachykinins, such as substance P. When ACE is inhibited, the resulting accumulation of these peptides irritates afferent neural pathways in the respiratory tract…

…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…

…vascular calcification; female sex; low body mass index; larger arterial sheaths; greater intensity of procedural anticoagulation; complex coronary anatomy and technically difficult PCI. For peri…

…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…

…S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization…

…thoracotomy remains the primary therapeutic intervention. Ideally, it should be performed within 15 minutes of the onset of collapse. Pericardiocentesis , performed using a large needle…

…effects of digoxin. Potassium levels must always be assessed in patients using digoxin whenever they seek medical attention. Arrhythmias may occur already at therapeutic plasma…

…than by a distinct advantage of one drug over the other. Mathew et al. Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock…

…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…