…heart failure armamentarium. Its use has declined over time due to the advent of more efficacious agents with wider therapeutic to toxic windows, and its…

Procedurer Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the…

Cardiology Pharmacology & dosing Definition and therapeutic rationale Aspirin, or acetylsalicylic acid, is an antiplatelet drug that irreversibly inhibits cyclooxygenase and thereby suppresses thromboxane A2 synthesis…

Cardiology Pharmacology & dosing Definition and Therapeutic Rationale Hypertension is a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It…

Cardiology Pharmacology & dosing Definition and therapeutic rationale Inclisiran is a liver directed small interfering RNA (siRNA) designed to reduce production of proprotein convertase subtilisin/kexin…

Myocardial ischemia and infarction Definition and therapeutic rationale Multivessel coronary artery disease (CAD) refers to clinically significant atherosclerotic disease affecting two or more major epicardial…

Myocardial ischemia and infarction Pharmacology & dosing Definition and therapeutic objectives Antianginal therapy in chronic coronary syndrome (CCS) is directed primarily at reducing myocardial ischaemia and…

…and pathophysiology Low density lipoprotein cholesterol (LDL C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play…

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…

…with downstream effects involving interleukin 6 and C reactive protein, has been a major therapeutic target. This concept is clinically relevant because cardiovascular risk may…

…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…

…patient with symptoms of myocardial ischaemia. The immediate therapeutic objective is restoration of coronary blood flow to the infarct zone, thereby limiting infarct size and…

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

…scenarios may remain challenging. Effective management of tachycardia requires a comprehensive understanding of differential diagnoses, therapeutic strategies, and evidence based interventions. Many tachyarrhythmias carry a…

…Haemarthrosis after trauma. A symptomatic effusion causing pain or restricted movement (therapeutic aspiration). Intra articular corticosteroid injection in verified inflammatory or osteoarthritis related joint disease…

…the opening pressure in suspected idiopathic intracranial hypertension. Therapeutic drainage in idiopathic intracranial hypertension and in assessment before shunt surgery. Contraindications Clinical signs of herniation —…

…can be given during the recording and unmask the atrial activity. The investigation is diagnostic, not therapeutic. An unstable patient should be cardioverted, not investigated…

…fenestrated drape; full sterile attire for therapeutic drainage with an indwelling catheter. Lidocaine 10 mg/mL, 5–10 mL, 25 G for the skin wheal…

…Suction and oxygen to hand. The patient sits leaning forward with the arms on a table for diagnostic and therapeutic aspiration; for drain insertion the…

…titration is possible. Maximum dose: 21 mg/h iv. Common therapeutic dose: 4 6 mg/h. Clevidipine is administered in lipid emulsion (containing soy, egg)…

…titration is possible. Maximum dose: 21 mg/h iv. Common therapeutic dose: 4 6 mg/h. Clevidipine is administered in lipid emulsion (containing soy, egg)…

…be evaluated with angiography earlier. Guidelines recommend the use of validated risk models to estimate the risk of acute myocardial infarction, 30 day and 1…

…2031 7. The TIMI risk score for unstable angina/non ST elevation MI: A method for prognostication and therapeutic decision making E M Antman, M…

…functional capacity, and quality of life may be equally important therapeutic objectives. Evidence from randomized trials is often less applicable to very frail or multimorbid…

…functional ventricular abnormalities and progressive neurohormonal activation. The therapeutic rationale for disease modifying treatment is to reduce mortality, prevent recurrent hospitalization for worsening heart failure…

…or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular dysfunction and/or MVD…

…or vasomotor coronary disorders. The investigation should be undertaken when its diagnostic or therapeutic consequences are likely to outweigh procedural risks. This balance forms part…

…sinus rate. Its principal therapeutic distinction from beta blockers is that it lowers heart rate without directly reducing myocardial contractility or altering vascular tone. Accordingly…

…activity therefore contributes to higher LDL C concentrations. The genetic evidence provides the rationale for therapeutic inhibition. Gain of function PCSK9 mutations are associated with…

…mmHg ≤15 mmHg ≤2 Wood units The source material also presents a CpcPH threshold of PVR ≥3 Wood units in an overlapping clinical classification table…

…does not produce a proportional reduction in cardiovascular harm. Complete cessation is therefore the preferred therapeutic endpoint. The cardiovascular benefits of cessation extend across primary…

…circulatory standstill and the underlying cause, as elaborated in earlier chapters (see The 3 Phase Model of Cardiac Arrest). Both chest compressions and defibrillation are…

…titration is possible. Maximum dose: 21 mg/h iv. Common therapeutic dose: 4 6 mg/h. Clevidipine is administered in lipid emulsion (containing soy, egg)…

…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…

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

…QTc duration. Risk Stratification and the 1 2 3 LQTS Risk Model Accurate risk stratification is pivotal in guiding therapeutic decisions for LQTS patients. Traditional…

…QTc duration. Risk Stratification and the 1 2 3 LQTS Risk Model Accurate risk stratification is pivotal in guiding therapeutic decisions for LQTS patients. Traditional…

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

…prediction models provide guidance, their accuracies are moderate. Clinical judgment should always complement risk scores, considering individual patient characteristics and preferences when making therapeutic decisions…

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

…lung, fat, and skin, with myocardial concentrations reaching 10 to 50 times those found in plasma. Plasma clearance is low, renal excretion is negligible, and…

…of falls Symptoms or history suggesting orthostatic hypotension Multimorbidity Polypharmacy and overall therapeutic burden Life expectancy Patient priorities and preferences Patients who are fit and…

…in the general sense; the decision depends on balancing the expected diagnostic or therapeutic benefit against the patient’s specific procedural risks. Vascular access and…

…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…

…and dysfunction, which is associated with poor outcomes. Preserving right ventricular function is therefore an important therapeutic objective. Exercise intolerance Exercise limitation is multifactorial. In…

…at high risk of progression and generally require all appropriate evidence based measures, including drug treatment and therapeutic lifestyle change. Implementation remains suboptimal: approximately half

…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…

…cardiovascular disease, including PAD Conversely, patients with CVD should be screened systematically for diabetes because undiagnosed T2DM is common and has major therapeutic and prognosti

…diagnostic and therapeutic decisions in the presence or absence of an acute coronary occlusion, rather than rigid ECG thresholds. Several machine learning models for ECG…

…cause discernible ECG changes. Hyponatremia Effective management of hyponatremia requires careful identification of its etiology, severity (Table 2), and temporal onset. Distinguishing between acute and…

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

…effects of digoxin The incidence of adverse drug reactions is high, owing to the narrow therapeutic index of the drug. Digoxin is significantly pro arrhythmic…

…catheter). The hemodynamic effects persist for 7–10 days after the end of infusion. Refer to Table 2 for a comparison between levosimendan, milrinone and…

…structural heart disease (SHD) and structurally normal hearts, a division that profoundly influences prognosis and therapeutic decision making. Structural Heart Disease (SHD): Accounting for approximately…