Arrhythmias and arrhythmology Pharmacology & dosing Pharmacokinetic Considerations Relevant to Dosing Amiodarone exhibits highly variable and complex pharmacokinetics that profoundly influence its dosing strategies. The drug…

…weak, slow deceleration variable dense, steep deceleration, early termination of diastolic flow Jet width colour Doppler small,, < 10 mm length, narrow origin variable large…

…profile mitral regurgitation weak variable dense Shape CW profile mitral regurgitation parabolic variable early peak, triangular Size left atrium normal normal or dilated dilated Size…

…Wound bed Fibrin covered, granulating, copious exudate Dry, necrotic, pale Variable, often deep Pain Moderate, relieved by elevation Severe, worse on elevation, better when dependent…

…or enlarged enlarged Size right atrium normal normal or enlarged enlarged CW profile tricuspid regurgitation weak variable dense Shape CW profile tricuspid regurgitation parabolic variable…

…embolization and may reduce the apparent luminal diameter on contrast aortography. AAA growth is variable. Aneurysms smaller than 4 cm may enlarge by approximately 1…

…is defined by these characteristics, the presentation can be highly variable, particularly in females, the elderly, or patients with diabetes [4]. Associated Findings: The sudden…

…incomplete penetrance and variable phenotypic expression complicate risk prediction. Familial clustering may also reflect shared environmental or behavioural factors rather than a single gene disorder…

…distinction is clinically useful but not absolute. Ejection fraction is a continuous variable and echocardiographic measurement has meaningful variability. Patients with LVEF 40% have substantial…

…and Symptoms The clinical presentation is variable. Patients may have: Stable angina or an anginal equivalent Exertional dyspnoea or reduced exercise tolerance Acute coronary syndrome…

…as an agonist of both beta1 and beta2 adrenergic receptors, with variable effects on alpha receptors. Stimulation of beta receptors increases inotropy and chronotropy by…

…cells mechanically and electrically. Most mutations are inherited in an autosomal dominant manner, with variable penetrance and expressivity. Recessive forms exist, although they are rare…

…develops over hours to days [1,2]. Six steps Step Question Practical interpretation : : : 1 Is the pH low or high? pH <7.35 is acidaemia…

…CW profile aortic regurgitation weak variable dense Size left atrium normal normal or enlarged enlarged Size left ventricle normal normal or enlarged enlarged Additional PISA…

…CW profile aortic regurgitation weak variable dense Size left atrium normal normal or enlarged enlarged Size left ventricle normal normal or enlarged enlarged Additional PISA…

…or enlarged enlarged Size right atrium normal normal or enlarged enlarged CW profile tricuspid regurgitation weak variable dense Shape CW profile tricuspid regurgitation parabolic variable…

…on triglycerides and lipoprotein(a) are variable or modest. In phase III studies involving patients with ASCVD or at least one ASCVD risk equivalent who…

…myocardium Viable dysfunctional myocardium is myocardial tissue whose contractile function improves after coronary revascularization. This functional definition encompasses several physiological states. Brief coronary occlusion or…

…Thus, even a modest absolute reduction may be clinically important in individuals at high or very high risk. Prolonged exposure to lower LDL C concentrations…

…Waist circumference is particularly important because intra abdominal, or visceral, adipose tissue is more closely related to insulin resistance and the risk of diabetes and…

…incorporates the following variables: Risk factor Points Congestive heart failure 1 Hypertension 1 Age ≥75 years 2 Diabetes mellitus 1 Prior stroke or TIA 2…

…the paradigm has shifted toward an oligogenic or polygenic architecture. Genome wide association studies (GWAS) have identified common single nucleotide polymorphisms (SNPs)—such as those…

Echocardiography Dilated cardiomyopathy (DCM) Dilated cardiomyopathy (DCM) is defined as dilation of one or both ventricles. Dilation of the left ventricle is virtually always accompanied…

…risk. Clinical Applications Personalized Decision Making : SYNTAX Score II helps determine whether a patient should undergo PCI or CABG based on their risk profile. Predicting…

…rate (eGFR), which assesses kidney function. Developed from the MDRD study, this equation incorporates variables such as serum creatinine, age, sex, and race to provide…

…The formula takes into account the following variables: Maximum Left Ventricular Wall Thickness (MaxLVWT) : Hypertrophy is a hallmark of HCM and is associated with increased…

…the anatomical complexity of CAD, particularly in patients with multivessel disease or left main coronary artery disease . It integrates multiple variables, including the number of…

…g—or both. The eGFR is generally estimated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) equation, incorporating relevant demographic variables…

…heart failure, chronotropic incompetence may be caused by beta blockers, amiodarone or digitalis. Sinus node dysfunction (SND) is a common cause of chronotropic incompetence. Definition…

…metal, or tissue and fluids in the human body. Sound waves arise when a sound source generates mechanical vibrations in the particles of the medium…

…aorta. Afterload affects myocardial muscle fibers during systole and diastole. Afterload is a function of the following three variables: Aortic resistance (pressure). Left ventricular volume…

…and death. The clinical consequences are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of…

…or SCORE2 OP estimate when certain clinical conditions are present. These include diabetes mellitus, familial hypercholesterolaemia, established CVD, moderate or severe CKD, or HMOD. Variables…

…or delayed approach is recommended in this setting unless other findings justify urgent intervention. Risk scores Several risk scores integrate clinical, ECG, and biomarker variables…

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

…must be stored in a database, where the patient's personal identification number or equivalent is used for secure identification. If the examination is performed…

…and the apex rotates counterclockwise. This rotating, or twisting, contraction is called circumferential shortening (Figure 1C). Left ventricular function depends on a complex interaction between…

…the analysis of electrolyte levels. Electrocardiography (ECG) serves as a valuable tool for detecting and assessing the severity of electrolyte disturbances, particularly before laboratory results…

…dyslipidaemia, and diabetes mellitus Reduce anxiety and depressive symptoms Facilitate return to work and appropriate recreational or sporting activity Limit recurrent myocardial infarction, cardiovascular morbidity…

…new loss of viable myocardium or a new regional wall motion abnormality in an ischaemic distribution Identification of a coronary thrombus by angiography or autopsy…

…Occlusion or impaired perfusion in a vessel supplying a large viable territory is more likely to produce rapid hemodynamic deterioration than a similar angiographic abnormality…

…when the occluded artery supplies viable myocardium with demonstrable ischaemia. However, randomized evidence has not shown a reduction in mortality or myocardial infarction with routine…

…changes New pathological Q waves Imaging evidence of new loss of viable myocardium or a new regional wall motion abnormality in an ischemic distribution Angiographic…

…first or anterior infarction. Single vessel disease without collateral support. Chronic kidney disease, particularly in relation to VSR. Large infarction, especially for septal or free…

…Occlusion Myocardial Infarction (OMI) versus Non Occlusion Myocardial Infarction (NOMI). This method focuses on the presence or absence of ACO, rather than rigid ECG thresholds…

…in patients with right ventricular ischemia or infarction. Recognizing ECG signs of right ventricular involvement is, therefore, important. Such knowledge is valuable for most clinicians…

…CAD. Risk stratification : Myocardial perfusion imaging is valuable for assessing the risk of future cardiac events in patients with known CAD or after myocardial infarction…

…probability of myocardial ischemia as the underlying cause. Holter ECG may be valuable if the diagnosis is uncertain. Echocardiography is generally performed in order to…

…treatment is given, and the test is performed later. Contraindications Known hypersensitivity to tetracosactide or ACTH. Marked atopic disease, particularly severe asthma and a history…

…Qp) to systemic blood flow (Qs). This measurement is pivotal in diagnosing and managing congenital or acquired cardiac shunts, such as atrial septal defects (ASD…

[calc_map] Mean arterial pressure (MAP) represents the average pressure within the arteries throughout a single cardiac cycle, encompassing both systole and diastole. It is…

…Definition and Clinical Purpose Myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) or positron emission tomography (PET) is a radionuclide based method…

…active electrical wavefronts at any given point in time, approximated as a single heart vector [3]. The orientation and intensity of this vector fluctuate throughout…

…new loss of viable myocardium or a new regional wall motion abnormality in an ischaemic pattern. Identification of a coronary thrombus by angiography or autopsy…

…However, the context indicates that if pharmacological therapy is inadequate, escalation to catheter ablation or mechanical circulatory support remains a viable therapeutic pathway [4]. Furthermore…

…cavity and affect heart valves that have some kind of damage, change or degeneration. Endocarditis with alpha streptococcus is most often subacute and can develop…

…ischemia or partial scarring. Severe defects : Defined by absent tracer uptake, with signal intensity comparable to background activity, typically representing infarcted tissue or non viable…

Cardiology SPECT vs. PET In SPECT (Single Photon Emission Computed Tomography), radiotracers emit gamma photons directly. These gamma rays are detected by gamma cameras to…