…vascular disease and renal dysfunction. The commonly used CHA2DS2 VASc score incorporates the following variables: Risk factor Points Congestive heart failure 1 Hypertension 1 Age…

…thrombus can fragment, embolize to other coronary branches or vascular beds, propagate through gaps between stent struts, and compromise the treated lumen. Conventional angiography has…

…the potential for bleeding complications. The CHA₂DS₂ VA score is a clinical tool designed to assess stroke risk in patients with non valvular atrial fibrillation …

…the expected diagnostic or therapeutic benefit against the patient’s specific procedural risks. Vascular access and access site complications Radial and femoral access Radial access…

…in which lipid accumulation, vascular cell dysfunction, immune cell recruitment, extracellular matrix remodelling, and thrombosis interact to produce focal arterial lesions. Although epicardial coronary arteries…

…stroke requires attention to the type of stroke and the possibility of thrombolytic treatment. Cardiac and pulmonary complications Acute hypertension may precipitate myocardial ischemia or…

…must be familiar with the vascular supply to these components. Figure 1 presents all relevant parts of the conduction system and their source of blood…

…intracerebral haemorrhage and assess early ischaemic changes CT angiography The standard investigation in acute stroke to identify large vessel occlusion, dissection or other vascular pathology…

…improves the chance of success by counteracting vascular spasm. Pressure monitoring set: stiff, short tubing, a transducer, and a flush system with physiological saline in…

…heartbeat Dyspnoea and worsening pulmonary congestion Reduced exercise capacity Symptoms or signs of heart failure Haemodynamic instability Myocardial ischaemic symptoms or electrocardiographic changes Thromboembolic complications…

…premature mortality compared with continued smoking. Cessation also improves vascular health and may reduce cardiovascular risk within several years, although risk may remain higher than…

…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

…but approximately one quarter of aneurysms are not calcified and therefore cannot be identified reliably by radiography. Assessment should include consideration of associated vascular disease…

…In patients with recurrent chest pain and hemodynamic compromise after MI, mechanical complications should be considered. Transthoracic echocardiography (TTE) can help assess for these complications…

…Tissue loss, ulcers and gangrene may develop. In patients with CLTI, early recognition and referral to a vascular team are essential for limb salvage. Acu

…transport—MRs are also present in cardiac myocytes, vascular smooth muscle, endothelial cells, macrophages, neurons and other tissues. This distribution helps explain why PA produces…

…are incompletely defined. Proposed contributors include hypercontractility or hypersensitivity of coronary vascular smooth muscle to vasoconstrictor stimuli, including adrenergic agonists, leukotrienes, and serotonin. In patients…

…cause: Aortic regurgitation Haemopericardium or pericardial effusion Aortic rupture Proximal aortic complications Malperfusion and pulse deficits are less common in type A IMH than in…

…existing valvular disease or excessive beta blocker or calcium channel blocker exposure. The incidence of cardiogenic shock complicating STEMI has fallen with prompt reperfusion and…

…valvular apparatus, as well as to embolization in the systemic circulation. The complications can be fatal. Approximately 500 Swedes are affected annually by endocarditis and…

…countries is age related degeneration of the valvular apparatus. Age related degeneration affects 2% of the population and leads to gradual prolapse of the valve…

…Definition and Clinical Role Invasive coronary angiography (ICA) is a catheter based investigation that visualizes the coronary arterial tree after selective intracoronary contrast injection under…

…low vascular tone or both, and the appropriate action differs fundamentally between these cases. Pressures in the heart and pulmonary circulation Flow, resistance and oxygen…

…TIA, systemic thromboembolism) in the next 12 months and the calculations apply to untreated patients with non valvular atrial fibrillation ( Table 1 ). CHADS VASc Score…

…calcium channel blocker. Clevidipine is highly selective for vascular smooth muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces…

…Induces arteriolar vasodilation without effects on venous circulation. The reduction in systemic vascular resistance (SVR) is rapid and may cause reflex sympathetic stimulation, including tachycardia…

…channel blocker (CCB). Nicardipine inhibits the influx of extracellular calcium in the myocardial and peripheral vascular smooth muscle cell membranes, thus inhibiting the contraction of…

…does not specify the loading dose. Efficacy and harms In secondary prevention trials involving patients with previous vascular disease, aspirin reduced the combined incidence of…

…affecting at least two vascular beds. Carotid disease therefore commonly coexists with coronary artery disease (CAD), peripheral artery disease (PAD), and other manifestations of systemic…

…cells to vascular lesions. The interleukin 1β pathway, with downstream effects involving interleukin 6 and C reactive protein, has been a major therapeutic target…

…acute heart failure to support systemic blood pressure through its infusion rate parameters. Clinical Presentation and Symptoms Acute heart failure necessitating inotropic or vasopressor support…

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…

…The haemodynamic phenotype is then determined using pulmonary arterial wedge pressure (PAWP) and pulmonary vascular resistance (PVR): Haemodynamic category mPAP PAWP PVR Precapillary PH 20…

…types I and III, elastin, and proteoglycans [6] . This matrix forms a fibrous cap that sequesters the highly thrombogenic lipid core from the flowing blood…

…cerebrovascular disease. Follow up after vascular surgery or endovascular intervention. Assessment of healing potential in ulcers and before deciding the level of amputation. Contraindications There…

…visit; a difference 15 mmHg suggests vascular disease, and the arm with the higher reading is used thereafter Two to three measurements one minute apart…

…in vasoconstriction and an increase in systemic vascular resistance (SVR). Beta 1 adrenergic receptors: expressed in the myocardium. Activation results in increased contractility and increased…

…associated with fracture and requires an orthopaedic surgeon. Dislocation of a native hip (as opposed to a prosthesis) — a high risk of avascular necrosis of…

…ears and penis has been abandoned in the modern literature for commercial preparations at normal concentrations; be cautious nonetheless in known peripheral vascular disease and…

…channel blocker (CCB). Nicardipine inhibits the influx of extracellular calcium in the myocardial and peripheral vascular smooth muscle cell membranes, thus inhibiting the contraction of…

…blood the heart pumps and the resistance encountered in the systemic circulation. Therefore, alterations in heart rate, stroke volume, or vascular tone can significantly impact…

…LVEF is associated with worse outcomes. Unprotected Left Main Disease : Increases complexity and risk. Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive Pulmonary Disease …

…by a vascular specialist or urgent transfer to a facility with vascular expertise. The initial evaluation should establish: The time of symptom onset and the…

…haemodynamic collapse, and death. The clinical consequences are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. 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 pharmacological rationale Bempedoic acid is an oral, small molecule lipid lowering agent used to reduce low density lipoprotein cholesterol (LDL…

…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…

…chambers, blood pool, and vascular structures is limited. CCTA has become an important first line investigation for selected patients with suspected coronary artery disease (CAD)…

…and, in some patients, bendopnea. Congestion may also aggravate functional mitral regurgitation, ventricular dilatation, myocardial wall stress and subendocardial ischemia. Neurohormonal activation and vascular and…

…neointimal hyperplasia following vessel wall injury. PCI and stent implantation produce local vascular injury and initiate a sustained inflammatory and reparative response. Proliferation and accumulation…

…ivabradine reduces the slope of diastolic depolarisation and produces a dose dependent reduction in sinus rate. Its principal therapeutic distinction from beta blockers is that…

… vascular inflammation; progression of calcific aortic stenosis; enhancement of a prothrombotic state. Its atherogenic and inflammatory effects may be mediated partly by oxidized phospholipids carried…

…circulation, vascular calcification and myocardial fibrosis further accelerate cardiovascular and renal injury. Adipokine imbalance contributes to insulin resistance, β cell failure, endothelial dysfunction and atherosclerosis…

…Structural CMD: resting vascular tone is increased, potentially reflecting capillary rarefaction, fibrosis, or left ventricular hypertrophy. Hypertension, diabetes, and elevated NT proBNP are more frequent…

…may be accompanied by inferior infarction if the occlusion affects both vascular territories. This will result in ST segment elevations in II, aVF and III…

…curable when its cause is clearly established and removed. Cure is not universal, however. Delayed recognition may permit vascular remodelling and renal impairment to develop…

…Marfan syndrome and Ehlers–Danlos syndrome. FMD may be clinically occult and can affect multiple vascular territories, including the renal, carotid, vertebral and coronary arteries…

…known as no reflow, structural and functional impairments sustain vascular obstruction. Endothelial dysfunction triggers leukocyte and platelet activation, while thrombotic debris may worsen the obstruction…

…The most important of these, and their implications, are as follows: The size of the thrombus (i.e the degree of artery obstruction): The greater…

…channel blocker (CCB). Nicardipine inhibits the influx of extracellular calcium in the myocardial and peripheral vascular smooth muscle cell membranes, thus inhibiting the contraction of…