…Subclinical cerebral injury may contribute to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS…

…Vascular access and access site complications Radial and femoral access Radial access is generally preferred for coronary angiography and PCI because it is associated with…

…occur despite the absence of significant epicardial obstruction. In patients with anginal symptoms and unobstructed or non obstructive coronary arteries, possible mechanisms include microvascular obstruction…

…9 m/s; severe, ≥ 4.0 m/s or a valve area < 1.0 cm² with a mean gradient ≥ 40 mmHg. Fluid responsiveness Static…

…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…

…and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction, immune cell recruitment, extracellular matrix remodelling…

…failure. Caution • Used cautiously in patients with acute heart failure. • Clevidipine can cause reflex tachycardia. • Contraindicated in severe aortic stenosis due to risk of hypotension…

…can be counteracted with simultaneous administration of beta blockers). Effects Induces arteriolar vasodilation without effects on venous circulation. The reduction in systemic vascular resistance (SVR…

…of extracellular calcium in the myocardial and peripheral vascular smooth muscle cell membranes, thus inhibiting the contraction of smooth muscle cells. As compared with nitroprusside…

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…multisite artery disease, defined as atherosclerosis affecting at least two vascular beds. Carotid disease therefore commonly coexists with coronary artery disease (CAD), peripheral artery disease…

…cytokine signalling and recruitment of inflammatory cells to vascular lesions. The interleukin 1β pathway, with downstream effects involving interleukin 6 and C reactive protein…

…hypertensive encephalopathy and should prompt consideration of stroke. Acute ischemic or intracerebral haemorrhage may coexist with severe hypertension. The decision to lower BP in acute…

…pharmacodynamic mechanisms. These drugs are broadly utilised to augment myocardial contractility, manipulate systemic and pulmonary vascular resistance, and restore adequate end organ perfusion. Dobutamine is…

…arteries. It frequently coexists with left main coronary artery disease, diabetes mellitus, left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous…

…Patients with mPAP greater than 20 mmHg, PAWP ≤15 mmHg, and PVR ≤2 Wood units may have increased pulmonary blood flow rather than pulmonary vascular…

…debris, modern vascular biology has redefined atherosclerosis as a dynamic, immune mediated fibroproliferative response to endothelial injury [2] . The process initiates with endothelial dysfunction, a…

…Secondary prevention, walking exercise ≤ 0.40 Severe ischaemia Urgent vascular surgical assessment Exercise ABI. With a normal or borderline resting ABI but typical claudication, the…

…Repeated blood gases, for example during mechanical ventilation or severe metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom…

…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…

…Inotropes increase myocardial contractility. There are several synthetic and endogenous agents with inotropic and vasopressor effects, and they often need to be combined in order…

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

…wounds where a long time has passed since the injury (see below). Be particularly cautious with impaired healing: peripheral vascular disease, diabetes with neuropathy, immunosuppression…

…of extracellular calcium in the myocardial and peripheral vascular smooth muscle cell membranes, thus inhibiting the contraction of smooth muscle cells. As compared with nitroprusside…

…Hemodynamic determinants of MAP Hemodynamically, MAP is influenced by cardiac output (CO) and systemic vascular resistance (SVR), as described by the relationship: MAP = (CO…

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

…and sensory disturbance. With progression, motor dysfunction develops, followed by profound anaesthesia, paralysis, muscle rigidity and ultimately major tissue loss. Reperfusion after severe or prolonged…

…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…

…disease, or peripheral artery disease. Secondary prevention concerns patients with established vascular disease, in whom aspirin has a substantially more favourable benefit–risk profile. Aspirin…

…vascular disease or familial hypercholesterolaemia, addition of bempedoic acid to statin therapy reduced LDL C by approximately 16.5%; the reduction in a subgroup with…

…older adults. It contributes to vascular injury, accelerates atherosclerosis, increases myocardial oxygen demand, and may worsen ischemia in patients with obstructive coronary disease. It is…

…with submillimetre spatial resolution. Iodinated contrast is generally required for coronary angiography because the intrinsic contrast between the cardiac chambers, blood pool, and vascular structures…

…ascites Older patients may present atypically, with fatigue, depression, sleep disturbance or altered mental status rather than prominent breathlessness. Hemodynamic phenotypes Initial assessment should distinguish…

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

…is required in severe hepatic or renal impairment, and clinically relevant interactions occur with CYP3A4 inhibitors and inducers. Clinical indications Heart failure with reduced ejection…

…in approximately one in five individuals. Pathophysiology Lp(a) is associated with several interrelated pathological processes: accelerated atherogenesis; vascular inflammation; progression of calcific aortic stenosis…

…of diabetes and cardiovascular disease than total adiposity alone. The waist circumference associated with risk varies among populations, reflecting differences in fat distribution and ethnicity…

…ANOCA/INOCA is more frequent in women, affecting approximately 50–70% of women compared with 30–50% of men. Microvascular angina (MVA) is myocardial ischaemia…

…As mentioned above, posterior myocardial infarction may be accompanied by inferior infarction if the occlusion affects both vascular territories. This will result in ST segment…

…advise screening adults with confirmed hypertension by measuring renin and aldosterone, although the strongest indications arise in patients with resistant or severe hypertension and associated…

…may permit vascular remodelling and renal impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated with a greater…

…cessation has been associated with a 36% reduction in premature mortality compared with continued smoking. Cessation also improves vascular health and may reduce cardiovascular risk…

…Pregnant patients with SCAD may have a more severe presentation than those with non SCAD ACS. SCAD may present with: ST elevation myocardial infarction (STEMI…

…and severity of ischemic injury. In its most severe form, known as no reflow, structural and functional impairments sustain vascular obstruction. Endothelial dysfunction triggers leukocyte…

…stroke risk is increased approximately five fold, and AF is associated with roughly one in five strokes. Thrombus formation is most commonly related to the…

…silent while vascular disease progresses. Many patients presenting with CVD have previously undiagnosed diabetes; systematic screening for diabetes is therefore recommended in patients with CVD…

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

…branches, and thus more myocardium, as compared with a distally located thrombus. The duration of the ischemia: the longer the duration of the ischemia, the…

…of extracellular calcium in the myocardial and peripheral vascular smooth muscle cell membranes, thus inhibiting the contraction of smooth muscle cells. As compared with nitroprusside…

…atria, ventricles and the heart valves. Similar to vascular endothelium, the endocardium contains an underlying basement membrane and a small layer of loose connective tissue…

…agents exert vasodilatory effects, increasing coronary blood flow by relaxing vascular smooth muscle. They are contraindicated in patients with bronchospastic lung disease, or a history…

…because the right ventricle is difficult to visualize clearly with trans thoracic echocardiography. Causes of right ventricular hypertrophy Lung disease (with increased pulmonary vascular resistance)…

…with them. In order to completely understand the different complications related to ischemia/infarction in the conduction system, one must be familiar with the vascular…

…Sudden cessation of tissue perfusion as a result of cardiac or vascular condition. May reverse spontaneously (e.g., vasovagal syncope) or with treatment (e.g.…

…Pilonidal abscess, hidradenitis abscess and paronychia with a collection of pus. Persistent painful induration after a few days of antibiotics — suggests that an abscess has…

…acute stroke to identify large vessel occlusion, dissection or other vascular pathology CT perfusion Used with an unclear time of onset, a late time window…

…arrhythmia, among others. Acute severe balance disturbance without nystagmus: HINTS does not apply. Assess gait and truncal stability and investigate for a central cause. Acute…

…crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing or new organ damage in which immediate, controlled blood pressure…

…under vascular surgical supervision Diabetes with neuropathy Reduced compression, closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe…

…vascular bleed. Perioperative bleeding that rapidly fills the suction, the swabs or the operative field and requires repeated units of red cells. Gastrointestinal bleeding with…