The basics
Ischaemic heart disease and CV risk
- Acute Coronary Syndrome
- NSTEMI
- STEMI
- Chronic coronary syndromes
- MINOCA and ACS mimics
- Hypertension: diagnosis and management
- Hypertension: secondary causes
- Hypertension: urgencies and emergencies
- Hyperlipidaemia
Disorders of heart rhythm
- Atrial Fibrillation / Flutter
- Palpitations and ectopy
- Broad complex tachycardia
- Narrow complex tachycardia
- Heart block
- Cardiac devices
- Sudden cardiac death and channelopathies
Diseases of the myocardium and pericardium
- Acute heart failure
- Chronic heart failure
- Cardiomyopathies
- Pericarditis
- Myocarditis
- Pericardial effusion & tamponade
- Cardiac amyloidosis
Vascular disease
- Aortic dissection
- Aortic disease
- Pulmonary hypertension
- Peripheral arterial disease
- Fibromuscular dysplasia
Valvular heart disease
- Valvular heart disease: general points
- Aortic valve disease
- Mitral valve disease
- Right sided valve disease
- Infective endocarditis
- Prosthetic heart valves
Topics in development
- Congenital heart disease
- Heart transplant
- Cardio-oncology
- Cardiovascular genomics
Emergency drug doses
- ACS protocol
- Aspirin 300mg PO
- Either clopidogrel 600mg, ticagrelor 180mg or prasugrel 60mg PO
- Fondaparinux 2.5-5mg s/c (unless going to the cath lab in the next 24 hours)
- Acute heart failure
- GTN infusion 2-10 ml/h of a 1mg/ml preparation (if not hypotensive)
- Fast AF
- Metoprolol 2.5mg (elderly) to 5mg IV – can repeat every 5 minutes, up to max 15mg total
- Chemical cardioversion of AF
- Amiodarone 300mg IV over 30-60 mins, then 900mg over 24 hours
- VT (patient stable)
- Amiodarone 300mg IV over 10-60 mins
- Or Metoprolol 5mg IV
- Polymorphic VT
- Magnesium 2g IV over 5 or 10 minutes
- Hypertensive emergency
- Labetolol infusion 200mg in 200ml. Give at 0.5-2mg/min, or 30-300mg/hour. Start at 120mg/hour and double rate every 15 mins to 480mg/hour maximum.
- Or can give 50ml GTN in 50ml normal saline. Infuse at 2mg/min, titrating to max 10mg/min. Increase rate every 15 mins if required
- Atrioventricular nodal reentrant tachycardia
- Adenosine IV 6mg-12mg (can repeat 12mg every 2 minutes, twice)
- Thrombolysis in acute MI
- Tenecteplase 30-50mg (dose dependent on weight)
Useful scores
- The GRACE score – estimates admission to 6 month mortality for patients with acute coronary syndrome
- The CRUSADE score – stratifies bleeding risk after NSTEMI
- The HEART score – predicts 6-week risk of major adverse cardiac events in patients with chest pain
- The Miracle2 score – predicts poor neurological outcome where a patient has suffered an out-of-hospital cardiac arrest
- Aortic Dissection Detection Risk Score – rules out aortic dissection
- CHA₂DS₂-VASc Score – calculates stroke risk for patients with atrial fibrillation
- The SPARCtool – estimates annual stroke risk and compare the potential benefits and risks of antithrombotic therapy in patients with non-valvular AF
- The ORBIT score – predicts bleeding risk in patients on anticoagulation for AF
- The HASBLED score – estimates risk of major bleeding for patients on anticoagulation
- Sgarbossa’s Criteria – criteria to diagnose acute MI in patients with prior LBBB
- HCM Risk-SCD – estimates risk of sudden cardiac death in patients with hypertrophic cardiomyopathy
- ARVC Risk Calculator v3.0 – estimates the risk of ventricular arrhythmias within 5 years for patients with a definite ARVC diagnosis
- CADence – ESC 2024 CCS Guideline-Based Probability Calculator for Coronary Artery Disease
- Society of Thoracic Surgeons Risk Calculator – calculates short term operative risk for adult cardiac surgery
- H2FPEF Score – estimates probability of underlying heart failure in patients with preserved ejection fraction on echo
- MAGGIC Risk Calculator – estimates 1- and 3- year mortality in heart failure
- Lipid management tool – interactive version of national guidance for lipid management for primary and secondary prevention of cardiovascular disease
- Q risk 3 risk calculator – estimates a patient’s 10-year risk of developing cardiovascular disease
- Simon Broome Diagnostic Criteria – diagnoses familial hypercholesterolemia (FH) based on clinical, genetic and family history
- North American Familial Chylomicronemia Score – facilitates familial chylomicronemia syndrome (FCS) diagnosis
- 2023 Duke-International Society for Cardiovascular Infectious Diseases Criteria – diagnostic criteria for infective endocarditis
- The BLISTER score – estimates the risk of CIED infection within 12 months of a procedure, and provides a threshold for which patients should be allocated an antimicrobial envelope
- Wound, Ischemia, foot Infection (WIfI) Classification – assesses severity of limb threat in patients with lower extremity disease
- The DETECT algorithm – helps detect pulmonary arterial hypertension in patients with systemic sclerosis
- REVEAL Registry Risk Score 2.0 – predicts survival in patients with pulmonary arterial hypertension
- TR risk score – a risk model to predict one-year mortality in isolated secondary TR patients
- The Shanghai Score – stratifies risk in suspected Brugada syndrome
- Modified Schwartz Score – estimates the probability of Congenital Long QT Syndrome (LQTS)
Guidelines
- The European Society of Cardiology Clinical Practice Guidelines – detailed, wide ranging and gospel!
- NICE guidelines for hypertension in adults: diagnosis and management
- National Guidance for Lipid Management for Primary and Secondary Prevention of CVD
- British Society of Echocardiography