Cardiology
Ischaemic heart disease, heart failure, arrhythmias and valve disease.
- Cardiovascular Disease How atherosclerotic plaques form, how to quantify 10-year risk with QRISK3, and how to use lifestyle measures and statins for primary and secondary prevention.
- Stable Angina Classifying anginal chest pain, why CT coronary angiography is first line, and the medical and revascularisation options for managing it.
- Acute Coronary Syndrome Unstable angina, NSTEMI and STEMI: reading the ECG, interpreting troponin, and the time-critical decisions that determine outcome.
- Pericarditis Positional pleuritic chest pain, widespread saddle-shaped ST elevation with PR depression, and why colchicine matters as much as the NSAID.
- Acute Left Ventricular Failure Cardiogenic pulmonary oedema: the ABCDE chest X-ray, and why nitrates, opioids and routine oxygen are no longer part of standard treatment.
- Chronic Heart Failure Using NT-proBNP to decide who needs an echocardiogram, classifying by ejection fraction, and the four drug classes that improve survival in HFrEF.
- Hypertension Confirming the diagnosis with ABPM, assessing end-organ damage, and working through the NICE A/C/D algorithm to resistant hypertension.
- Secondary Hypertension Who to screen for a curable cause, which test for which condition, and why alpha-blockade always precedes beta-blockade in phaeochromocytoma.
- Valvular Heart Disease A systematic approach to murmurs - timing, site, radiation and the manoeuvres that separate them - plus prosthetic valves and the UK position on endocarditis prophylaxis.
- Aortic Valve Disease Aortic stenosis and regurgitation: the SAD triad, the collapsing pulse and its eponymous signs, and when to replace the valve.
- Mitral Valve Disease Stenosis, regurgitation and prolapse: the signs at the apex, why the left atrium suffers in stenosis, and the surgical thresholds that look deceptively normal.
- Right Heart Valve Disease Tricuspid and pulmonary valve disease: reading the JVP waveform, why most tricuspid regurgitation is the left heart's fault, and the causes students forget.
- Prosthetic Valves Mechanical versus bioprosthetic, why DOACs are contraindicated, what a normal prosthesis sounds like, and recognising thrombosis, endocarditis and haemolysis.
- Infective Endocarditis Fever with a new murmur: the organisms and who gets them, the modified Duke criteria, why blood cultures come before antibiotics, and when the valve needs surgery.
- Hypertrophic Obstructive Cardiomyopathy The commonest inherited cardiac condition: separating it from aortic stenosis at the bedside, who needs a defibrillator, and why vasodilators are dangerous.
- Dilated and Restrictive Cardiomyopathy The reversible causes of a dilated ventricle worth hunting for, cardiac amyloidosis, and the constrictive pericarditis you must not miss.
- Myocarditis The young patient with chest pain and a raised troponin after a viral illness: the non-coronary MRI pattern that makes the diagnosis, and why exercise must be avoided for months.
- Pericardial Effusion and Cardiac Tamponade Why the rate of accumulation matters more than the volume, Beck's triad and pulsus paradoxus, electrical alternans, and the two causes where you must not aspirate.
- Atrial Fibrillation The irregularly irregular pulse, choosing between rate and rhythm control, the CHA2DS2-VASc score, and why cardioverting after 48 hours can cause a stroke.
- Atrial Flutter Sawtooth waves at 300 per minute, why a rate of exactly 150 should make you suspicious, and why isthmus ablation cures it far more reliably than AF ablation.
- Supraventricular Tachycardia Treating an SVT with the modified Valsalva manoeuvre and adenosine, separating AVNRT from AVRT, and why AV nodal blockers can be fatal in pre-excited AF.
- Ventricular Tachycardia and Fibrillation Why every broad complex tachycardia is VT until proven otherwise, capture and fusion beats, treating polymorphic VT by the QT interval, and who needs an ICD.
- Long QT Syndrome and Torsades de Pointes Measuring the QTc, the drugs and electrolytes that prolong it, the inherited subtypes and their distinctive triggers, and why magnesium rather than amiodarone treats torsades.
- Bradyarrhythmias and Heart Block Separating Wenckebach from Mobitz II and why it changes everything, recognising complete heart block at the bedside, and why atropine fails in infranodal block.
- Arrhythmias The four questions that classify any abnormal rhythm - stable or unstable, fast or slow, narrow or broad, regular or irregular - and the drugs that follow.
- Pacemakers and Implantable Defibrillators Reading the pacing code and the paced ECG, the four modes of device malfunction, who needs an ICD or resynchronisation, and the practical questions patients ask.
- Cardiac Arrest The ALS algorithm in full: shockable versus non-shockable rhythms, drug timing, the four Hs and four Ts, post-ROSC care, and when not to start or to stop.
- Congenital Heart Disease Acyanotic shunts versus the five cyanotic Ts, the murmurs and their eponymous signs, duct-dependent circulations in the newborn, and how Eisenmenger syndrome develops.
- Pulmonary Hypertension The five WHO groups and why giving vasodilators to the wrong one causes harm, the signs of right heart failure, and why a V/Q scan finds the curable group.
- Superior Vena Cava Obstruction Facial swelling with fixed non-pulsatile neck veins, Pemberton's sign, why a tissue diagnosis usually comes before treatment, and the features that make it a true emergency.
- Syncope Separating reflex from cardiac syncope and both from seizure, the NICE red flags that mandate urgent assessment, and the driving advice that is easily forgotten.
- Postural Hypotension Measuring lying and standing blood pressure properly, what an absent compensatory tachycardia tells you, and why deprescribing beats any drug you could add.
- Shock Telling the four types apart at the bedside from peripheries and JVP, why lactate beats blood pressure, and the treatments that differ fundamentally between them.
- ECG Interpretation A fixed sequence for every trace - rate, rhythm, axis, intervals, waveforms - plus the patterns you must recognise instantly and the artefacts that mimic them.