Cardiovascular

A tear in the aortic intima drives blood into the media, splitting it into a true and a false lumen that can rupture or occlude branch arteries.

Disease of the conducting tissue delays or blocks atrial impulses reaching the ventricles, leaving a slow escape rhythm whose site of origin decides how dangerous the block is.

Cardiomyopathy is a primary myocardial disorder classified by its structural and functional phenotype; it may present with heart failure, arrhythmia, syncope or a family history and requires specialist phenotyping, aetiological assessment, sudden-death risk review and family screening.

Blood enters the wall of a cervical carotid artery and forms an intramural haematoma whose raw surface embolises to the retina or brain, hours to days after the pain starts.

Heart failure is a clinical syndrome in which a structural or functional cardiac abnormality raises filling pressures, lowers cardiac output, or both. Ejection fraction then chooses the treatment; it does not make the diagnosis.

Congenital heart disease comprises structural heart or great-vessel abnormalities present from birth; classify the physiology as shunt, obstruction, abnormal mixing or single-ventricle circulation, then recognise duct-dependent neonatal collapse, cyanotic spells, heart failure and the need for lifelong specialist follow-up.

A DVT is a venous clot, usually in a leg vein, that can extend or embolise to cause PE; diagnose it with a validated pathway and treat confirmed proximal disease with anticoagulation.

Hyperlipidaemia is raised atherogenic lipoprotein cholesterol or triglycerides; it is usually silent, so treatment is based on overall cardiovascular risk, established disease, familial lipid disorders and pancreatitis risk rather than on a cholesterol number in isolation.

Hypertension is persistently raised arterial blood pressure, usually without symptoms, diagnosed by correctly measured clinic pressure plus ambulatory or home confirmation unless severe pressure and acute target-organ injury require immediate specialist assessment.

Infective endocarditis is infection of the endocardium, usually a valve or intracardiac device; obtain adequate blood cultures, image early and involve the endocarditis team urgently.

Myocarditis is inflammation of the heart muscle that can present as an acute coronary syndrome mimic, new heart failure, ventricular arrhythmia or conduction disease; the immediate priorities are to assess instability, exclude time-critical alternatives, confirm myocardial inflammation and arrange cardiology follow-up.

Postural hypotension is a clinically important fall in blood pressure after standing, caused by inadequate compensation for gravitational blood pooling; it presents with postural dizziness, falls or syncope and should trigger medication, volume, cardiovascular, neurological and endocrine assessment.

Pulmonary hypertension is a haemodynamic disorder in which the pulmonary circulation places an abnormal load on the right ventricle; diagnosis requires specialist classification because treatment differs between pulmonary arterial, left-heart, lung-disease, chronic-thromboembolic and multifactorial disease.

Stable angina is predictable myocardial ischaemic pain from supply-demand mismatch, usually due to atherosclerotic coronary disease; new, worsening or rest pain is an ACS emergency until assessed.

Compression, invasion or thrombosis of the superior vena cava blocks venous drainage from the head, neck and arms, raising upstream pressure until collaterals open or the airway is threatened.