Cardiology Pathways

Assessment and treatment of acute decompensated heart failure including diuresis, vasodilator therapy, and escalation.

Risk stratification and management of non-ST-elevation myocardial infarction using GRACE score, dual antiplatelet therapy, and invasive strategy timing.

Assessment, rate control, rhythm control, and anticoagulation decisions for new-onset or paroxysmal atrial fibrillation.

Recognition and management of hypertensive emergency (SBP >180/120 with end-organ damage) versus hypertensive urgency.

Assessment and treatment of symptomatic bradycardia including AV blocks, sick sinus syndrome, and pacing indications.

Management of ventricular tachycardia (VT) and ventricular fibrillation (VF) including defibrillation, antiarrhythmic therapy, and ICD considerations.

Systematic evaluation of transient loss of consciousness to distinguish vasovagal, cardiac, and orthostatic syncope using ROSE, San Francisco, and Canadian syncope risk scores.

Diagnosis, medical management, and revascularisation decision-making for stable angina.

Diagnosis using modified Duke criteria and management of infective endocarditis including antibiotic selection and surgical indications.

ESC 2023 — STEMI diagnosis, primary PCI vs thrombolysis decision-making, antiplatelet/anticoagulation, post-MI care.

ESC 2015 — diagnosis (≥2 of 4 criteria), differentiate from MI, NSAID + colchicine, recognise tamponade and myopericarditis.

AAS includes classical dissection, intramural haematoma, penetrating ulcer — Stanford A vs B, BP/HR control, type-specific management.

ESC 2023 — SCAI staging, identification of cause (ACS most common), inotropes/vasopressors, mechanical circulatory support, urgent revascularisation.

Diagnose with Beck's triad + echo, distinguish from constrictive pericarditis, urgent pericardiocentesis (echo-guided), surgical drainage when indicated.

NICE NG196 / ESC 2024 — rate vs rhythm control, anticoagulation by CHA₂DS₂-VASc, ablation, lifestyle.

ESC 2021 / NICE NG106 — four pillars of HFrEF therapy, titration, monitoring, device therapy.

Acute termination with vagal manoeuvres + adenosine, identification of AVNRT vs AVRT, definitive ablation pathway.

ECG features, recognition of pre-excited AF (FBI rhythm), avoidance of AV-nodal blockers, ablation indication.

Distinguish typical (cavotricuspid isthmus-dependent) from atypical, rate vs rhythm control, ablation curative for typical.

Severe acute aortic regurgitation, severe acute mitral regurgitation, decompensated severe aortic stenosis — recognition and urgent surgical pathway.

Recognise RV failure, cautious fluid, vasopressor + pulmonary vasodilators, identify reversible cause (PE, sepsis, hypoxia).

Pacemaker malfunction (failure to capture/sense), ICD storm, lead infection / device pocket infection — recognition and management.

Recognition (post-viral, autoimmune, drug-induced), cardiac MRI, supportive care, biopsy if fulminant, escalation pathway.

Approach to an ACHD patient in ED — critical considerations for Eisenmenger, Fontan, single-ventricle, transposition variants.

ESC 2022 — Revised Cardiac Risk Index, functional capacity, biomarkers, decision on further testing and beta-blocker / statin / antiplatelet management.