Cardiology, respiratory and critical-appraisal teams get an evidence update on intermediate-risk pulmonary embolism. It separates anticoagulation from catheter-directed thrombolysis and mechanical thrombectomy while keeping right ventricular dysfunction, biomarkers, oxygen requirement, bleeding risk, clinical deterioration endpoints, multidisciplinary PERT decisions and post-PE symptoms in view.

Cardiology, emergency and acute medicine clinicians get a focused update on recurrent angina despite non-obstructive coronary angiography. ANOCA, INOCA and MINOCA are separated clearly, with microvascular dysfunction, vasospasm, SCAD, myocarditis, Takotsubo, early cardiac MRI, risk-factor treatment and cardiac rehabilitation kept in view.

Cardiology, emergency and acute medicine teams get a focused update on late-presenting ST elevation myocardial infarction. A stable, pain-free patient with completed infarction more than 24 hours after symptom onset does not routinely benefit from opening an occluded infarct-related artery, but ongoing ischaemia, shock, severe heart failure or life-threatening arrhythmia changes the decision.

Cardiology, respiratory and acute medicine teams get a structured approach to persistent symptoms after pulmonary embolism. It differentiates post-PE impairment, chronic thromboembolic disease and chronic thromboembolic pulmonary hypertension, linking follow-up to symptom scoring, V/Q imaging, echocardiography, functional assessment and individualised anticoagulation decisions.

ACS angiography planning should not stop at choosing the wrist. Radial access is preferred when feasible, but femoral backup, crossover triggers, radial spasm and possible mechanical circulatory support need to be anticipated before the case becomes unstable.

Acute pulmonary embolism can look deceptively stable before blood pressure falls. This teaching keeps risk stratification dynamic, using right ventricular dysfunction, oxygenation, lactate, troponin and trajectory to separate low, intermediate-high and high-risk PE.

Stable chest discomfort may need anatomy, physiology and plaque burden considered together. CCTA can show coronary atherosclerosis directly; CT-FFR and CAD-RADS modifiers help interpret lesion-specific flow limitation, plaque burden and high-risk plaque features.

Heart failure with broad left bundle branch block needs CRT decisions grounded in response, anatomy and evidence limits. Biventricular pacing remains the guideline-supported first-line strategy for typical reduced ejection fraction, while left bundle branch area pacing raises capture, expertise and selection questions.

Complex atrial fibrillation is framed around the decision that changes management: rhythm control, rate control, cardioversion, ablation or pacing. Pre-excitation, pregnancy, repaired Tetralogy of Fallot and tachy-brady syndrome each need a more precise description than chronic AF.

Cardiology history is mainly for physiology-minded learners. It still helps when chest pain, valve disease or hypertrophic cardiomyopathy feels mechanical: heart rate, wall tension, contractility and dynamic gradients explain why bedside anomalies deserve careful checking.