Cardiac physical examination
How to examine the heart at the bedside: hands, pulses, blood pressure, JVP, precordium, heart sounds, murmurs and oedema, and what each sign means.
Checked against sourcesVerified 24 October 2026
Cardiology
Diseases of the heart and circulation, from heart failure to arrhythmia, and how they are diagnosed and treated.
Introduction
Cardiology is the study of the heart and the circulation it drives. It is one of the most examined and most practised parts of medicine, because heart and vessel disease is a leading cause of death and because so many other illnesses, from diabetes to kidney disease, end up damaging the circulation.
This section follows the way a clinician builds up the subject. You learn to examine the patient and read the ECG first, because almost every later topic depends on them. Then come the diseases of the coronary arteries, the failing pump and the muscle diseases behind it, the rhythm disorders, the valves and the sac around the heart, the two great risk factors (lipids and blood pressure), and finally the diseases of the great vessels, limb arteries, veins and lymphatics.
Every topic is written in the same layout: a short summary, what you should be able to do afterwards, the mechanism, the clinical picture, tests, treatment and the traps. Doses and thresholds are checked against named guidelines and are shown with their source, because different guidelines sometimes disagree.
How to study cardiology
Work through the contents in order for a first pass. The ECG and examination topics repay a second look after the rhythm and valve topics, when the patterns have a meaning.
For each topic, read the summary and the learning objectives first, then close the page and try to state the mechanism in your own words before reading it. Most cardiology facts follow from the mechanism: if you know why a lesion causes a murmur or why a drug lowers mortality, you do not need to memorise the fact separately.
Learn the emergencies as pathways rather than lists: chest pain, the unstable tachycardia, acute heart failure, tamponade, aortic dissection and the hypertensive emergency. Practise saying the first three actions aloud, and use the check-yourself questions at the end of each topic to test recall a few days later.
Where two guidelines give different numbers, such as blood-pressure thresholds or shock energies, learn the one your own examination or hospital uses, and know that the other exists. Content here is for study and does not replace local protocols or a senior clinician's judgement.
Contents by part
The topics below are in teaching order. Each part builds on the one before it.
- Bedside tools. Start with the two skills every later topic assumes: examining the heart and reading an ECG.
- Coronary artery disease. From the narrowed artery that causes effort pain to the blocked artery that causes infarction.
- Heart failure and the cardiomyopathies. The failing pump, then the diseases of heart muscle that cause it.
- Rhythm disorders and fainting. A systematic approach to fast rhythms, then each rhythm in turn, then the slow rhythms and the symptom that links them.
- Approach to tachyarrhythmias
- Supraventricular tachycardias
- Atrial fibrillation and atrial flutter
- Wolff-Parkinson-White syndrome
- Ventricular arrhythmias
- Long QT syndrome
- Bradyarrhythmias and atrioventricular block
- Syncope
- Inherited arrhythmia syndromes and sudden cardiac death
- Pacemakers, implantable defibrillators and
- Cardiac arrest and advanced life support
- Valves, pericardium and heart tumour. Structural disease around the chambers: valve lesions, the sac around the heart, and the one common benign tumour.
- Lipids and blood pressure. The two big modifiable risk factors, from prevention to emergency.
- Blood vessels and lymphatics. Disease of the aorta, the arteries of the neck and legs, the deep veins and the lymphatic system.
Topics
Electrocardiogram (ECG) interpretation
What the 12-lead ECG records and a systematic way to read it: rate, rhythm, axis, intervals, ischaemia, chamber enlargement, artefacts and who needs one.Checked against sourcesVerified 24 October 2026Bundle branch blocks
How bundle branch blocks and fascicular blocks arise, how to read them, and what they mean for ischaemia, syncope, pacing and resynchronisation.Checked against sourcesVerified 24 October 2026Cardiac imaging and stress testing
Choosing and interpreting cardiac imaging and stress tests: echocardiography, exercise ECG, stress echo, nuclear MPI, coronary CT and cardiac MRI.Checked against sourcesVerified 31 October 2026Perioperative cardiac assessment
Risk indices, functional capacity, testing and cardiac drugs around non-cardiac surgery: a current evidence-based approach.Checked against sourcesVerified 31 October 2026Chronic coronary syndrome and stable angina
What chronic coronary syndrome is, how stable angina arises, how to confirm it, and how to manage it over the long term.Checked against sourcesVerified 25 October 2026
Vasospastic (Prinzmetal) angina
Rest angina from transient coronary spasm: triggers, ECG changes, diagnosis, treatment, and arrhythmia risk.Checked against sourcesVerified 25 October 2026Unstable angina and NSTEMI
How acute coronary syndromes present as unstable angina or NSTEMI: definition, pathophysiology, diagnosis, troponin pathways, risk scores, and management.Checked against sourcesVerified 25 October 2026ST-elevation myocardial infarction (STEMI)
How coronary occlusion causes STEMI: ECG criteria and territories, reperfusion by PCI or fibrinolysis, antithrombotic drugs and post-infarct care.Checked against sourcesVerified 25 October 2026Post-myocardial infarction care and cardiac rehabilitation
Care after a heart attack: complications to watch for, secondary prevention, cardiac rehabilitation, and return to work, driving and daily life.Checked against sourcesVerified 31 October 2026MINOCA, Takotsubo syndrome and spontaneous coronary artery
MINOCA, Takotsubo and SCAD: definitions, mechanisms, diagnosis, imaging and management of myocardial infarction without obstructive coronary disease and.Checked against sourcesVerified 31 October 2026Heart failure
Heart failure: definition, classification by ejection fraction, stage and NYHA class, causes, diagnosis, four-pillar drug therapy, devices, acute care.Checked against sourcesVerified 24 October 2026Dilated cardiomyopathy
Left ventricular dilation with systolic dysfunction not explained by load or coronary disease: causes, tests, family screening, and HFrEF-based treatment.Checked against sourcesVerified 25 October 2026Hypertrophic cardiomyopathy (HCM)
A thick, stiff heart muscle that can obstruct outflow, cause breathlessness and fainting, and cause sudden death — and how treatment changes the outlook.Checked against sourcesVerified 25 October 2026Restrictive cardiomyopathy
Stiff ventricles that cannot relax: how restricted filling causes heart failure, from amyloid to fibrosis, and how to tell it from constrictive pericarditis.Checked against sourcesVerified 25 October 2026Myocarditis
Inflammation of the heart muscle: viral and immune causes, how cardiac MRI diagnoses it, management, and its link to dilated cardiomyopathy.Checked against sourcesVerified 31 October 2026Cardiogenic shock
A syndrome of low cardiac output and tissue hypoperfusion from cardiac dysfunction, its stages, inotropes and vasopressors, and mechanical circulatory support.Checked against sourcesVerified 31 October 2026Approach to tachyarrhythmias
The patient with a fast heart rate or palpitations: red flags, history, ECG, the unstable-patient rule, and the stable pathway by QRS width and regularity.Checked against sourcesVerified 24 October 2026Supraventricular tachycardias
Supraventricular tachycardias: sinus, atrial, AVNRT and AVRT types, the ECG approach, vagal manoeuvres, adenosine, cardioversion, ablation and special groups.Checked against sourcesVerified 24 October 2026Atrial fibrillation and atrial flutter
Atrial fibrillation and flutter: types, causes, ECG, emergency cardioversion, rate and rhythm control, ablation, and stroke prevention with CHA2DS2-VASc.Checked against sourcesVerified 24 October 2026Wolff-Parkinson-White syndrome
Ventricular pre-excitation through an accessory pathway: delta wave, AVRT, pre-excited AF and sudden death risk, why AV-nodal drugs harm, and ablation.Checked against sourcesVerified 24 October 2026Ventricular arrhythmias
PVCs, ventricular tachycardia, ventricular fibrillation and torsades de pointes: ECG recognition, cardiac arrest, drugs, ICDs and ablation.Checked against sourcesVerified 24 October 2026Long QT syndrome
Inherited and acquired long QT syndrome: repolarisation, QTc measurement, genotypes, torsades de pointes, diagnosis, beta-blockers, ICD, sport and pregnancy.Checked against sourcesVerified 24 October 2026Bradyarrhythmias and atrioventricular block
Slow heart rhythms and conduction block: sinus node disease, first- to third-degree AV block, emergency treatment and pacemaker indications.Checked against sourcesVerified 24 October 2026Syncope
Syncope is brief, self-limited loss of consciousness from cerebral hypoperfusion. Classify the cause, spot red flags, and choose tests and treatment.Checked against sourcesVerified 25 October 2026Inherited arrhythmia syndromes and sudden cardiac death
Brugada syndrome, CPVT and arrhythmogenic cardiomyopathy: how they are found, how families are screened, and how athletes stay safe.Checked against sourcesVerified 31 October 2026Pacemakers, implantable defibrillators and
How pacemakers, ICDs and CRT work, their pacing codes and indications, shocks, follow-up, and safe care in MRI and surgery.Checked against sourcesVerified 31 October 2026Cardiac arrest and advanced life support
Recognition of cardiac arrest, high-quality CPR, adult ALS algorithms, drugs, reversible causes and post-arrest care.Checked against sourcesVerified 31 October 2026Valvular heart disease
The main valve lesions: presentation, echo severity grading and timing of intervention, plus pregnancy, endocarditis prophylaxis and rheumatic fever prevention.Checked against sourcesVerified 25 October 2026Acute pericarditis
How to recognise, risk-stratify and treat inflammation of the pericardium, and tell it apart from a heart attack.Checked against sourcesVerified 25 October 2026Cardiac tamponade
Fluid or blood around the heart raises pressure until the chambers cannot fill. Recognise tamponade, read the echo and drain before shock kills.Checked against sourcesVerified 25 October 2026Atrial myxoma
A common benign heart tumour: how it blocks, embolises and inflames, how echocardiography finds it, and why it is removed urgently.Checked against sourcesVerified 24 October 2026Constrictive pericarditis
Stiff pericardium causing diastolic heart failure: signs, echo and catheter findings, management, and how to separate it from restriction and tamponadeChecked against sourcesVerified 31 October 2026Congenital heart disease in adults
Congenital heart disease that survives into adult life: common lesions, late complications, investigation and management in adults.Checked against sourcesVerified 31 October 2026Dyslipidaemia
How lipoproteins drive atherosclerosis, how to estimate cardiovascular risk, and how to lower LDL-C to guideline targets with lifestyle and drug therapy.Checked against sourcesVerified 25 October 2026Essential (primary) hypertension
Essential hypertension: definitions and BP thresholds by guideline, measurement, risk, and treatment from lifestyle to resistant hypertension.Checked against sourcesVerified 27 October 2026Secondary hypertension
Secondary hypertension: how to spot the identifiable causes of high blood pressure, test for them, and treat each one.Checked against sourcesVerified 25 October 2026Hypertensive crises
A severe rise in blood pressure with organ damage is a hypertensive emergency; a severe rise without it is not. How to recognise, assess and treat each.Checked against sourcesVerified 25 October 2026Atherosclerosis and cardiovascular risk assessment
How atherosclerotic plaque forms and ruptures, and how cardiovascular risk is assessed with SCORE2, PREVENT and pooled cohort equations.Checked against sourcesVerified 31 October 2026Aortic aneurysm
How aortic aneurysms form, who to screen, when to repair, and how to recognise and manage rupture.Checked against sourcesVerified 25 October 2026Aortic dissection
A tear in the aortic wall: recognising it fast, controlling aortic wall stress, and choosing emergency surgery or TEVAR.Checked against sourcesVerified 25 October 2026Peripheral arterial disease
Atherosclerotic narrowing of the lower limb arteries: how it causes claudication, rest pain and gangrene, how the ABI and duplex find it, and how to treat it.Checked against sourcesVerified 25 October 2026Carotid artery stenosis
Carotid artery narrowing as a cause of TIA and stroke: how to grade it, who benefits from endarterectomy or stenting, and how to treat the plaque.Checked against sourcesVerified 25 October 2026Deep vein thrombosis
Deep vein thrombosis: Virchow's triad, risk factors, diagnosis with Wells and D-dimer, imaging, anticoagulation dosing and duration, complications.Checked against sourcesVerified 25 October 2026Lymphoedema
Chronic swelling from lymphatic failure: recognition, staging and lifelong management of primary and secondary lymphoedema.Checked against sourcesVerified 25 October 2026Antithrombotic therapy: antiplatelets and anticoagulants
How aspirin, P2Y12 inhibitors, heparins, warfarin and DOACs prevent and treat clots, with dosing, reversal, durations and combinations across ACS, AF, VTE.Checked against sourcesVerified 31 October 2026Raynaud phenomenon and vasculitis of the limbs
Raynaud phenomenon and vasculitis of the limbs: primary and secondary Raynaud, scleroderma link, thromboangiitis obliterans, and treatment.Checked against sourcesVerified 31 October 2026