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IMF-012-01-0001-en	Why must history, examination, electrocardiography, biomarkers and imaging be integrated in cardiovascular assessment?	The same finding can arise from different mechanisms, so no single source settles the cause.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0002-en	Exertional pressure suggests myocardial ischaemia, but which complaints can be ischaemic equivalents?	Burning, indigestion, dyspnoea, fatigue, or nausea.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0003-en	Chest pain is reproduced by palpation. What does that support, and what does it fail to establish?	It supports a musculoskeletal source but does not absolutely exclude coexisting cardiac disease.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0004-en	By what mechanism does lying flat provoke orthopnoea?	Supine posture increases venous return and redistributes blood in a patient whose cardiac reserve is limited.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0005-en	Why is paroxysmal nocturnal dyspnoea more specific for congestion than simple breathlessness?	It wakes the patient after a period of sleep, a timed pattern ordinary breathlessness does not follow.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0006-en	Why is a pulse or wearable recording taken during palpitations more useful than the patient's later description?	It captures the actual rhythm, whereas a retrospective adjective does not reliably separate ectopy, tachycardia and irregular rhythm.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0007-en	What defines syncope in physiological terms?	Transient loss of consciousness caused by global cerebral hypoperfusion, with rapid recovery.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0008-en	Which features of a syncopal episode raise risk?	Exertional or supine syncope, structural heart disease, family history of sudden death, abnormal electrocardiogram, bleeding, or persistent instability.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0009-en	What does a slow-rising, low-volume pulse suggest?	Severe outflow obstruction.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0010-en	What haemodynamic state produces a collapsing pulse?	High stroke volume with rapid diastolic runoff.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0011-en	What does jugular venous pressure estimate, and how is its height measured?	Right-atrial pressure, measured as the vertical height of internal jugular pulsation above the sternal angle.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0012-en	An elevated jugular venous pressure suggests which mechanisms?	Volume overload, right-heart failure, tamponade, constriction, or obstruction.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0013-en	What does a rise in jugular venous pressure during inspiration indicate?	Impaired right-sided filling.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0014-en	What generates a third heart sound, and what generates a fourth?	The third arises from rapid ventricular filling, the fourth from atrial contraction into a stiff ventricle.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0015-en	Why does murmur intensity fail to indicate lesion severity, especially when flow is low?	Intensity reflects flow across the lesion as much as the lesion itself, so a severe lesion with reduced flow can sound quiet.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0016-en	What do dynamic manoeuvres alter, and why does that clarify a murmur?	They alter venous return, afterload, chamber size, or outflow, and the resulting change in the murmur points to its mechanism.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0017-en	Peripheral oedema is present. Why does that not establish heart failure?	Kidney, liver, venous, lymphatic and medication causes can produce the same finding.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0018-en	A twelve-lead electrocardiogram is normal. What does that fail to exclude?	Intermittent arrhythmia and acute coronary disease.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0019-en	Why is correlating symptoms with the recorded rhythm more important than simply finding an abnormality on a monitor?	Incidental ectopy can be present without explaining the patient's events.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0020-en	How should a troponin result be interpreted?	Through assay-specific timing and the change between samples, not a single value alone.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0021-en	Which factors make a natriuretic peptide concentration harder to interpret?	Age, obesity, kidney function, rhythm, and acute strain.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0022-en	What determines which cardiac investigation is the best one to order?	Pre-test probability and the decision that the result will change.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0023-en	Why can the ankle-brachial pressure index be falsely high, and what may help then?	Calcified incompressible vessels, especially in diabetes or kidney disease; toe pressure or waveform assessment may help.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending
IMF-012-01-0024-en	Which vascular presentations must never have treatment delayed by testing?	Clinically evident limb-threatening occlusion, ruptured aneurysm, and unstable obstruction.	Integrated Medical Foundations; chapter 12, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: afdf5df1feefa48d4d9529f35bcc2b59c73c86af613949f540531d8976142a73; editorial review pending	imf lang::en chapter::012 module::012-01 review::pending