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IMF-012-02-0001-en	Why do cardiovascular symptoms so often appear only during exertion?	Rising demand exposes reserve that is sufficient at rest but limited under load.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0002-en	A patient denies exertional symptoms yet appears to be deteriorating. What line of history uncovers this?	Asking what they have stopped doing, since walking, stairs, carrying and pace are often reduced gradually.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0003-en	What does the a wave of the jugular venous waveform reflect, and why does it disappear in atrial fibrillation?	It reflects atrial contraction, which fibrillation abolishes.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0004-en	What physiological question does the hepatojugular test ask, and what does a sustained rise mean?	Whether the right heart can accommodate a transient increase in venous return; a sustained rise supports elevated filling pressure.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0005-en	In which circumstances do dynamic manoeuvres become unreliable for separating murmurs?	Tachycardia, low output, obesity, poor cooperation, or multiple coexisting lesions.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0006-en	A new murmur appears after myocardial infarction with pulmonary oedema or shock. What does this suggest, and what sets the urgency?	Acute mechanical complication; urgency follows the physiological consequence, not the auscultatory finding.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0007-en	Which technical errors can imitate axis change, infarction, or poor R wave progression?	Limb-lead reversal and misplaced chest leads.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0008-en	Why assess rate and rhythm before morphology on an electrocardiogram?	The sequence stops one dramatic feature from capturing attention before atrial activity and ventricular activation are settled.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0009-en	Computed-tomography coronary angiography shows a stenosis. Why does this not establish the cause of the symptoms?	Anatomical stenosis does not always establish that flow limitation is producing them.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0010-en	A stress test is negative. Which technical explanation must be excluded before treating that as reassurance?	The patient may not have reached adequate stress.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0011-en	What does troponin indicate, and what do natriuretic peptides indicate?	Troponin indicates myocardial injury; natriuretic peptides indicate myocardial wall stress.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending
IMF-012-02-0012-en	Creatinine worsens during diuresis. What can that represent?	Altered haemodynamics, persistent congestion, true injury, or a mixture, so read it with volume, pressure, urine output, electrolytes and symptoms.	Integrated Medical Foundations; chapter 12, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cc9e28338ab6d37ea9e4e47a9f865649aa5d45f25e28459ffa9ff4f37cbc1868; editorial review pending	imf lang::en chapter::012 module::012-02 review::pending