Cardiology Pathways

25 pathways

Work through 25 interactive cardiology decision pathways — branching, guideline-grounded workflows that take you from presentation to assessment, risk stratification and management. Each pathway cites its source (NICE, ESC, AHA and specialty guidance), embeds the relevant calculators, and makes escalation and safety-netting explicit. For decision support only — apply clinical judgement and local protocols.

Acute Heart Failure

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

ESC 2021 Heart Failure Guidelines; NICE NG106
NSTEMI / Unstable Angina

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

ESC 2020 NSTEMI Guidelines; NICE NG185
New-Onset Atrial Fibrillation

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

ESC 2020 AF Guidelines; NICE NG196
Hypertensive Emergency

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

ESC/ESH 2018 Hypertension Guidelines; NICE NG136
Bradycardia Management

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

Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
Ventricular Tachycardia / Fibrillation

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

Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Syncope Assessment

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

ESC 2018 Syncope Guidelines; NICE NG109
Stable Angina Assessment and Management

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

NICE NG185; ESC 2019 Chronic Coronary Syndromes Guidelines
Infective Endocarditis

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

ESC 2023 Infective Endocarditis Guidelines; NICE NG41
STEMI & Reperfusion

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

ESC 2023 ACS Guidelines; NICE NG185
Acute Pericarditis

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

ESC 2015 Pericardial Diseases
Acute Aortic Syndrome / Dissection

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

ESC 2014 Aortic Diseases; ACC/AHA 2022
Cardiogenic Shock

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

ESC 2023 ACS; SCAI 2019
Cardiac Tamponade

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

ESC 2015 Pericardial Diseases
Chronic Atrial Fibrillation Management

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

NICE NG196; ESC 2024 AF Guidelines
Heart Failure — GDMT Optimisation

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

ESC 2021 HF; NICE NG106
Paroxysmal SVT (AVNRT / AVRT)

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

ESC 2019 SVT; AHA/ACC/HRS 2015
Wolff-Parkinson-White Syndrome

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

ESC 2019 SVT; AHA 2015
Atrial Flutter Management

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

ESC 2024 AF/flutter; AHA/ACC/HRS
Acute Valvular Emergency

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

ESC 2021 Valvular HD; AHA/ACC 2020
Acute Pulmonary Hypertension / RV Failure

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

ESC/ERS 2022 Pulmonary Hypertension
Pacemaker / ICD Complications

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

ESC 2021 CIED; HRS 2017 device infection
Acute Myocarditis

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

ESC 2013 Myocarditis Position; AHA 2020
Adult Congenital Heart Disease — ED Presentation

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

ESC 2020 ACHD; ACC/AHA 2018 ACHD
Perioperative Cardiac Risk Assessment

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

ESC 2022 Non-Cardiac Surgery; ACC/AHA 2014