…Initial evaluation of bradycardia according to ABCDE. Symptoms of bradycardia Bradycardia may be an incidental and asymptomatic finding. The absence of symptoms indicates that the…

…CAC on a non gated chest CT, can modify the estimated likelihood of atherosclerotic obstructive CAD. CAC is therefore not merely an incidental imaging finding…

…CAC findings incidentally identified on a chest CT performed for another indication can also contribute to risk assessment. Visual reporting of coronary calcification using four…

…evaluated. The findings were as follows: The absence of a pupillary reflex demonstrated a sensitivity of 72.2% for predicting an unfavorable neurological outcome, indicating…

…exercise. Mechanisms of cardiac arrhythmias The mechanisms underlying cardiac arrhythmias are being unraveled at an accelerating pace, making arrhythmology a field of intense research activity…

…on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is an acute or subacute worsening of dyspnoea, cough and…

…of the commonest minor procedures in general practice concern the nails, and all three rest on the same foundation: an effective digital block and a…

…basis of the haemodynamics, not the volume of fluid. A litre that has accumulated slowly can be asymptomatic, while 150 mL collected over an hour…

…injection has gone to the right place — immediate pain relief is a diagnostic finding — and appears to reduce the risk of a post injection flare…

…chosen finding — measurement, photograph or video. 3. Give atropine 0.5 mg intravenously (alternatively glycopyrronium 0.2 mg) to reduce the risk of a cholinergic…

…6. Which of the following ECG findings is generally considered a normal variant in asymptomatic athletes and typically does not require further evaluation, assuming no…

…Procedure Batteries and magnets A button battery in the nose or the ear canal is an emergency, not a finding that can wait until the…

…it encounters a refractory right bundle branch and therefore the impulse is conducted with right bundle branch block morphology. This is an example of how…

…A single central feature is enough to proceed with urgent investigation , and a normal CT of the brain does not exclude an infarction in the…

…in hypoxaemia, repeated doses of an inhaled short acting β2 agonist, ipratropium in more severe attacks, and a systemic steroid given early [2,3]. Grading…

…a negative T wave in adults. III and aVL may occasionally display an isolated (single) T wave inversion. The term isolated implies that none of…

…dysfunction caused by a dysregulated host response to infection. Clinically this usually corresponds to an acute increase in the SOFA score of at least 2…

…pneumatic otoscopy: a slight change of pressure with the bulb shows whether the tympanic membrane is mobile — an immobile membrane suggests fluid in the middle…

…AV block. A shortened PR interval (<0,12 s) indicates pre excitation (presence of an accessory pathway). This is associated with a delta wave. For…

…only cause an irregularity of the contour of the T wave. Finding the P wave is a requirement for establishing a diagnosis of sinus tachycardia…

…fibrinolysis (Wilner et al.). Their findings revealed that a substantial number of these patients had complete coronary artery occlusions, and outcomes improved when they were…

…absence of a major residual epicardial obstruction. No reflow is associated with serious short and long term outcomes. Its occurrence is associated with an approximately…

…once the exercise is stopped. Some experts believe that these ST segment depressions represent a benign form of subendocardial ischemia. Refer to Exercise Stress Testing…

…effect and a negative chronotropic effect, enhancing ventricular contractility while lowering heart rate. The positive inotropic effect is due to the inhibition of the sodium…

…which is considered a normal finding. Pathological tricuspid regurgitation is more pronounced. Echocardiography is the preferred method for diagnosing tricuspid regurgitation. Causes of tricuspid regurgitation…

…subdivided into three layers: the inner lining ( endocardium ), a thick muscle layer ( myocardium ) and an outer lining ( epicardium ). The myocardium is the thick muscle layer…

…nonspecific finding. In patients presenting with angioedema, a rapid assessment of the airway is paramount to evaluate for impending respiratory compromise. Diagnostics The diagnosis of…

…Autoimmune/Malignancy: A history suggesting an autoimmune disorder or known malignancy may suggest specific, nonidiopathic etiologies [2]. Summary of Pain Characteristics The following table synthesizes…

…risk patients regardless of ECG findings. Thush, it serves as a valuable diagnostic tool and educational model, promoting earlier identification and treatment of high risk…

…as a standardized framework for identifying and localizing areas of ischemia or infarction. This segmentation facilitates precise reporting and ensures consistent communication of findings across…

…Myocardial ischemia and infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute myocardial ischaemia, electrocardiographic findings…

…the ECG findings dictate the management of acute coronary syndromes. Hence, an ECG must be performed and interpreted within 10 minutes of arrival to the…

…an algorithm, as it minimizes the risk of missing important abnormalities and also speeds up the interpretation. Note that this chapter is preceded by a…

…is commonly a consequence of increased resistance to empty blood into the right ventricle. This may be due to pulmonary valve stenosis, increased pulmonary artery…

…This saturation effect can lead to an underestimation of blood flow in regions affected by significant coronary artery disease, potentially resulting in false negative findings…

…out of hospital cardiac arrest should not routinely undergo immediate angiography. A selective or delayed approach is recommended in this setting unless other findings justify…

…in terms of morphology (appearance), durations and intervals. A rather extensive discussion is provided in order to give the reader firm knowledge of normal findings …

…with asthma/chronic obstructive pulmonary disease (COPD). Dyspnea has been reported in patients treated with ticagrelor. Patients with a history of ischemic stroke can be…

…regardless of all other circumstances. The initial rhythm is an indicator of the underlying etiology, duration of cardiac arrest, quality of CPR, and a prognostic…

…mmHg and a saturation < 90 per cent. An sPESI of 0 indicates low risk. Anticoagulation A DOAC is the first choice in pulmonary embolism…

…needed. Intubate for a threatened airway, a marked risk of aspiration, or failure that is not rapidly reversed by an antidote B Respiratory rate, saturation…

…dosing Definition and Pathophysiology Bradycardia encompasses a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within the context of acute coronary syndromes…

…these findings increase diagnostic confidence. The presence of symptoms alone is insufficient. Anaemia and pulmonary, renal, thyroid or hepatic disease may produce a similar symptom…

…prevention and reduction of LDL C, non HDL C and apolipoprotein B. Causes and secondary contributors A search for secondary contributors is an essential first…

…diabetes mellitus Atherosclerotic cardiovascular events HF and atrial fibrillation Obesity therefore acts both as an independent cardiovascular risk factor and as a driver of hypertension…

…particularly an occluded bypass graft; in such cases, clinical manifestations may be less dramatic despite a sudden deterioration in function. The severity of tissue injury…

…than a stable dialysis patient with a plasma potassium of 6.6 mmol/L and an unchanged ECG. Both, however, need rapid assessment and an…

…is an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature…

…hypertension is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive ventilation or intubation. Aortic disease An acute aortic…

…therapeutic studies of pulmonary arterial hypertension (PAH). The threshold is not absolute: patient phenotype, risk factors for heart failure with preserved ejection fraction, echocardiographic findings…

…are associated with an excellent prognosis, whereas discordant measurements require interpretation in the context of the clinical presentation and other findings. A reduced CFR may…

…relation to ACE inhibitor therapy. Biomarkers and Laboratory Findings Monitoring renal function and potassium is a critical component of ACE inhibitor therapy. Blood pressure (including…

…periods of the atrium, atrioventricular (AV) node, His Purkinje system, and ventricle. It extends the A H interval, which serves as an index of AV…

…Clear focal neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination is therefore not sufficient to…

…of diastolic pressures in the cardiac chambers, with chamber pressures approaching intrapericardial pressure. The jugular venous waveform typically has a prominent x descent and an…

…provoked by less exertion. Angina occurring after a recent myocardial infarction. UA belongs to the broader spectrum of acute coronary syndromes, which may present with…

…cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting the relevant variant to each child. However…

…and a narrow neck. These findings may reflect plaque disruption or thrombus. A rounded or polypoid intraluminal mass and lesion haziness raise suspicion of thrombus…

…which is a manifestation of post cardiac injury syndrome (PCIS). PCIS is an umbrella term that also includes post pericardiotomy syndrome and post traumatic pericarditis…

…an indicator of increased cardiovascular risk and a setting in which secondary hypertension is relatively common. Patients presumed to have resistant hypertension should undergo a…