…condition) In addition to these five conditions, there are numerous other causes of chest pain, but the other causes are either subacute or non acute…

…exercise capacity (and VO2 max , see below). In addition to exercise capacity, stress testing also provides information on electrocardiographic (ECG) reaction, the occurrence of arrhythmias…

…In addition to the gel, it is important to apply some pressure when holding the transducer against the skin. Patients with extensive subcutaneous fat require…

…disease or familial hypercholesterolaemia, addition of bempedoic acid to statin therapy reduced LDL C by approximately 16.5%; the reduction in a subgroup with diabetes…

…contractility. Analogous electrophysiological changes occur within the sinus and atrioventricular (AV) nodes. In addition to these direct effects, adenosine antagonizes catecholamine stimulated adenylate cyclase. This…

…is associated with poor outcomes. Preserving right ventricular function is therefore an important therapeutic objective. Exercise intolerance Exercise limitation is multifactorial. In addition to elevated…

…drug users (intravenous addiction), elderly patients with altered valves, patients with valve prostheses or other cardiac devices (pacemaker, CRT, ICD). In addition to staphylococcus aureus …

…mm/s. In addition to stimulation artifacts, ventricular pacing yields wide QRS complexes with LBBB morphology (i.e left bundle branch block appearance). This is…

…its surroundings, the myocardium and valves. ECG is recorded in all patients with suspected pericardial disease. In addition to echocardiography, ECG and clinical examination, blood…

…EMS) is trained in BLS. It is increasingly common to dispatch first responders to OHCA, in addition to ambulances. Chest compressions are prioritized above ventilations…

…bag or a 50 mL syringe with a three way tap — intraosseous flow requires pressure ; gravity is not enough. Lidocaine 10 mg/mL to anaesthetise…

…for detecting valvular regurgitation and defects in the atria or ventricles (Figure 2). In addition, color Doppler can be used to align the continuous Doppler…

…with severe chest pain, diaphoresis, hypotension, pulmonary edema, malignant arrhythmias, and rapid progression to cardiogenic shock. Ventricular fibrillation or asystole may occur early due to…

…required, in addition to the mealtime dose Never stop basal insulin in a person with type 1 diabetes , not even before fasting or an investigation…

…therefore contributes to higher LDL C concentrations. The genetic evidence provides the rationale for therapeutic inhibition. Gain of function PCSK9 mutations are associated with familial…

…Administered to reduce adrenergic stimulation [4]. Sedation and Intubation : Along with anxiolytics, these measures minimize sympathetic surges [4]. Surgical Interventions : Stellate ganglion block (SGB) or…

…levels of cardiac troponins. In addition to elevated troponins, the patient must display either symptoms or ECG changes consistent with myocardial infarction/ischemia. Most patients…

…duration of 120 ms (0.12 s) or more is required to diagnose a complete left bundle branch block . In addition to prolonged QRS duration…

…hypersensitivity to the preparations. Relative: Poorly controlled diabetes — expect a raised blood glucose for 2–5 days. Suspected or known tendon rupture. No response to…

…in addition to LDL and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years without diabetes and with LDL…

…catheterization. Principles of management of congenital heart disease and GUCH Complex malformations often require intervention (surgical or catheter based intervention). In addition to the malformation…

…patients with ACS to reduce major adverse cardiovascular events. Therapy should preferably begin before planned percutaneous coronary intervention when feasible. Patients already taking low or…

…which is comparable to common cancers ( Stewart et al ). In addition, heart failure is a disabling condition with a very negative impact on quality of…

…which is comparable to common cancers ( Stewart et al ). In addition, heart failure is a disabling condition with a very negative impact on quality of…

…1930s, to a routine, safe, and sophisticated treatment used worldwide. Artificial pacemakers have benefitted immensely from advances in engineering, notably with the advent of transistors…

…interpreted systematically. Failure to perform systematic interpretation may actually be detrimental. We have therefore compiled a pocket guide with a universal interpretation algorithm. These 22…

…narrow at the top. Refer to Figure 1 . Patients with left ventricular hypertrophy may instead display normalization of secondary T wave inversions (lead V5, V6…

…reperfusion therapy. This approach fails to identify a substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting…

…to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization, sarcoidosis, thyrotoxicosis, familial hypocalciuric hypercalcemia, Addison's disease, renal insufficiency, therapeutic interventions with tamoxifen or…

…Unstable Angina presents with clinical and/or electrocardiographic signs of myocardial ischemia but lacks this biomarker elevation. With the ubiquitous adoption of hs cTn assays…

…is, from left superior basal to right inferior. In other words, the following order: aVL, I, −aVR (i.e., lead aVR with reversed polarity), II…

…hypersensitivity to tetracosactide or ACTH. Marked atopic disease, particularly severe asthma and a history of anaphylaxis — a relative contraindication; the test is then performed with…

…strategies aim to shift risk across the whole community through healthier environmental defaults, whereas individual level prevention focuses more intensively on people with elevated risk…

…For instance, administering nitroglycerin to alleviate ischemic chest pain may lead to hemodynamic collapse in patients with right ventricular ischemia or infarction. Recognizing ECG signs…

…ACS) with multivessel coronary artery disease (MVD), revascularization may be directed exclusively at the infarct related artery (IRA), or it may extend to additional non…

…used as an adjunct to dietary measures and maximally tolerated statin therapy, with or without other LDL C lowering drugs, when additional LDL C reduction…

…recommendations are not restricted to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the documented ischaemic…

…with demonstrated cardiovascular effects. Diabetes may also contribute to arrhythmogenesis through diabetic neuropathy and adverse metabolic effects, independently of coexisting CAD, previous myocardial infarction or…

…survive with severe, diffuse CAD that is no longer amenable to additional mechanical revascularization. Despite treatment with antianginal drugs and PCI or CABG, daily or…

…activity undertaken to maintain or improve physical fitness. Regular physical activity is a central component of cardiovascular prevention and treatment. It is associated with lower…

…refer to ECG leads or Additional leads in acute myocardial infarction). Importance of performing ECG during ongoing chest pain It is of paramount importance to…

…almost not compressible Additional qualitative parameters Mild regurgiation Moderate regurgitation Severe regurgitation Coaptation defect mild moderate severe Size right ventricle normal normal or enlarged enlarged…

…as the patient can convert to sinus rhythm. Dose adjustments Patients with body weight 113 kg : The initial dose is 339 mg (84.7 ml…

…Population to which SCORE2 and SCORE2 OP apply SCORE2 and SCORE2 OP are intended for apparently healthy people or for individuals with elevated BP who…

…additional therapy alongside standard treatment. Interleukin 1β inhibition Canakinumab reduced inflammatory biomarkers without affecting lipids or other major coronary risk factors. In patients with…

…dysfunction or haemodynamic instability; and additional nephrotoxic exposures. The typical biochemical pattern is a rise in serum creatinine beginning 24–48 hours after exposure, with…

…additional reduction compared with simvastatin monotherapy Bempedoic acid plus ezetimibe Approximately 38% reduction PCSK9 inhibitor added to statin therapy Approximately 60% reduction Inclisiran, with or…

…it may present with chronic angina, an anginal equivalent or exertional dyspnoea. Patients may continue to have lifestyle limiting symptoms despite guideline directed medical therapy…

…troponin rise, with thresholds differing for PCI and CABG; and At least one additional indicator of new myocardial ischemia or procedural coronary compromise. When preprocedural…

…symptoms are severe, refractory to guideline directed medical therapy, occur at a low level of exertion, or are associated with high event risk. The apparent…

…defined. Proposed contributors include hypercontractility or hypersensitivity of coronary vascular smooth muscle to vasoconstrictor stimuli, including adrenergic agonists, leukotrienes, and serotonin. In patients with CAD…

…ultimately lead to ventricular dilation. However, the term dilated cardiomyopathy (DCM) refers to idiopathic or genetic dilation of the left ventricle . Patients with DCM typically…

…These additional leads are V3R, V4R and V7. V3R and V4R are used in children under the age of 5 years due to the fact…

…possess an additional pathway between the atria and the ventricles. Such pathways may be conductive, such that they can transmit the atrial impulse to the…

…derived from a study population primarily consisting of individuals with CKD, limiting its accuracy when applied to healthy populations or those with acute kidney injury…

…dosing in known adrenal insufficiency A patient with primary adrenal insufficiency (Addison's disease), secondary adrenal insufficiency or long term corticosteroid treatment cannot increase their…

…variable dense Size left atrium normal normal or enlarged enlarged Size left ventricle normal normal or enlarged enlarged Additional PISA parameters Mild regurgitation Moderate regurgitation…

…variable dense Size left atrium normal normal or enlarged enlarged Size left ventricle normal normal or enlarged enlarged Additional PISA parameters Mild regurgitation Moderate regurgitation…

…almost not compressible Additional qualitative parameters Mild regurgiation Moderate regurgitation Severe regurgitation Coaptation defect mild moderate severe Size right ventricle normal normal or enlarged enlarged…

…underlying genetic abnormality is yet to be discovered. Diagnosis of this syndrome is based on ECG, family history and clinical presentation. Patients present with syncope…