…A joint prosthesis: the aspiration must be performed by an orthopaedic surgeon under strictly sterile conditions. For corticosteroid injection there is an additional absolute contraindication…

…under acute coronary syndromes (ACS). Aortic dissection Pneumothorax Pulmonary embolism Mediastinitis (rare condition) In addition to these five conditions, there are numerous other causes of…

…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…

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

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

…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…

…ventricular function is therefore an important therapeutic objective. Exercise intolerance Exercise limitation is multifactorial. In addition to elevated exercise induced filling pressures, patients may have:

…and can develop gradually over several days to weeks. More acute endocarditis is often caused by staphylococcus auerus . This usually affects drug users (intravenous addiction)…

…pacing. 25 mm/s. In addition to stimulation artifacts, ventricular pacing yields wide QRS complexes with LBBB morphology (i.e left bundle branch block appearance)…

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

…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…

…question): A fracture of the bone to be punctured, or a major injury proximal to the puncture site. A joint prosthesis or orthopaedic metalwork in…

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

…myocardial territory through the left anterior descending (LAD) and left circumflex (LCx) arteries (Figure 1). Acute obstruction can lead to rapid hemodynamic deterioration, cardiogenic shock…

…high value As required, in addition to the mealtime dose Never stop basal insulin in a person with type 1 diabetes , not even before fasting…

…receiving background statin therapy and in those unable to tolerate statins, provided that hepatic LDL receptor expression is present. Additional lipid effects include: Approximately 25%…

…Additional pharmacological options include quinidine, ranolazine, and procainamide [4]. Catheter Ablation : Catheter ablation may be employed as an interventional alternative to suppress the arrhythmia [4…

…The diagnosis requires elevated levels of cardiac troponins. In addition to elevated troponins, the patient must display either symptoms or ECG changes consistent with myocardial…

…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…

…Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in the adjacent joint. Known hypersensitivity to the preparations. Relative: Poorly controlled diabetes — expect a…

…combined dyslipidaemia, non HDL C is particularly relevant because it captures triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk…

…heart disease and GUCH Complex malformations often require intervention (surgical or catheter based intervention). In addition to the malformation, these subjects frequently develop associated complications…

…L). Reasonable addition of a non statin agent when LDL C is 55–69 mg/dL (≥1.4 to <1.8 mmol/L). Non statin…

…after hospitalization for heart failure is 60%, which is comparable to common cancers ( Stewart et al ). In addition, heart failure is a disabling condition with…

…after hospitalization for heart failure is 60%, which is comparable to common cancers ( Stewart et al ). In addition, heart failure is a disabling condition with…

…inventions of the 20th century. Cardiac pacing has evolved from a hazardous experiment in the 1930s, to a routine, safe, and sophisticated treatment used worldwide…

…without any recurring costs. Purchasing this membership grants you permanent access to the website and there are no additional costs and no recurring costs. Ever.

…Addison's disease, renal failure, tamoxifen, lithium, thiazide diuretics, D vitamin and calcium overdose. ECG changes due to hypercalcemia Common ECG changes Shortened QT interval…

…earlier identification and treatment of high risk ACS patients. Future randomized trials are needed to validate this paradigm and support its broader adoption. Figure 1…

…of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization, sarcoidosis, thyrotoxicosis, familial hypocalciuric hypercalcemia, Addison's disease, renal insufficiency…

Introduction to Coronary Atherosclerosis, Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by…

…if leads I, II and III would have been displayed next to each other, the T wave inversion in lead III would not be consistent…

…Addisonian crisis, hydrocortisone must be given immediately — the test must never delay treatment. Indications Suspected primary adrenal insufficiency (Addison's disease): fatigue, weight loss, hyperpigmentation…

…weight, smoking, diet, physical inactivity, and alcohol consumption. Additional considerations include psychosocial stress, obstructive sleep apnoea, social determinants of health, air pollution, family history, ethnicity…

ECG Myocardial ischemia and infarction Using the ECG to localize myocardial infarction and the coronary occlusion Determining the localization of myocardial infarction and ischemia, as…

…exclusively at the infarct related artery (IRA), or it may extend to additional non infarct related lesions. Culprit only revascularization treats the artery responsible for…

…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…

Myocardial ischemia and infarction Definition and Pathophysiology Left main coronary artery disease (LMCAD) refers to atherosclerotic narrowing of the left main coronary artery, which supplies…

…additional mechanisms include vascular stiffness and accelerated medial calcification related to disturbed calcium–phosphate metabolism. Patients with advanced CKD are particularly vulnerable to structural cardiac…

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

…on at least 2 days each week. Activities need not be undertaken in bouts of at least 10 minutes; shorter episodes also contribute to health…

…s leads etc). Note that in some situations it is appropriate to connect additional electrodes in order to detect right ventricular infarction (leads V3R, V4R…

…RVD 2), cm 2.7–3.3 3.4–3.7 3.8–4.1 4.2 Base to apex length (RVD 3), cm 7…

…The infusion is diluted to 4 mg/ml and administered over 10 minutes. A maximum of two infusions can be given. Each infusion should be…

…confirmed hypertension generally require BP lowering treatment without additional risk stratification for that treatment decision. Population to which SCORE2 and SCORE2 OP apply SCORE2 and…

…lowering and other guideline directed therapies. Anti inflammatory treatment seeks to reduce this residual risk without necessarily altering lipid concentrations, blood pressure or other conventional…

Cardiology Nephrology Definition and terminology Contrast associated acute kidney injury is an acute deterioration in renal function occurring after exposure to iodinated contrast media, particularly…

…ACS Approximately 20–25% additional reduction compared with simvastatin monotherapy Bempedoic acid plus ezetimibe Approximately 38% reduction PCSK9 inhibitor added to statin therapy Approximately 60…

…CTOs are common among patients undergoing coronary angiography, with reported prevalence ranging from 18% to 52%. They frequently occur in patients with severe coronary artery…

Myocardial ischemia and infarction Definition and pathophysiology Periprocedural myocardial infarction (MI) is myocardial necrosis temporally related to coronary revascularization. It may follow percutaneous coronary intervention…

…and infarction Definition and clinical rationale Stable angina, or chronic chest pain attributable to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of…

…and an additional trigger is required. Potential triggers include thrombus formation and sympathetic activation. Rho kinase may increase vascular smooth muscle sensitivity to calcium by…

…sudden cardiac arrest is common. The following cardiomyopathies lead to dilation of the ventricle: Dilated cardiomyopathy (DCM) Idiopathic or genetic . Ischemic cardiomyopathy Alcoholic cardiomyopathy Diabetic…

…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…

…CKD), facilitating early intervention and management. Standardization: Its widespread adoption has led to standardized reporting of eGFR in clinical laboratories, enhancing consistency in patient care…

…which must be tapered in a controlled fashion). The management is the opposite in each case. Equivalent doses Agent Equivalent glucocorticoid dose Mineralocorticoid effect Biological…

…normal normal or enlarged enlarged Size left ventricle normal normal or enlarged enlarged Additional PISA parameters Mild regurgitation Moderate regurgitation Severe regurgitation EROA (cm²) <…

…36 mm 13 17 mm/m2 Aortic arch 22 36 mm Descending aorta 20 30 mm ​Adjustment refers to adjusting for body surface area (BSA)…

…jet reaching liver veins Additional quantitative parameters Mild regurgiation Moderate regurgitation Severe regurgitation Jet size < 5cm² 5 10 cm² 10 cm² size vena cava…