…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…

…the index marker is used to determine left and right in the obtained image. Figure 1 illustrates how the index marker is used for orientation…

…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:

…Mural vegetations are attached to the endocardium and, accordingly, less mobile. Echocardiography is the first place method for detecting vegetation in case of suspicion of…

…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…

…obtained for visualizing the pericardium, its surroundings, the myocardium and valves. ECG is recorded in all patients with suspected pericardial disease. In addition to echocardiography…

CPR Time is the most critical factor for survival in cardiac arrest. Life saving interventions must be initiated momentarily to maximize the probability of survival…

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

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

…panel A for cross modality comparison. Clinical features Occlusion of the left main coronary artery (LMCA) abruptly interrupts blood flow to both the left anterior…

…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…

…cholesterol (LDL C). Increased PCSK9 activity therefore contributes to higher LDL C concentrations. The genetic evidence provides the rationale for therapeutic inhibition. Gain of function…

…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…

…A joint prosthesis in the adjacent joint. Known hypersensitivity to the preparations. Relative: Poorly controlled diabetes — expect a raised blood glucose for 2–5 days…

…it captures triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years…

…25% of children with congenital heart disease require intervention during their first year of life ( Triedman et al ). According to the European Society for Cardiology…

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

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

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

…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.

…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…

…of patients with acute coronary occlusion (ACO) who do not meet the established ECG criteria for STEMI, leading to delays in potentially life saving interventions…

…tool for detecting and assessing the severity of electrolyte disturbances, particularly before laboratory results are available. Notably: Both hyperkalemia and hypokalemia can induce life threatening…

…The transition from a quiescent plaque to a highly thrombogenic surface occurs via three primary mechanisms: Plaque Rupture: Accounting for 60 70% of ACS presentations…

…the chest leads (V1 through V6) are displayed on the ECG paper in their anatomically contiguous order from right anterior (V1) to left lateral (V6)…

…be given dexamethasone. That is the practical key: the patient does not have to be left unprotected for the test to be interpretable. Procedure 1…

…factors make a particularly large contribution to cardiovascular disease. Hypertension is a major component of this burden, followed by non HDL cholesterol. For myocardial infarction…

…de Winter's sign, widespread ST segment depressions) that point to the left anterior descending artery (LAD) as the culprit. The coronary arteries: a brief…

…or it may extend to additional non infarct related lesions. Culprit only revascularization treats the artery responsible for the acute clinical event during the index…

…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…

…presentations Left main disease may be clinically silent, and revascularisation recommendations are not restricted to patients with symptoms. Current guidance supports revascularisation for significant left…

…vulnerable to structural cardiac abnormalities, HF and sudden cardiac death. The relationship between glycaemia and cardiovascular disease is complex. Glycaemic control is important for prevention…

…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…

…Balance exercises Flexibility exercises Walking, yoga and gardening may provide useful activity for individuals who are reluctant to undertake formal exercise. Increasing movement during daily…

…to connect additional electrodes in order to detect right ventricular infarction (leads V3R, V4R, V5R, V6R) and posterolateral infarction (leads V7, V8, V9). Criteria for…

…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…

…If conversion to sinus rhythm is not successful, blood pressure and ECG should be observed for an additional 15 minutes after the completion of the…

…to age and the presence of concomitant risk factors. In contrast, patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification for…

…previous acute coronary syndrome. The available evidence supports consideration of low dose colchicine as an adjunct to, rather than a replacement for, established secondary prevention…

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…

…bempedoic acid in selected patients, particularly those with statin intolerance or persistent failure to reach goal. For statin intolerant patients, ezetimibe may be used initially…

…equivalent symptoms. The response to GDMT. The extent of myocardial ischaemia. The presence of viable myocardium supplied by the occluded vessel. Left ventricular function. The…

…in stent restenosis. Type 5 MI: MI related to CABG. Type 4b and type 4c events fulfil the criteria for type 1 MI. Procedural myocardial…

…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…

…spasm produces a reversible functional occlusion and usually causes transmural ischaemia. The resulting abnormalities in left ventricular function may lead to myocardial infarction, ventricular tachycardia…

…to valvular heart disease Long term prognosis varies markedly across these conditions. The prognosis in idiopathic dilated cardiomyopathy may be poorer than the prognosis for…

…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…

…apply to the anti inflammatory effect. They say nothing about the mineralocorticoid effect or about suppression of the HPA axis, where a long half life…

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

…22 36 mm Descending aorta 20 30 mm ​Adjustment refers to adjusting for body surface area (BSA). Standardized values for aorta (mean ± SD) Aortic annulus…

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