…mass. Waist circumference and the waist to hip ratio provide additional information about visceral adiposity and may correlate more closely with outcomes than BMI, particularly…

…exposure to lower LDL C concentrations is associated with lower ASCVD risk. Atherogenic particle burden is not completely represented by LDL C alone. Non high…

…a high flow but the cannula kinks when the arm is flexed. The dorsum of the hand is suitable for finer cannulae. Avoid the lower…

…LDL receptor. They lower LDL C by approximately 50–60%, including in patients receiving background statin therapy and in those unable to tolerate statins, provided…

…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…

…angiographic reduction of coronary obstruction. Intensive lipid lowering improves endothelial function, lowers circulating high sensitivity C reactive protein, reduces thrombogenicity, and favourably modifies inflammatory and…

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

…a lesion proximal to the first septal perforator of the left anterior descending artery was associated with lower five year survival than a more distal…

…as an adjunct to, rather than a replacement for, established secondary prevention treatment. Its potential role is greatest when cardiovascular risk remains high despite optimal…

…needed to treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy of these interventions is much lower or…

…raise strong suspicion of another or an additional cause [1]. Delirium tremens most often begins after one to three days but can start earlier in…

…cardiovascular risk. Dyslipidaemia may be difficult to interpret during active disease: inflammatory cytokines can lower LDL and HDL concentrations while increasing the atherogenic index, a…

…histology IVUS can provide additional information regarding calcific, fibrotic, fibro fatty, and necrotic components. Virtual histology IVUS has also been used to identify thin cap…

…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…

…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…

…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:

…refined. Similarly, the development of transesophageal echocardiography (TEE) has been extremely valuable. Echocardiography is used to assess the morphology of valves, the presence of vegetations…

…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…

…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…

…eating Correction dose (rapid acting) Corrects a currently high value As required, in addition to the mealtime dose Never stop basal insulin in a person…

…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…

…however, that current troponin assays are extremely sensitive. These assays, referred to as high sensitive cardiac troponin, may actually detect the presence of troponins in…

…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…

…not an alternative to it. See the separate guide to joint aspiration and injection. Indications Condition Injection site Comment : : : Subacromial bursitis, rotator cuff syndrome The…

…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…

…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…

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

…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…

…3] . Plaque Erosion: Responsible for up to 30% of ACS cases, plaque erosion is increasingly recognized in the modern era of high intensity statin therapy…

…be universal adoption of the Cabrera format. This recommendation, 1 was issued 16 years ago and fortunately all modern ECG machines can switch to the…

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

…risk and reducing exposure to established, modifiable determinants of cardiovascular disease. The principal targets include blood pressure, lipid abnormalities, diabetes and glycaemic status, body weight…

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…

…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…

…where it is stated that it is extremely uncommon to have a non ischemic ECG (absence of ST T changes) during chest pain caused by…

…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…

…for an additional 15 minutes after the completion of the infusion. The initiated infusion should always be completed (regardless of whether conversion to sinus rhythm…

…For adults with elevated BP, a calculated 10 year risk of ≥10% is considered sufficiently high to support BP lowering treatment, whether through lifestyle intervention…

…The kidney is particularly vulnerable to toxic injury because of its high blood flow and the concentration of filtered substances along the nephron as water…

…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…

…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…

…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…