All patients with NSTE ACS (NSTEMI or unstable angina) are treated similarly with respect to anti ischemic and anti thrombotic drugs. Management must, however, be…

…tongue depressor, a vomit bowl. Local anaesthesia and vasoconstriction: lidocaine 4 % with oxymetazoline 0.5 % (or xylometazoline) on cotton pledgets. Cautery: silver nitrate sticks; electrocautery…

…never at the lower border where the neurovascular bundle lies, and the drainage is stopped for coughing, chest pain, or when the volume limit is…

…cardiac arrest in a pregnant individual, either within or outside the hospital, prompt communication with an obstetrician and neonatologist is critical. Cardiopulmonary resuscitation (CPR) should…

…commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being the most common…

…of cardiac arrest. Recurrent VT or VF after ROSC in a patient with a coronary risk profile should lead to consideration to perform early angiography.

…or with a history of gastrointestinal bleeding Refeeding syndrome There is a risk in starvation, alcoholism, anorexia nervosa, or more than 5 days without nutrition…

…with suture of any nail bed laceration Contraindications There are no absolute contraindications, but be cautious and consider referral in: Diabetes with neuropathy or peripheral…

…which is fundamental in all arrhythmias, the first task is to determine whether the arrhythmia is a wide complex tachycardia (WCT) or a narrow complex…

…pulmonic) regurgitation Pulmonary regurgitation is also called pulmonic regurgitation . The majority of all adults exhibit a small pulmonary regurgitation, which is considered a normal finding…

…myocardium generates reflections with high amplitude and low Doppler shift. To analyze reflections from the myocardium, the ultrasound machine filters out all other reflected sound…

…pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or other symptoms that may be caused by…

…Conventional thoracic X ray sometimes reveals calcification of the pericardium. With MRI or CT, the thickness of the pericardium can be measured and in most…

…Table 1: Myocardial and ECG reaction in various settings with ischemia or increased workload STATUS OF CORONARY ARTERY SETTING EFFECT ECG REACTION Normal coronary artery…

…Acute myocardial infarction (AMI) always affects the left ventricle Myocardial infarction is virtually synonymous with left ventricular infarction . All myocardial infarctions affect the left ventricle…

…the same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure…

…principles that are common to all protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific…

…applied at all, and if so at what pressure. Palpable foot pulses are not an acceptable substitute, and in patients with diabetes or renal failure…

…expected course and the possibility of rapid reversal with an antidote. Intubation is recommended for neurological, respiratory or haemodynamic failure that cannot be corrected quickly…

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

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

…detrimental. We have therefore compiled a pocket guide with a universal interpretation algorithm. These 22 pages includes all you need to perform methodological ECG interpretation…

…cardiovascular prevention and treatment. It is associated with lower cardiovascular and all cause mortality and with reduced incidence or burden of hypertension, type 2 diabetes…

…young adults with congenital heart disease. Initiation Strategies Because of its ability to significantly prolong the QT interval and cause torsades de pointes or provoke…

…of the Electrical Axis The heart's electrical axis represents the net vectoral sum of all active electrical wavefronts at any given point in time…

…regardless of the appearance of the QRS complex. All positive waves are referred to as R waves. The first positive wave is simply an "R…

…irregular rhythms with frequently changing RR intervals. Refer to Figure 2 . Figure 2. Ashman's phenomenon. Aberrancy can occur in three different situations, all related…

…the left ventricle, which therefore contracts without pre load (the ventricle is empty or nearly empty). In patients with an initial shockable rhythm, compressions and…

…AVNRT or in patients with underlying structural heart disease, the arrhythmia may result in symptoms indicative of reduced cardiac output, such as pre syncope or…

…by a repolarization (recovery). The action potential occurs in all cardiac cells but its appearance varies depending on cell type. During de and repolarization ions…

…If many sample volumes are placed along several Doppler lines, then all velocities in the area can be presented with colors. The brighter the color…

…depolarize all connected myocardium. This is the main principle behind artificial pacemakers; i.e applying an external electrical current that depolarizes cells in contact with…

…parallel with the prolongation of survival. Neonatal screening with pulse oxymetry The majority of all congenital heart defects are detected early in infancy or childhood…

…from the sound source, will instead be reflected with a lower frequency than the sound waves emitted from the sound source. The difference in frequency…

…cases of fatal myocardial infarction were examined. The authors reported that 60–70% of all cases had no myocardial disease or acute coronary syndrome. Indeed…

…is accompanied with a sensation, which threatens instant death if the motion is persisted in; and, that on stopping, the distress immediately abates, or altogether…

…ventricular mass. Most formulas are simple mathematical equations, included in all ultrasound systems, and assume that the geometry of the left ventricle is normal. Figure…

…all structures along that line over time (the x axis displays time). Since M mode only analyzes a single ultrasound line, its temporal and axial…

…practice, beginning with a discussion of the underlying mechanisms of cardiac arrhythmias. While a detailed understanding of these mechanisms is not essential for all clinicians…

…the same phenomenon. Sinus arrhythmia fulfill all criteria for sinus rhythm except from the fact that the rhythm is slightly irregular ( Figure 1 ). This is…

…microscopy and urinary albumin or protein. 6. Perform an ECG in hyperkalaemia or where a rapid rise in potassium is suspected. 7. Review all medication…

…body drape. Lidocaine 10 mg/mL for local anaesthesia, normal saline to flush all lumens, suture material or a securement device, transparent dressing. Monitoring throughout…

…12.0 ± 1.0 18.2 ± 1.9 18.1 ± 1.7 All 11.7 ± 1.0 11.6 ± 1.0 17.0 ± 1.9…

…INR ≥ 2.0 checked weekly on warfarin, or documented well managed DOAC therapy with no missed doses. A single missed DOAC dose makes the pretreatment…

…repeat treatment until the patient has recovered. 7. Follow up with a meal or with continued glucose administration adapted to the cause. 8. Identify drugs…

…improve above all the logistics, the communication and the simultaneous delivery of red cells, plasma and platelets. Observational data from trauma suggest a lower overall…

…and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is a clinical…

…Avoid the lower limb in adults. In shock with collapsed vessels, the antecubital fossa or the external jugular vein are the vessels that can most…

…may stay: all silicone and latex with a hydrogel or silicone elastomer coating may remain for up to twelve weeks, latex with a PTFE coating…

…without being found. Indications A traumatic wound that gapes and cannot be expected to heal with good function or cosmesis without apposition. A wound that…

…at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly prolonged QT intervals—the implantation…

…at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly prolonged QT intervals—the implantation…

…Bicuspid aortic valve with coarctation or additional risk factors 55 mm (ascending aorta, aortic arch) All individuals 60 mm (descending aorta) All individuals Risk factors…

…12.0 ± 1.0 18.2 ± 1.9 18.1 ± 1.7 All 11.7 ± 1.0 11.6 ± 1.0 17.0 ± 1.9…

…and bone mass. It does not indicate the types or distribution of body fat. It may not be accurate for all populations, particularly at the…

…Creatinine Clearance : Reduced renal function increases risk. Left Ventricular Ejection Fraction (LVEF) : Lower LVEF is associated with worse outcomes. Unprotected Left Main Disease : Increases complexity…

…more closely associated with cardiovascular risk than LDL C in many studies, although the relative advantage of apoB over non HDL C or standard lipid…

…or all cause mortality. Reported relative effects include: Approximately 11% reduction in cardiovascular events in a meta analysis of primary prevention trials involving individuals with…

…repolarization is present if all of the following criteria are met (illustrated above): 1. There is an end QRS notch or slur on the downslope…

…age) V2 to V3 Greater than or equal to 1.5 mm All patients Other leads Greater than or equal to 1 mm These criteria…