…with all agents prescribed at maximum or maximally tolerated doses. The apparently uncontrolled office blood pressure must be confirmed using home blood pressure monitoring or…

…redness after working with a grinder, a drill, a lawnmower, or in the wind. Suspected corneal abrasion. A red eye where the diagnosis is not…

…mL (1 mL made up to 10 mL with sodium chloride) before intravenous titration. Half of all opioid dosing errors arise at the dilution step…

…132 patients who unexpectedly experienced sudden cardiac arrest while being monitored with Holter ECG (the indications were palpitations, chest pain, syncope, etc.). The results were…

…in the size of the thrombus. This means that a patient who experienced chest pain at home may be asymptomatic during the assessment in the…

…during the stressful circumstances surrounding a sudden cardiac arrest, uncertainty may arise with regard to no flow time, low flow time, patient preferences, patient background…

…by the fact that there are no means of determining what phase the patient is in. The three phases following a sudden cardiac arrest were…

…block in a patient presenting with chest discomfort is strongly suggestive of ongoing ischemia/infarction. Among all patients with acute myocardial infarction the prevalence of…

…the former, a COPD exacerbation with carbon dioxide retention for the latter. The treatment is also time limited by its very nature: a patient who…

…the patient. Preparation and equipment Cannulae in several sizes, a tourniquet, chlorhexidine in alcohol 5 mg/mL, gauze, a transparent dressing, an extension set with…

…reduced food intake Insulin pump The patient manages the pump themselves where possible. In impaired consciousness or DKA: remove the pump and change to an…

…T waves) do not affect the management of cardiac arrest. Recurrent VT or VF after ROSC in a patient with a coronary risk profile should…

…take place with the patient's ongoing consent, and be able to be stopped at any moment. A trauma informed approach also improves the technical…

…L). Non statin treatment for patients who are statin intolerant. Possible concurrent initiation of ezetimibe with maximally tolerated statin therapy during ACS hospitalization. European recommendations…

…to selected patients with an eGFR of 30 40 mL/min for lower urinary tract infection. At an eGFR <30 mL/min the antibacterial effect…

…patients who do not achieve satisfactory effects using first line therapies. Digoxin is also used frequently in the emergency setting to control ventricular rate during…

…All patients with severe acute heart failure who receive levosimendan should be monitored invasively (e.g. arterial line, PiCCO, central venous catheter). The hemodynamic effects…

…al. demonstrated the following, among patients with known coronary artery disease: Achieving 85% of age adjusted MHR resulted in myocardial perfusion defects in all patients,…

…syndrome who have additional risk factors • Patients with mutations in TGFBR1, TGFBR2 or Loes Dietz syndrome. 50 mm • Marfan syndrome • Bicuspid aortic valve with coarctation…

…ST depressions and/or T wave inversions. Patients with NSTE ACS (NSTEMI, unstable angina), on the other hand, may only display ST depressions and/or…

…Exercise Intensity Intensity may be prescribed using several complementary approaches. Heart rate based methods For patients with cardiovascular disease, dynamic aerobic exercise may be prescrib

…seeks to prevent the development of cardiovascular risk factors themselves, and from secondary prevention, which addresses patients with established disease to reduce recurrent events and…

…The incidence is 10–34% among patients with premature ventricular contractions and/or nonsustained ventricular tachycardia who are referred for electrophysiological evaluation (Hasdemir et al…

…testing for all patients with non ischemic HFrEF. Toxic and infiltrative causes are increasingly recognized. The burgeoning field of cardio oncology has highlighted the cardiotoxic…

…patient who exhibits an ecotdense mass entrenched in the endocardium with impaired mobility (for example, after myocardial infarction), most likely has a parietal thrombus. The…

…In such scenarios, it is very common to provide the patient with a permanent pacemaker to continue optimal medical treatment. Sick sinus syndrome (sinus node…

…should be organized by certified instructors who design their courses in accordance with official guidelines (ERC, AHA, ACC). The chain of survival EARLY RECOGNITION OF…

…communities. Late presentation is clinically important: Within 12 hours of symptom onset: reperfusion therapy is recommended for all patients with a working diagnosis of STEMI…

…results in ST elevations on the ECG. Virtually all patients with STE ACS exhibit elevated troponin levels, and are thereby diagnosed as ST elevation myocardial…

…results in ST elevations on the ECG. Virtually all patients with STE ACS exhibit elevated troponin levels, and are thereby diagnosed as ST elevation myocardial…

…as prognostic markers during the disease course. In summary, the risk of severe disease and death is several times higher in patients with cardiovascular diseas

…currently recommended global risk scores, and its interpretation should remain integrated with the overall risk profile. Measurement Who should be tested? Current recommendations support measuring…

…of the cause. A person who is not breathing will therefore develop a cardiac arrest. During the first minute after a cardiac arrest, the person…

…does not interfere with ongoing CPR or airway management, no risk of pneumothorax Highest risk of thrombosis and contamination, immobilises the patient The right internal…

…the glucose should therefore be checked with a capillary or venous measurement [5]. Treatment The awake patient who can swallow safely Give 15 to 20…

…preparations The procedure must be explained carefully to the patient, who must also be informed that his/her performance will affect the validity of the…

…for all opioids Obesity Dose according to effect, not according to total body weight Concomitant benzodiazepine A markedly increased risk of respiratory depression. Avoid the…

…vagal tone. In all other situations, sinus arrest/pause should be considered abnormal, and the following differential diagnoses are at hand: Sinus node dysfunction. Side…

…a clear example, consider a patient with ischemic heart disease, who has normal ejection fraction but impaired contractile function in the inferior wall. This finding…

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…

…with clean intermittent self catheterisation rather than an indwelling catheter. A catheter is not, however, indicated for incontinence as the sole reason, for convenience where…

…in a pregnant patient, immediate consultation with an obstetrician, neonatologist, and anesthesiologist is essential. Figure 1 . When a pregnant woman is supine, the uterus can…

…dilated in patients with pulmonary hypertension. Echocardiography in pulmonary regurgitation Echocardiography is the modality of choice for diagnosing pulmonary regurgitation. Continuous Doppler through the pulmonary…

…will regularly encounter patients with CHD. Approximately 95% of all incident cases of congenital heart disease reach adulthood ( Mandalenakis et al ). The largest leap in…

…and summarises the order in which measures are taken and the principles that are common to all protocols. Children, pregnant women and patients with advanced…

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

…recurrent symptoms, myocardial infarction, or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular…

…patients with a working diagnosis of NSTE ACS and a high probability of unstable angina (UA), and patients whose initial findings are less definitive. The…

…is approved to treat patients with life threatening ventricular tachyarrhythmias and atrial fibrillation (AF). It is also effective in preventing the recurrence of a wide…

…However, in cases of rapid AVNRT or in patients with underlying structural heart disease, the arrhythmia may result in symptoms indicative of reduced cardiac output…

…of patients with stroke or TIA. The purpose of performing an ultrasound is to scrutinize potential cardiac sources of emboli and to evaluate the carotid…

…a primary differential diagnosis and presents with distinct characteristics compared to transmural ischemia [4, 5]. Acute Pericarditis vs. Acute Myocardial Infarction The ST segment elevation…

…Cardiovascular Risk Assessment Screening for cardiovascular and kidney disease All patients with diabetes should be assessed for: ASCVD Severe target organ damage (TOD) HF AF…

…syndrome is a likely diagnosis in patients presenting with these symptoms and typical ST segment elevations in V1–V3 (see below). The characteristic ECG changes…

…With echocardiography, good conditions are obtained for visualizing the pericardium, its surroundings, the myocardium and valves. ECG is recorded in all patients with suspected pericardial…

…contingent upon the specific mutation present. For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker…

…contingent upon the specific mutation present. For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker…

…around the isoelectric baseline. The risk of ventricular fibrillation is very high during torsade de pointes . ECG showing an episode of sinus rhythm (with multiple…

…including the SYNTAX trial. Limitations Requires detailed clinical and angiographic data. Calculation can be complex without dedicated software. May not account for all patient specific…

…disease, or peripheral artery disease. Secondary prevention concerns patients with established vascular disease, in whom aspirin has a substantially more favourable benefit–risk profile. Aspirin…