…without current symptoms, alternating bundle branch block in acute anterior infarction, and before drugs or procedures with a known risk of bradycardia. Transvenous pacing is…

…Monomorphic VT : VT with constant QRS morphology. Polymorphic VT : VT with beat to beat variations in QRS morphology. Bidirectional VT : VT with alternating QRS axis…

…morphology (rSR pattern), which is due to aberrant ventricular conduction (aberration, aberrancy). In clinical practice aberration is commonly seen in patients with atrial fibrillation because…

…Monomorphic VT : VT with constant QRS morphology. Polymorphic VT : VT with beat to beat variations in QRS morphology. Bidirectional VT : VT with alternating QRS axis…

…there is atrioventricular conduction, these rhythms typically compete which is seen on the ECG with sinus rhythm alternating with accelerated ventricular rhythm. As mentioned in…

…year . The injection is therefore a tool to make rehabilitation possible, not an alternative to it. See the separate guide to joint aspiration and injection…

…exceeding 200 beats per minute. While ECG appearances with flutter like patterns are predominantly caused by macroreentrant circuits, microreentry remains a possible alternative mechanism. Conversely…

…The local stroke protocol and immediate contact with the on call stroke consultant or the thrombectomy centre take precedence where there is a discrepancy or…

…below apply to adults unless otherwise stated, and paediatric doses are given per kilogram with the stated maximum. Always check against the local guideline and…

…ICU (intensive care unit) or ER (emergency room). Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is…

…is also an alternative to invasive coronary angiography (ICA) for excluding non ST segment elevation acute coronary syndrome (NSTE ACS) in patients with a low…

…disruption of the adventitia can result in rupture. An alternative proposed mechanism is primary rupture of the vasa vasorum, followed by disruption of the intima…

…Management Definition and Clinical Characteristics Torsades de pointes (TdP) represents a multifactorial clinical entity typically associated with drug induced long QT syndrome (DI LQTS) [1]…

…or present with cardiac arrest, electrical or haemodynamic instability, or cardiogenic shock. UA itself is defined by a recent change in the pattern of myocardial…

…such circumstances, the efficacy of compressions and defibrillation diminishes considerably. Extracorporeal Life Support (ECLS) emerges as the sole therapeutic alternative for such situations. Presently, this…

…ICU (intensive care unit) or ER (emergency room). Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is…

…lactate Circulatory compromise or an alternative diagnosis Silent or nearly silent chest Very severe airflow obstruction pH below 7.35 with raised pCO₂ Acute or…

…course (no more than 7 days) may be given to selected patients with an eGFR of 30 40 mL/min for lower urinary tract infection…

…of treatment response and measurement of residual disease (MRD). Fever of unknown origin or suspected granulomatous disease with marrow involvement. Work up of unexplained iron…

…standing up, tilting the head backwards. A symptom free interval between attacks, with possible residual unsteadiness. No hearing loss, tinnitus or neurological deficits. In horizontal…

…half of ocular myasthenia, thereafter MuSK and LRP4 antibodies) and on neurophysiology (repetitive nerve stimulation with a decrement ≥ 10 % at 3 Hz, sensitivity about 75…

…managed DOAC therapy with no missed doses. A single missed DOAC dose makes the pretreatment inadequate and the cardioversion must be postponed. Alternative when more…

…is an alternative but lies closer to the brachial plexus and the vessels. The elbow The elbow is flexed to 90 degrees with the palm…

…deep unconsciousness with unreactive pupils, an altered breathing pattern, a rising blood pressure with bradycardia. A known or suspected intracranial space occupying lesion with mass…

…commonest error in paracentesis is not performing it. Every patient admitted with ascites should undergo a diagnostic paracentesis , because spontaneous bacterial peritonitis often lacks abdominal…

…mmHg for 15 minutes, or a need for a vasopressor), obstructive shock or cardiac arrest with suspected pulmonary embolism. Urgent bedside echocardiography, looking for right…

…renal function Formula Used for : : CKD EPI 2021 (creatinine) The first choice for eGFR in adults Cystatin C based eGFR With an atypical muscle mass…

…after pituitary surgery or radiotherapy, or with suspected suppression of the HPA axis after long term glucocorticoid treatment. A basal morning cortisol in the grey…

…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…

…critical, especially in individuals with near normal kidney function, alternative equations like the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) equation may offer improved accuracy…

…s formula. Note that a QTc interval 480 is always considered pathological. For patients with bundle branch blocks, the corresponding figure is 500 ms. The…

…standardized method to evaluate the anatomical complexity of CAD, particularly in patients with multivessel disease or left main coronary artery disease . It integrates multiple variables…

…those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no…

…in a patient taking an ACE inhibitor should begin with a comprehensive history and physical examination. Clinicians should inquire about historical clues suggesting alternative etiologies…

…established alternative to aspirin. In patients with previous MI, stroke, or peripheral arterial disease, clopidogrel produced a modest reduction in ischaemic events compared with aspirin…

…myocardial injury, demonstrated by a rising and/or falling troponin pattern with at least one value above the assay specific 99th percentile upper reference limit;…

…The phenomenon occurs in approximately 2%–3% of PCI procedures overall. It is particularly associated with intervention on degenerated saphenous vein grafts (SVGs), rotational atherectomy…

…C remains above the recommended goal despite maximally tolerated statin therapy, generally with ezetimibe where appropriate. Established clinical atherosclerotic cardiovascular disease (ASCVD) and FH are…

…factors influencing treatment selection The following characteristics favour CABG when clinically and anatomically appropriate: Diabetes mellitus, particularly with multivessel disease involving the LAD Left v

…involvement is commonly associated with inferior or lateral myocardial infarction. Consequently, posterior infarction should not be regarded as an isolated electrocardiographic pattern in every case…

…transmission through the atrioventricular (AV) node, thereby interfering with the pathway that enables reentry tachyarrhythmias (AVNRT and AVRT). These arrhythmias rely on AV node transmission…

…supraglottic airway is a reasonable alternative if a tracheal tube cannot be established. Nasopharyngeal airways may cause complications in patients with skull fractures (risk of…

…beginning with 500 ml of normal saline over 5 10 minutes, adjusting based on response. If hypotension persists despite fluid and epinephrine administration, consider alternative…