…Intra articular corticosteroid injection in verified inflammatory or osteoarthritis related joint disease. Contraindications Infection of the skin or soft tissues over the puncture site — use…

…oxide Rapid onset and offset; the patient cooperates Intra articular local anaesthesia Lidocaine into the glenohumeral joint in shoulder dislocation, with an effect equivalent to…

…impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated with a greater likelihood of cure. When to investigate…

…an acute or subacute worsening of dyspnoea, cough and sputum in particular that exceeds the patient's normal variation and requires a change of treatment…

…In clinical practice, obesity is conventionally defined by a body mass index (BMI) of ≥30 kg/m2. Severe obesity is generally defined as BMI ≥35…

…across the mitral valve using pulsed Doppler. Estimating left ventricular filling pressure via e' . Measurement of deceleration time (DT) . Diastolic function can be estimated from…

…of interest; e.g the aortic valve can be zoomed in to study its anatomy and function. Zooming in improves the resolution in a particular…

…the ventricles. First degree AV block is rarely serious and may be left untreated in the vast majority of cases (exceptions are discussed later). Second…

…in particular computed tomography (DT) and/or magnetic resonance imaging (MRI). Anatomy of the pericardium The pericardium consists of a parietal layer and a visceral…

…Causes of acute pericarditis/myocarditis The most frequent cause of pericarditis is infections, in particular viral infections. This explains why pericarditis may affect individuals of…

…but only if the examiner is trained. Brief attacks triggered by the position of the head relative to gravity: perform Dix Hallpike and, if needed…

…Common manifestations are hypertensive encephalopathy, intracerebral haemorrhage, acute coronary syndrome, acute left ventricular failure with pulmonary oedema, acute aortic syndrome, acute kidney injury, microangiopathic haemolysis…

…is an emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint or absent. Take cultures immediately, but never let…

…crisis. Contraindications There are no absolute contraindications in hypoxaemia. Take particular care in: A risk of hypercapnic respiratory failure — COPD, severe obesity with hypoventilation, neuromuscular…

…patients at increased bleeding risk if the benefits of preventing ischemic events outweigh the risk of severe bleeding. Particular caution is required for: Patients aged…

…Whether the patient has persistent or progressive disease suggestive of an advanced phenotype. Particular attention should be paid to potentially reversible causes and associated cardiovascular…

…scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular…

…and pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose lowering in type 2 diabetes mellitus …

…to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other…

…the presentation represents ACS and whether the patient is clinically unstable. Particular attention is required for evidence of: Ongoing or recurrent chest discomfort. Haemodynamic instability…

…The orientation of myocardial muscle fibers results in longitudinal, radial and circumferential shortening (contraction). Traditional methods for investigating left ventricular function — e.g ejection fraction…