…assess renal function and the rate of rise. Often outpatient or brief inpatient follow up depending on the clinical picture Moderate 6.0 to 6…

…collectively dictate the urgency and modality of intervention [3] . By Duration: Non sustained VT (NSVT): Defined as three or more consecutive ventricular beats at a…

…ongoing or recurrent pain [1,3,4]. This quick reference gives internationally established doses. Drug availability, thrombolysis regimens, renal function thresholds and the division of…

…table below shows a systematic history taking in patients presenting with chest pain (chest discomfort) or other symptoms suggestive of the five conditions listed above…

…the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is an acute or subacute worsening of dyspnoea…

…in the general sense; the decision depends on balancing the expected diagnostic or therapeutic benefit against the patient’s specific procedural risks. Vascular access and…

…Clinical Applications Natriuretic peptides have three principal roles: Supporting or excluding the diagnosis of HF Estimating disease severity and prognosis Contributing to longitudinal assessment and…

…and proposes an integrated decision pathway for physiology guided revascularization. Overview: Comparison of Physiological Indices The table below summarizes the four index families discussed in…

…The decision to transfer the patient to the ICU or CCU depends on the system of care and patient status. The absolute majority of patients…

…refractory to guideline directed medical therapy, occur at a low level of exertion, or are associated with high event risk. The apparent differences between thresholds…

…Occlusion Myocardial Infarction (OMI) versus Non Occlusion Myocardial Infarction (NOMI). This method focuses on the presence or absence of ACO, rather than rigid ECG thresholds…

…A score of 3 or more indicates a difficult intubation — call for help and get out the videolaryngoscope and plan B before you give the…

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

…can refine interpretation. Coronary plaque and future events Angiographic stenosis severity is an imperfect predictor of future myocardial infarction or sudden death. Lesions causing only…

…disease and evaluation of treatment effect, the medication is continued — abrupt withdrawal carries a risk of rebound. The referring physician should have made this decision…

…GFR in individuals with near normal or mildly reduced kidney function (eGFR 60 mL/min/1.73 m²), potentially leading to misclassification of CKD stages…

…used to classify 10 year risk as follows: Risk category 10 year risk of fatal or non fatal CVD Low <2% Moderate ≥2% to <10%…

…a large change in TSH. During acute illness the TSH can be falsely low or high in the absence of thyroid disease; repeat it once…

…2 mm of coved type with a negative T wave in V1–V2. Early repolarisation: J point elevation ≥ 1 mm with notching or slurring in…

…a lumbar puncture is rarely the needle itself. It is the decision whether to perform it now or after imaging, how the patient is positioned…

…risk of falls; anaemia and a known gastrointestinal source are investigated before starting. A referral or notification to the anticoagulation clinic, and a decision on…

…risk. Clinical Applications Personalized Decision Making : SYNTAX Score II helps determine whether a patient should undergo PCI or CABG based on their risk profile. Predicting…

…extremely low and the potentially catastrophic consequences of wrongfully withholding an attempt, CPR is often initiated in individuals who are biologically dead or in w

…a blood gas the treatment cannot be guided. A decision on the level of care and on whether intubation is appropriate, documented before treatment begins…

…and respect is also what makes the decision hold afterwards. Organ preserving treatment — treatment given solely for the sake of the donation — may continue for…

…a reduced level of consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged endoscopic intervention a need…

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…

…and quality of life may be equally important therapeutic objectives. Evidence from randomized trials is often less applicable to very frail or multimorbid patients because…

…of both thromboembolic and hemorrhagic risks. The diagnostic prerequisite for clinical AF remains the documentation of the arrhythmia via a standard 12 lead ECG or…

…The decision must be documented and alternatives (iron, tranexamic acid, cell salvage, haemorrhage control) planned in advance. A history of a severe transfusion reaction: contact…

…signs of deep vein thrombosis 3 Pulmonary embolism is the most likely diagnosis 3 Heart rate 100/min 1.5 Immobilisation ≥ 3 days or surgery…

…nature of HCM. By combining these factors, the calculator generates a 5 year SCD risk percentage , which helps clinicians stratify patients into low, intermediate, or…

…anatomical complexity of CAD, particularly in patients with multivessel disease or left main coronary artery disease . It integrates multiple variables, including the number of lesions…

…A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation. 2000 Oct…

…of coronary angiography and possible revascularization. Revascularization may be selected for symptom relief after shared decision making, particularly when the anginal burden is high or…

…decision to prescribe colchicine requires attention to the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes. Mechanisms of…

…by itself, establish the presence or haemodynamic significance of a specific stenosis. Clinical Role and Indications CAC scoring is principally a risk stratification tool for…

…hypertensive encephalopathy and should prompt consideration of stroke. Acute ischemic or intracerebral haemorrhage may coexist with severe hypertension. The decision to lower BP in acute…

…investigation should be undertaken when its diagnostic or therapeutic consequences are likely to outweigh procedural risks. This balance forms part of shared clinical decision making…

…is moderate or near a treatment decision threshold. Failure to account for a high Lp(a) level may lead to substantial underestimation of cardiovascular risk…

…risk of hypoglycaemia; it can usually be continued Red flags and pitfalls Stopping basal insulin in type 1 diabetes. The single most dangerous prescribing decision…

…contractility of hypothermia are not tolerated. A decision to withhold further life sustaining treatment. Preparation and equipment Continuous core temperature measurement. An oesophageal probe or…

…angina, an anginal equivalent or exertional dyspnoea. Patients may continue to have lifestyle limiting symptoms despite guideline directed medical therapy (GDMT), prompting consideration of revascularization…