…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…

…the precordium and may radiate to the neck, shoulder, jaw, back, upper abdomen, and left or right arm. Onset and evolution How do symptoms start…

…overt congestion is not apparent. Such a discrepancy should prompt consideration of an infiltrative cardiomyopathy within the appropriate clinical context. Several patient related factors influence…

…of long term outcomes after revascularization. It incorporates both anatomical (from the original SYNTAX Score) and clinical variables (e.g., age, sex, renal function, left…

…to adults in sinus rhythm, recorded at a paper speed of 50 mm/s with 1 mV = 10 mm. At 50 mm/s a…

…despite appropriately titrated medical therapy should prompt consideration of coronary angiography and possible revascularization. Revascularization may be selected for symptom relief after shared decision making…

…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…

…shared decision making process is appropriate when revascularization is being considered. The choice between PCI, coronary artery bypass grafting (CABG) and medical therapy should incorporate…

…asymptomatic, NSVT serves as a critical marker of arrhythmogenic risk, particularly in the setting of ischemic heart disease or reduced left ventricular ejection fraction (LVEF)…

…whereas contemporary decision making increasingly combines anatomical imaging with functional assessment. A central practical principle is that the visual severity of a stenosis does not…

…the day of the test can therefore be given dexamethasone. That is the practical key: the patient does not have to be left unprotected for…

…and routine follow up is usually sufficient. Shared decision making The calculator provides a quantitative estimate of SCD risk, which facilitates informed discussions between clinicians…

…of thyroid disease; repeat it once the patient has recovered. Pitfalls Haemolysis raises the potassium, LDH and AST and lowers the haptoglobin. A tourniquet left…

…the left atrial appendage (LAA). The LAA is a highly trabeculated, windsock like embryonic remnant that exhibits uniquely low flow velocities during the loss of…

…s predictive accuracy. The SYNTAX Score remains a cornerstone in the management of complex CAD, providing a structured approach to revascularization strategy. While it has…

…functional capacity, and health related quality of life substantially influence both cardiovascular risk and the balance between treatment benefit and harm. Prevention in the very…

…out a possible donor on your own on grounds of age or medical history — contact the transplant coordinator and let the assessment be made there…

…or a very strong clinical suspicion. 3. Give intravenous calcium in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells…

…thrombolysis regimens, renal function thresholds and the division of work between the ambulance service, the emergency department and the PCI laboratory may differ between Swedish…

…8. Document the ceiling of care and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is…

…the risk of embolization. Risk assessment should be individualized. There are no absolute contraindications to coronary angiography in the general sense; the decision depends on…

…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…

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

…modify the estimated likelihood of atherosclerotic obstructive CAD. CAC is therefore not merely an incidental imaging finding; it can refine the decision to test and…

…identification of acute coronary occlusion (Al Zaiti et al, 2023). The proposed transition from the traditional STEMI/NSTEMI/UA classification to the OMI/NOMI approach…

Procedurer What determines the outcome of an emergency intubation is rarely the laryngoscopy itself but what was done before it: how well the patient was…

…misestimations. Clinical implications While the MDRD eGFR calculator has significantly advanced the detection and management of CKD, clinicians should be aware of its limitations. In…

…entered into the table or application. Estimates should be adjusted upwards as the individual approaches the next age category. The models are calibrated to four…

…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…

…the article follows: [...] Of every 10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle…

…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…

…the last dose, the renal function and the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not routinely stop aspirin…

…high risk patients should be evaluated with angiography earlier. Guidelines recommend the use of validated risk models to estimate the risk of acute myocardial infarction…

…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…

…do it. Otherwise the echocardiographic findings plus the clinical picture are sufficient for a treatment decision. Systemic thrombolysis is the first line treatment in high…

…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…

…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…

…liver disease. Interpretation of the Agatston Score The score should be interpreted both by its absolute value and in relation to age and sex. A…

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

…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…

…patient instead. Refractory shock in which the bradycardia and reduced contractility of hypothermia are not tolerated. A decision to withhold further life sustaining treatment. Preparation…