…jaw, back, upper abdomen, and left or right arm. Onset and evolution How do symptoms start (suddenly or gradually)? When did the patient first note…

…there is conflict about that decision, DCD must not be raised — the two decisions must never be conflated. There is no absolute upper age limit…

…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)…

…plasma concentrations of the two peptides are not interchangeable. Natriuretic peptide concentrations reflect haemodynamic stress, but their release is not specific to left ventricular systolic…

…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…

…of rebound. The referring physician should have made this decision; document which applies. Nitroglycerin is continued; note it in the report. Shaving and careful skin…

…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…

…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…

…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…

…blood pressure, left ventricular dysfunction, contraindications, or intolerance limit escalation of beta blocker or CCB therapy. Nicorandil and trimetazidine are additional options in selected patients…

…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…

…to complement ICA, particularly for intermediate non left main coronary stenoses. Myocardial ischaemia may occur despite the absence of significant epicardial obstruction. In patients with…

…left ventricular ejection fraction, procedural factors and anticipated outcomes. The supplied material does not describe specific physical signs of CTO or a dedicated physical examination…

…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…

…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…

…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…

…consistent with the treatment plan — check any decision to limit treatment when time allows. There is complete upper airway obstruction where laryngoscopy will not succeed…

[calc_mdrd] The Modification of Diet in Renal Disease (MDRD) equation for estimating the Glomerular Filtration Rate (eGFR) is: eGFR = 175 × (Scr)^ 1…

…the presence of concomitant risk factors. In contrast, patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification for that treatment decision…

…the threshold, but the threshold varies between regions. Infection of the skin over the puncture site. Marked haemodynamic instability — stabilise the patient first. CT before…

…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…

…and the decision to initiate CPR is often ambiguous. Since the risk of attempting CPR is extremely low and the potentially catastrophic consequences of wrongfully…

…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…

…strong suspicion of portal hypertension? Variceal and ulcer bleeding are managed differently from the first minute. Peptic ulcer remains the commonest cause of upper gastrointestinal…

…calc_timi_nstemi] TIMI SCORE 30 days mortality 30 days acute MI Probability of revascularization 0 1 1,2% 2,3% 1,2% 2 1…

…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…

…Duration of treatment: at least 3 months. Extended treatment in unprovoked pulmonary embolism, a persisting risk factor, or recurrence. Special situations Situation Comment : : Pregnancy Leg…

…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…

…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…

…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…