ECG Myocardial ischemia and infarction Approach to patients with chest pain: differential diagnoses, evaluation and management Chest pain is one of the most common symptoms…

…the right shoulder. A reservoir mask with a tight fitting seal, a separate nasal cannula for apnoeic oxygenation, a bag with a PEEP valve, and…

…the chin on the chest, and the shoulders and hips stacked vertically. The back must be flexed like a bow — it is that flexion that…

…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…

…speed of 50 mm/s with 1 mV = 10 mm. At 50 mm/s a small square (1 mm) corresponds to 20 ms and…

…bundles of myocytes that form the slow conducting isthmuses critical for re entry [6] . Non ischemic dilated cardiomyopathy (NICM), hypertrophic cardiomyopathy (HCM), and arrhythmogenic right…

…cortisol assay, whether the samples were taken at the right times, and whether you know which decision threshold your own laboratory's method uses. In…

…malignant than anomalous origin of the right coronary artery. High risk anatomical features include: An interarterial course between the aorta and pulmonary artery A slit…

…a treatment decision. Systemic thrombolysis is the first line treatment in high risk embolism, unless there is an absolute contraindication. The agent and dose are…

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

…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…

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

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

…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…

…for defining the extent of coronary artery disease because it provides anatomical information while permitting functional assessment and, when appropriate, immediate percutaneous coronary intervention (PCI…

…recent noninferiority trials of wire free angiography derived physiology (ALL RISE and FAST III) within this evolving landscape, and proposes an integrated decision pathway for…

…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…

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

…classification of acute coronary syndromes (ACS) into ST segment elevation myocardial infarction (STEMI), non STEMI (NSTEMI), and unstable angina (UA) has guided clinical decision making…

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

…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…

…Correct selection of the country risk cluster is therefore essential. The clusters include different European and surrounding countries, and the applicable regional category should be…

…carries a risk of pancreatitis Cardiac markers and coagulation Test Reference Comment : : : High sensitivity troponin T < 14 ng/L The decision thresholds are assay…

…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…

…designed to improve the prediction of long term outcomes after revascularization. It incorporates both anatomical (from the original SYNTAX Score) and clinical variables (e.g…

…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…

…within a couple of hours should be intubated, not given another hour. Indications CPAP: Acute cardiogenic pulmonary oedema with hypoxaemia and marked work of breathing …

…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…

…ischemic and anti thrombotic drugs. Management must, however, be individualized with respect to the delay to coronary angiography (PCI). The majority of patients should undergo…

…70% of older adults presenting with myocardial infarction, stroke, acute aortic syndromes, or heart failure have preexisting hypertension. The relationship between blood pressure and outcome…

…enlarge. Risk Stratification: Stroke and Bleeding Assessment The decision to initiate oral anticoagulation (OAC) hinges on a rigorous assessment of both thromboembolic and hemorrhagic risks…

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

…the management of complex CAD, providing a structured approach to revascularization strategy. While it has limitations, its evolution into SYNTAX Score II and potential future…

…2031 7. The TIMI risk score for unstable angina/non ST elevation MI: A method for prognostication and therapeutic decision making E M Antman, M…

…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…

…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…

…encounters improves detection of risk factors such as elevated blood pressure and lipid abnormalities. CAC should therefore be integrated with clinical assessment and established risk…

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

…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…

…substantial underestimation of cardiovascular risk. Conversely, Lp(a) measurement provides limited additional reclassification beyond currently recommended global risk scores, and its interpretation should remain integrated…

…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…

…in which the bradycardia and reduced contractility of hypothermia are not tolerated. A decision to withhold further life sustaining treatment. Preparation and equipment Continuous core…

…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…