…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…

…Congestion is a central expression of the heart failure syndrome and reflects excessive retention of sodium and water, with expansion of both the intravascular and…

…a chronic, relapsing and biologically complex disease characterized by excessive accumulation of adipose tissue. It is an important cause of cardiovascular disease (CVD), cardiovascular risk…

…g in 1 ml vial. Dilute with 10 ml of normal saline and give by slow injection over 5 10 minutes. Dilute immediately before use…

…procedural safety, reduced repeat revascularization, and broadened the range of lesions amenable to PCI. Stent selection must nevertheless be integrated with lesion anatomy, clinical presentation…

Cardiology Endocrinology & metabolism Definition and pathophysiology Hypertriglyceridaemia (HTG) is defined by an increased concentration of circulating triglycerides. Both fasting and non fasting measurements provide prognostic…

Arrhythmias and arrhythmology Pharmacology & dosing Definition and Pathophysiology Sotalol is a nonselective beta adrenoceptor blocker devoid of intrinsic sympathomimetic activity that also prolongs cardiac repolarization…

…zone and contributes to ventricular failure. Mechanisms of Shock The central consequence of extensive infarction is loss of contractile myocardium, with reduced cardiac output and…

…Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas…

…Always follow the local protocol for exact infusion rates, electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises…

…in the same order every time, reduces the risk of missing abnormalities. The eight steps below go through the rhythm and then the waveforms one…

…Contraindications Atrial fibrillation or flutter of unknown or excessive duration without adequate anticoagulation or exclusion of thrombus — the most important relative contraindication to elective cardioversion…

…the ventricular response is not excessive, or may cause substantial haemodynamic compromise. Symptoms and consequences may include: Palpitations and awareness of an irregular or rapid…

…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…

…is performed, is 12 months of DAPT unless there is a contraindication, an indication for oral anticoagulation, or an excessive risk of bleeding. The duration…

…objects in the image whiter. This may clarify some tissue borders but excessive use of gain results in deterioration of image quality. Time gain compensation …

…CYP2C9 variants) (1 point) E xcessive fall risk (1 point) S troke (1 point) HEMORR₂HAGES Score Risk category Incidence of major bleeding (per 100 patient…

…suggested that pathological Q waves may also arise due to extensive subendocardial infarction (NSTEMI). If pathological Q waves occur as a result of myocardial infarction…

…oral dose, plasma concentrations peak within 3 to 6 hours. The agent undergoes extensive hepatic metabolism, yielding desethylamiodarone as a major active metabolite. Both the…

…failure (HF) symptoms may result from several overlapping processes: Recurrent or extensive MI with necrosis and scar formation Diffuse myocardial fibrosis Reversible ischemic dysfunction Chronic…

…associated with extensive anterior or transmural infarction, apical dysfunction, LV aneurysm formation, and reduced LV systolic function. The principal mechanisms are the combination of an…

…minor right ventricular necrosis is found in approximately one third of patients with inferior infarction. Extensive involvement is less common in patients with inferoposterior left…

…The resulting extensive ischemia causes immediate myocardial stunning (akinesia) and electrical instability. Fewer than 1% of patients with ST elevation myocardial infarction (STEMI) who reach…

Procedurer The ankle brachial index is the cheapest and most accessible method of objectively demonstrating peripheral arterial disease, and it is needed more often than…

…kills because the tube would not pass, but because the team keeps trying to intubate instead of changing the plan. The aim is always oxygenation…

…sample. Indications Diagnostic paracentesis: Newly detected ascites — always. Every admission of a patient with known ascites. Clinical deterioration in a cirrhotic patient with ascites: fever…

…Instillation therapy and contrast studies of the urinary tract. Wound healing with a sacral pressure sore or extensive perineal wounds where urinary leakage prevents healing…

…in females. Untreated HoFH is associated with extensive premature and progressive ASCVD; CAD and aortic stenosis may occur before the age of 20 years, with…

Cardiology Pharmacology & dosing Definition and pharmacological basis Ivabradine is a selective inhibitor of the If, or “funny,” current in sinoatrial node pacemaker cells. This current…

…extensive myocardium at risk, severe baseline stenosis, multivessel coronary artery disease, or diffuse disease. No reflow represents impaired antegrade myocardial perfusion in the absence of…

…2%–24% of patients with CAD. The pathophysiology of refractory angina is heterogeneous. In obstructive CAD, symptoms may result from extensive or diffuse epicardial disease…

…specific and produces more extensive fibrinogen depletion. Successful fibrinolysis is generally accompanied by relief of ischaemic symptoms, at least 50% resolution of ST segment elevation…

…coronary artery disease (CAD). It combines echocardiographic assessment of left ventricular (LV) structure and function with exercise or pharmacological stress. The physiological basis is an…

…and subsequent sudden death are rare, the arrhythmia is precipitated by an extensive list of "torsadegenic" or "QT liability" drugs. This includes Class III antiarrhythmic…

…is of paramount importance. The primary concern in correcting hyponatremia is the prevention of osmotic demyelination syndrome (ODS), previously known as central pontine myelinolysis. Excessively…

…in terms of morphology (appearance), durations and intervals. A rather extensive discussion is provided in order to give the reader firm knowledge of normal findings…

…duration of the ischemia: the longer the duration of the ischemia, the more extensive the infarction. These three are the most important determinants of infarct…

…in mitral prolapse. Extensive myocardial infarction may lead to papillary muscle rupture. The risk of rupture is greater for the posteromedial papillary muscle, which only…

…and stabilisation for transfer in a suspected fracture. Clinical suspicion of a scaphoid fracture despite a normal radiograph. Contraindications An open fracture or a wound…

…applies where you work. They assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick…

…haematoma (IMH), and penetrating atherosclerotic ulcer (PAU). Aortic dissection accounts for approximately 80%–90% of acute aortic syndromes, IMH for approximately 10%–20%, and PAU…

…typical circuits occurring in diseased atria—most frequently following surgery or extensive ablation, or under the influence of antiarrhythmic drugs—can produce atypical ECG patterns…

…ST segment elevation myocardial infarction; extensive vascular calcification; female sex; low body mass index; larger arterial sheaths; greater intensity of procedural anticoagulation; complex coronary anatomy…

…level of exertion. Left ventricular dysfunction suggesting extensive obstructive CAD. A high risk result on non invasive testing. Symptoms that are strongly suggestive of obstructive…

…causes extensive reorganization of left ventricular activation [2]. This leads to abnormal LV mechanical function [7]. Furthermore, LBBB significantly complicates the electrocardiographic diagnosis of MI…

…CABG. Physical examination findings are not specific to left main disease. The examination should nevertheless assess the consequences of extensive myocardial ischaemia, including heart failure…

…assays may therefore identify a continuum of myocardial injury ranging from minor or reversible injury to extensive necrosis. Causes of myocardial injury Important causes include…

…presence of extensive comorbidity may alter the balance between procedural risk and benefit. An early invasive strategy is not recommended when the risks of revascularization…

…is powered by a lithium battery with a lifespan of 5–10 years. A shorter lifespan can be expected if the pacing requirement is extensive…

…complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive myocardial ischemia (referred to as transmural ischemia). Yet…

Echocardiography Principles of echocardiographic examinations In small children, it is possible to perform the entire transthoracic echocardiography (TTE) with the child in the supine position…