…are elevated. Consequently, congestion may occur across the full range of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both…

…In parallel, large outcome trials have clarified, and in some cases substantially narrowed, the role of revascularization itself in stable coronary artery disease, while a…

…up to and including the age of 70, and the last sample is in practice taken some time between the ages of 64 and 70…

…degree of hypoxia in all neurons. There is one fundamental difference between neurons and myocardium in the setting of hypoxia. Myocardium ceases contracting immediately when…

…cases, the arrhythmia is self limiting; however, it may recur and, in some instances, persist for extended durations. As for any long standing tachycardia, there…

…of completely discrete diseases. Heart failure extends across the full range of LVEF, and echocardiographic measurement is subject to meaningful variability. HFmrEF may therefore represent…

…aortic valve 2.5–3.5 Some centres use 2.0–3.0 with a modern bileaflet prosthesis and no risk factors Mechanical mitral valve…

…3 degrees as the threshold [4,5]. Some Swedish and local care programmes use 38.5 degrees instead. Follow the local definition where one exists…

…SLE and type 1 diabetes. Traditional factors such as smoking, family history of premature coronary disease, hypertension and hypercholesterolaemia did not fully explain the excess…

…rub is detected varies among clinical descriptions. It may be present intermittently during the illness and, in some series, is reported in up to approximately…

…produces an exaggerated inspiratory fall in systemic systolic blood pressure, termed pulsus paradoxus. Tamponade is therefore characterized haemodynamically by elevation and near equalization of diastolic…

…while some fibers are still refractory. In this case ( Figure 1 ) it encounters a refractory right bundle branch and therefore the impulse is conducted with…

…specific 99th percentile upper reference limit. It is classified as acute when serial measurements demonstrate a rise and/or fall. A stable elevation indicates chronic…

…be assessed and prescribed using the components of: Frequency Intensity Time or duration Type Progression The prescription should be individualized rather than based solely on…

…adjustable Humidified and warmed gas; it provides some positive airway pressure and washes out dead space. It requires special equipment and monitoring The nasal cannula…

…the concepts and basically lacks everything you need for clinical purposes. Regrettably, I cannot recommend this book, despite it being the most sold book on…

…The discrepancy between traditional figures and recent studies is due to the dramatic decrease in the incidence of acute coronary syndromes over the past decades…

…2 to 24 hours After failed fibrinolysis Immediate rescue PCI The 120 minute limit is a ceiling for the choice between primary PCI and fibrinolysis…

…both hypovolaemia and venous congestion. 4. Take an urgent panel: creatinine, urea, sodium, potassium, bicarbonate or blood gas, calcium, phosphate, glucose and a full blood…

…Swedish law and practice; the legal framework, the consent model and the time limits differ between countries. The two pathways DBD DCD : : : Full name Donation…

…stenosis Known — perform the test only on a clear indication and with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment Hypertrophic cardiomyopathy…

… full sterile attire for therapeutic drainage with an indwelling catheter. Lidocaine 10 mg/mL, 5–10 mL, 25 G for the skin wheal and 21…

…At 5 minutes A full, adequate dose of a benzodiazepine About 10 minutes Repeat the benzodiazepine once if the seizure persists, and prepare step 2…

…without being found. Indications A traumatic wound that gapes and cannot be expected to heal with good function or cosmesis without apposition. A wound that…

…cancer and previous venous thromboembolism. A documented decision on the ceiling of care. Signs of a serious condition Finding Significance : : Inability to speak in full…

…attack : : : : Speech Full sentences Cannot complete a sentence in one breath Single words or unable to speak Position and behaviour Can lie down or sit…

…A full blood count, electrolytes, creatinine, coagulation tests and troponin are taken in parallel but must not delay treatment in a patient without suspected coagulopathy…

…is inadequate and closer monitoring is required. Dabigatran is contraindicated at an eGFR < 30 mL/min. Check the full blood count and creatinine when…

…necessary. After previous punctures: change side, and avoid irradiated fields. Preparation and equipment Informed consent, current full blood count and coagulation screen, medication list. Chlorhexidine…

…cap, mask, sterile gown, sterile gloves and a large full body drape. Lidocaine 10 mg/mL for local anaesthesia, normal saline to flush all lumens…

…calcium and magnesium. Full blood count. Plasma glucose before insulin. Creatine kinase in suspected rhabdomyolysis. Phosphate, urate and lactate dehydrogenase in suspected tumour lysis syndrome…

…towards the anterior superior iliac spine and the middle finger extended along the iliac crest. Inject into the triangle between the index and middle fingers …

…i gel type have no cuff to inflate and are chosen on weight alone. When in doubt between two sizes in an adult: choose the…

…pH, base excess, haemoglobin and ionised calcium, together with a full blood count, INR, APTT and fibrinogen. 7. Give tranexamic acid where it is indicated…

…history, two people, full monitoring and airway preparedness With procedural sedation, one person must manage the sedation and another the reduction . Check the fasting status…

…inhibitors stabilize left ventricular remodeling, improve patient symptoms, prevent hospitalization, and prolong life. Furthermore, because ACE inhibitors also inhibit kininase II, they may lead to…

…may also be affected by perioperative electromagnetic interference (EMI). The principal perioperative concern is interaction between the CIED and equipment used during surgery, particularly electrosurgery…

…term apical ballooning syndrome ). This syndrome was first descried in 1991 in Japan and the authors termed it takotsubo , which is the Japanese word for…

…person and the probability is around 46 % that at least one will fall outside. The ranges below are guide values for adults. The method and…

…An unsynchronised shock that happens to fall in the T wave can precipitate ventricular fibrillation, and cardioversion of fibrillation of unknown duration without anticoagulation can…

…least two occasions, and preferably confirmation by home measurement or 24 hour recording — the thresholds for which are lower than for office measurement. Classification of…

…alert value < 3.9 mmol/L but at least 3.0 mmol/L Prompt action is needed to prevent a further fall Level 2…

…With ultrasound guidance, the point at which the fluid lies most superficially is chosen and the needle is followed all the way in, which has…

…thereby decreasing the likelihood of arrhythmia onset. However, beta blockers do not fully eliminate the risk. In LQT3 patients, where arrhythmias often occur at rest…

…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…

…the plaque through the disrupted surface. Type 2 MI: Attributed to an imbalance between myocardial oxygen supply and demand, without the presence of acute atherothrombosis…

…The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias. Mechanical or pump failure complications , including heart failure and cardiogenic shock…

…upper reference limit (URL). It is considered acute when there is a rise and/or fall in cTn values. An elevated cTn alone does not…

…descending aorta and vena cava inferior . The pressure in the vena cava inferior is very low, such that the vein can be fully compressed in…

…mechanism. Sequential activation implies that the atria are activated first and they fill the ventricles with adequate volumes of blood before ventricular contraction commences. To…

…the absolute majority. The CCU may be suitable for stable (hemodynamically and respiratory) and fully conscious patients who experienced a brief cardiac arrest. Post resuscitation…

…emitted from the sound source. The difference in frequency between the emitted and the reflected sound waves is called Doppler shift . Erythrocytes in motion will…

Arrhythmias and arrhythmology ECG Premature atrial contraction (premature atrial beat / complex) A premature atrial contraction is produced by an impulse discharged from an ectopic focus…

…on schedule. The interval between the sinus beats occurring before and after the premature beat will be two sinus cycles (2 RR intervals). This is…

…Wide variability between measurements. Hypertension in pregnancy. Contraindications There are no absolute contraindications. Refrain or adapt in atrial fibrillation with a rapid and irregular ventricular…

…claudication, the ankle pressure is measured immediately after treadmill walking or after repeated heel raises. A fall of ≥ 20 % after exercise confirms peripheral arterial disease…

…dose daily and follow creatinine. Underdosing in sepsis is more dangerous than exceeding the upper dose limit during the first 24 hours. Give the ful

…as fully interchangeable with an arterial sample [3]. Venous pH is on average slightly lower than arterial pH. Agreement is usually good for pH and…

…of water balance. The plasma sodium reflects the ratio between the body's exchangeable sodium and potassium and the total body water. In hypotonic hyponatraemia…

…autonomic reflexes that influence the haemodynamic result. Reflex tachycardia is the rule after a rapid fall in blood pressure. Drug Indications Dosing α1 β1 β2…