…thrombi are predominantly platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes thrombogenic material…

…syndrome lipid lowering recommendations. Acute coronary syndrome The period immediately following ACS is associated with particularly high risk of recurrent cardiovascular events. Intensive LDL C…

…presenting symptoms of NSTEMI. It does identify several clinical manifestations that indicate particularly high risk and should influence the urgency of management: Recurrent or ongoing…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…compromise or skin tenting — reduce promptly, before radiography. The longer a joint remains dislocated, the harder the reduction becomes and the greater the risk of…

…and the magnitude of LDL C reduction. Thus, even a modest absolute reduction may be clinically important in individuals at high or very high risk…

…site Relative Mechanical ventilation with a high PEEP (an increased risk of pneumothorax; ultrasound guidance is mandatory) Relative A very small or loculated effusion — consider…

…additional reduction of approximately 6%. Clinical indications and treatment goals Established atherosclerotic cardiovascular disease Patients with established ASCVD are at very high cardiovascular risk and…

…aortic dissection or active major bleeding is not suspected. 6. Call the PCI service immediately in STEMI, a STEMI equivalent or very high risk NSTEMI…

…confer greater risk per particle or unit of cholesterol than LDL cholesterol. Clinical implications High Lp(a) is independently associated with first and recurrent atherosclerotic…

…those with high bleeding risk, or those considered unlikely to adhere to medication. However, contemporary data support the use of DES in most PCI procedures…

…when triglycerides are elevated, LDL C is very low, or cardiometabolic abnormalities make LDL C an incomplete representation of atherogenic burden. Clinical Presentation and Symptoms…

…refractory to guideline directed medical therapy, occur at a low level of exertion, or are associated with high event risk. The apparent differences between thresholds…

…10 year risk of fatal or non fatal CVD Low <2% Moderate ≥2% to <10% High ≥10% to <20% Very high ≥20% The risk categories…

…defined by an increased concentration of circulating triglycerides. Both fasting and non fasting measurements provide prognostic information regarding cardiovascular risk. Thresholds vary among guideline systems:…

…young individuals. The severity of symptoms and presence of high risk arrhythmias on ECG guides the management of non acute or asymptomatic bradyarrhythmia. In patients…

…with normal renal function, the occurrence of contrast induced AKI is negligible or very low. Risk rises substantially with chronic kidney disease, particularly diabetic kidney…

…and quality of life may be equally important therapeutic objectives. Evidence from randomized trials is often less applicable to very frail or multimorbid patients because…

…recommended as the initial study in patients with low to moderate risk of CAD. In patients with a high to very high risk of CAD…

…90 mg or treatment with another adenosine diphosphate (ADP) receptor inhibitor for patients who had coronary syndrome and are at high risk of developing a…

…illness or after prolonged very high intake More than 90 percent of withdrawal seizures occur within 48 hours. Seizures later than this, focal seizures or…

…sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real…

…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…

…ECG monitoring and early assessment of the need for dialysis ECG changes or serious neuromuscular symptoms mean a high risk even if the plasma potassium…

…seconds. Case reports have indicated that the risk of high degree AV block and ventricular arrhythmias is greater in patients on digoxin or verapamil, although…

…Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced…

…I High Obesity 35.0–39.9 II Very high Extreme obesity ≥40 III Extremely high BMI is useful for screening and population level risk…

…is symptomatic or at risk of developing symptoms. The most common non reversible causes of sinus bradycardia are sinus node dysfunction, side effects of medications…

…majority of individuals in high income countries have some degree of coronary atherosclerosis. Risk factors for atherosclerosis (e.g smoking, hypertension, diabetes, hyperlipidemia [particularly high…

…majority of individuals in high income countries have some degree of coronary atherosclerosis. Risk factors for atherosclerosis (e.g smoking, hypertension, diabetes, hyperlipidemia [particularly high…

…at very high risk HDL Women 1.3, men 1.0 mmol/L Triglycerides < 1.7 mmol/L 10 carries a risk of pancreatitis…

…foreign materials pose a high risk of infection. Approximately 20% of all endocarditis affect people with valve prostheses and among other cases 18% show significant…

…double blind, placebo controlled study of 13,970 patients at high cardiovascular risk who were unable or unwilling to take statins. Approximately 70% were in…

…characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic cardiovascular disease (ASCVD)…

…with reduced left ventricular function (e.g. defined as ejection fraction <40 %) are at high risk of sudden cardiac arrest. Idiopathic ventricular tachycardia (IVT) Ventricular…

…presumably explained by a higher incidence of malignant ventricular arrhythmias. It has been suggested that the high risk of ventricular arrhythmias is due to the…

…has very good prognosis and may even occur in otherwise healthy individuals. However, if the QRS complexes are wide there is a risk of distal…

…and the balance of risk and benefit determine whether treatment is initiated. High 3 9 As above. Very high Oral anticoagulation (warfarin or NOAC) is…

…The risk of ventricular fibrillation is very high during torsade de pointes . ECG showing an episode of sinus rhythm (with multiple ventricular premature beats) spontaneously…

…the risk of terminating drug therapy as compared with implementing an artificial pacemaker in order to be able to continue drug therapy. It is very…

…even if the relative risk is high, the absolute risk can be low. Mechanisms and pathogenesis of early repolarization The biological mechanisms underlying the early…

…with a very high clinical likelihood of obstructive CAD, defined in the source material as greater than 85%, particularly when one or more of the…

…nonspecific intraventricular conduction delays were at particularly high risk of death due to arrhythmias. Note that other causes of wide QRS complex must always be…

…aspects of pathophysiology and discussions on differential diagnoses for each condition. Moreover, most books included very few real world examples of the conditions, or provided…

…treatment, with a very low number needed to treat (NNT), indicating high effectiveness. Although BLS is primarily developed for out of hospital cardiac arrest (OHCA)…

…is of paramount importance. In cardiac arrest due to asphyxia, the probability of return of spontaneous circulation (ROSC) is high but survival is very low…

…international consensus report of 2024, the diagnosis of DKA requires three components: diabetes or hyperglycaemia, ketosis and metabolic acidosis. A very high glucose value is…

…IPAP against hypercapnia SpO₂ 88–92% Hypoxaemic failure without hypercapnia CPAP or high flow nasal oxygen 5–10 cmH₂O According to oxygenation requirement SpO₂ 92…

…Chest pain rated as 6 or above (according to the 10 point scale) should prompt termination of the stress test (refer to Termination criteria during…

…is normal or inconclusive. The principal diagnostic strength of CCTA is its ability to exclude significant anatomical CAD with high sensitivity and a high negative…

…circumstances of hypotension and hemorrhage, it is imperative to administer appropriate fluid or erythrocyte boluses to restore circulatory volume. To ensure optimal oxygen delivery, high…

…of 60%. 4 points make LVH probable. 5 points make LVH very likely. Romhilt Este's score system Points Any of the following: R or…

…the Purkinje system is very rapid, due to the high density of gap junctions. This rapid transmission ensures that the majority of the ventricular myocardium…

…firm evidence of myocardial necrosis (i.e infarction). This is explained by the fact that there is no (or very little) turnover of myocardial cells…

…atrioventricular node from those originating in the bundle of His. Well trained athletes may have very high Vagal tone which lowers the automaticity in the…

…with or without shivering 28 31°C Severe hypothermia Unconscious, with signs of life <28 °C Very severe hypothermia No signs of life <24 °C Actions…

…or QS complex suggest ventricular tachycardia. R or RR complex without initial q wave suggests SVT. All in all, Brugada's criteria have very high…

…of 5–10 years. A shorter lifespan can be expected if the pacing requirement is extensive, or if the stimulus threshold (discussed below) is high…

…and Mobitz type 2. A very simple rule of thumb can be applied to do this: whenever there are varying PR intervals, the diagnosis is…

…results in high, pointed and asymmetric T waves. These must be differentiated from hyperacute T waves seen in the very early phase of myocardial ischemia…