…are relative contraindications and are an argument for a superficial, compressible vessel. Allen's test is still used in many units to assess the collateral…

…include: High intensity statin therapy for all patients with ACS. Addition of a non statin lipid lowering agent in patients receiving maximally tolerated statin therapy…

…but in critical illness, marked hypoxaemia, or when an accurate PaCO₂ is needed, an arterial blood gas should be considered. Do not wait for the…

…treatment review. For a fuller account of two of the commonest acute drug problems, see Warfarin therapy and Opioid therapy in severe pain. Cardiac arrest…

…workload. Levosimendan is used in severe acute or chronic heart failure. Consider urgent angiography in patients with unknown etiology for acute severe heart failure. A…

…acquired). The VT is polymorphic with a gradual alteration in the QRS amplitude, often with twisting of the QRS complex around the isoelectric line. Most…

…Definition and pharmacological basis Ezetimibe is a non statin lipid lowering agent that inhibits the Niemann–Pick C1 like 1 (NPC1L1) transporter in the intestine…

…acquired). The VT is polymorphic with a gradual alteration in the QRS amplitude, often with twisting of the QRS complex around the isoelectric line. Most…

…considered in selected lower risk individuals with a family history of premature coronary artery disease. CAC findings incidentally identified on a chest CT performed for…

…In summary, the continuous wave Doppler cannot determine the location of the maximum velocity recorded, but it allows for the recording of very high velocities…

…time for all ultrasound waves to be emitted, reflected and processed in the machine determines the frame rate. As mentioned above, using 200 ultrasound lines…

…useful for quantifying the mobility of structures and measuring dimensions. In order to obtain representative measurements, it is pivotal to align the M mode line…

…charcoal — is the first line measure in decontamination, and gastric lavage is today a rare procedure reserved for very serious poisonings in which the patient…

…for high dependency or intensive care 3 Take at least two sets of blood cultures from separate peripheral punctures. Also culture from a central line…

…SA, et al. Use of CPR in hemorrhagic shock, a dog model. J Trauma Acute Care Surg 2016; 81:27 33 . Watts S, Smith JE…

…As in adults, the x axis represents time (the paper speed is typically 25 mm/s or 50 mm/s) and the y axis represents…

…To calculate flow across a valve, the Doppler line is placed in the valve orifice. The ultrasound machine displays the recorded flows as the spectral…

…3,4]. In parallel with the drug treatment Resuscitation, investigation and drug treatment must proceed simultaneously. Do not wait for laboratory results, CT or EEG…

…line therapy for patients who remain profoundly symptomatic despite optimal neurohormonal blockade and adequate volume control. It is also utilized for ventricular rate control in…

…line investigation for patients with low risk of CAD. Risk stratification : Myocardial perfusion imaging is valuable for assessing the risk of future cardiac events in…

…from the standard of care for these conditions. However, digoxin is still used in patients who do not achieve satisfactory effects using first line therapies…

…in line with guidelines issued by ASE, EACVI and BSE. External resources Guidelines from ASE (American Society of Echocardiography) Guidelines from ESC (European Society for…

…in this chapter are in line with guidelines issued by the American Heart Association (AHA), American College of Cardiology (ACC) and the European Society for…

…For diagnostic aspiration the point chosen is instead where the ultrasound shows the most fluid, usually in the scapular line one to two intercostal spaces…

…of known HPA suppression to determine whether replacement can be stopped. The test is not the first line investigation in a suspected acute crisis. There…

…cause life threatening compromise of the airway, breathing or circulation. Skin symptoms may be absent, and circulatory shock does not have to be present for…

…for emergency insertion in an unstable situation: intraosseous access or a large bore peripheral cannula bridges the gap until conditions are controlled. Contraindications In life…

…and continuous monitoring. An arterial line is often appropriate when very rapid or precise control is required, for example in acute aortic syndrome, marked neurological…

…rise in SVR. As for the intermediate dose, together with marked hypertension (caution during non selective beta blockade). Dobutamine Cardiogenic shock. Bradycardia (second line treatment…

…the patient gets too little oxygen but that the prescription has no target — the nasal cannula stays in place for days without anyone asking why…

…the cable, not through the pads. A pulse oximeter, a blood pressure cuff, and an arterial line for prolonged pacing. Venous access, oxygen, suction, airway…

…intervention during life threatening arrhythmias, thereby preventing sudden cardiac death. The 2015 European Society of Cardiology (ESC) guidelines advocate for ICD implantation in high risk…

…intervention during life threatening arrhythmias, thereby preventing sudden cardiac death. The 2015 European Society of Cardiology (ESC) guidelines advocate for ICD implantation in high risk…

…vasopressor and inotropic effects (Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER…

…vasopressor and inotropic effects (Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER…

…syndrome are fairly specific to the disorder, provided that the clinical characteristics are in line with the disorder. There are however other disorders that may…

…ACC) will be in line with the European guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment…

…are in line with recent guidelines (2020) issued by the American Heart Association (AHA), American College of Cardiology (ACC) and the European Society for Cardiology…

…ACC) will be in line with the European guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment…

…Otherwise the echocardiographic findings plus the clinical picture are sufficient for a treatment decision. Systemic thrombolysis is the first line treatment in high risk embolism…

…minutes' rest, if the patient's condition allows. 7. With titratable intravenous treatment and an unstable course, an arterial line should be considered. The blood…

…The Swedish clinical care programme for bacterial CNS infections states that CT must not be performed before lumbar puncture in suspected bacterial meningitis — not even…

…after the endoscopy. Fluid and monitoring Use a balanced crystalloid in the first instance. Give small boluses, for example 250 to 500 mL, with immediate…

…vascular structures is limited. CCTA has become an important first line investigation for selected patients with suspected coronary artery disease (CAD), particularly those with stable…

…remain central. Diagnostic Strategy Initial 12 lead ECG The resting 12 lead ECG is the first line diagnostic test in suspected acute coronary syndrome. It…

…PR interval is assessed in order to determine whether impulse conduction from the atria to the ventricles is normal. The flat line between the end…

…into the mediastinum. The anterior superior iliac spine is a second line alternative in marked obesity or when the supine position is necessary. After previous…

…Paroxysmal atrial fibrillation in patients with severe symptoms, provided that first line therapies have failed and the patient does not have structural heart disease or…

…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…

…interventions form the foundation of treatment. Statins are the preferred first line pharmacological therapy for patients at increased ASCVD risk. Ezetimibe is appropriate when the…

…include a Q wave, R wave and S wave, it is still referred to as a QRS complex . In other words, if ventricular depolarization only…

…ultrasound is constant in the body. The investigator specifies where the measurement should be performed by moving the sample volume (SV) along the Doppler line…

…of this discussion. The bottom line, however, is of direct clinical relevance and states that increased afterload results in a slower relaxation. Any condition leading…

…PR interval (<0,12 s) indicates pre excitation (presence of an accessory pathway). This is associated with a delta wave. For further details on the…

…Although BLS is primarily developed for out of hospital cardiac arrest (OHCA), it can be used in any setting until advanced cardiac life support (ACLS)…

CPR Time is the most critical factor for survival in cardiac arrest. Life saving interventions must be initiated momentarily to maximize the probability of survival…

…paradigm in cardiometabolic medicine. These therapies are revolutionizing public health strategies, transcending their original roles as glucose lowering agents to become essential tools for cardiovascular…

…and health related quality of life substantially influence both cardiovascular risk and the balance between treatment benefit and harm. Prevention in the very elderly therefore…

…the elderly also tend to have more atherosclerosis (both in frequency and severity) which may compensate for the inability to reach their maximal heart rate…

Cardiology Clinical medicine Definition and Clinical Context Blood pressure management in older adults must account for chronological age, biological age, frailty, multimorbidity, cognitive status, functional…