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Sinus bradycardia: definitions, ECG, causes and management

…heart rates. During vasovagal syncope (e.g during intense emotional stress) During vagal maneuvers (Valsalva maneuver, carotid sinus [baroreceptor] stimulation). It is common to discover…

Opioids in acute pain: quick reference for dosing and conversion

…pain: the onset takes 12 to 24 hours and the offset just as long. Breakthrough dose During ongoing opioid treatment: a breakthrough dose of about…

Quiz: ECG in athletes

…is borderline or abnormal and the heart rate is less than 50 beats/min? A: Proceed directly to an exercise ECG test without repeating the…

Pericardial Effusion & Cardiac tamponade

…as congenital malformations leading to an incomplete or absent pericardium. In case of suspicion of pericardial disease, it is important to conduct a careful investigation…

Opioid therapy in severe pain

…started in an opioid naive patient, or when a conversion between drugs is made without reduction for incomplete cross tolerance. Indications Acute severe nociceptive pain…

Complete Versus Culprit-Only Revascularization in Acute Coronary Syndrome

…function, bleeding risk, comorbidities, frailty, and anticipated adherence to antithrombotic treatment. Whether the patient is suitable for PCI, CABG, or an initial medical strategy. In…

Familial and Genetic Screening in Premature Cardiovascular Disease

…50% risk of transmitting the relevant variant to each child. However, other inheritance patterns, de novo variants, incomplete penetrance and variable phenotypic expression complicate risk…

Left Bundle Branch Block: ECG criteria and clinical implications

…7]. Etiology and Mechanisms LBBB may result from lesser degrees of conduction delay within the left bundle system in the case of incomplete LBBB [7]…

Myocardial Infarction with Non-Obstructive Coronary Arteries: Causes, Work-up and Management

…or systemic, and treatment is inappropriate or incomplete if the mechanism is not established. Myocarditis and takotsubo syndrome can produce myocardial injury and troponin elevation…

Refractory Angina: Options When Standard Therapy Fails

…or weekly despite multiple antianginal agents and prior revascularization procedures. In many patients, the burden is sufficiently severe to limit ordinary activities and substantially impair…

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