…example, heterozygous carriers in a clearly recessive cardiomyopathy may not require the same follow up as individuals at risk in an autosomal dominant family, whereas…

…the highest risk of experiencing malign ventricular arrhythmias. Brugada syndrome is hereditary with an autosomal dominant inheritance pattern, meaning that only one mutated gene is…

…an increased risk of sudden cardiac arrest. They identified five unrelated families with features that represent a previously unrecognized autosomal dominant syndrome (4). Figure 1 …

…the reason for which remains elusive. Gene mutations can be confirmed in roughly 60% of individuals with ARVC. Mutations in the desmosomal gene PKP2 is…

…Brugada syndrome was classically defined as a monogenic, autosomal dominant channelopathy with incomplete penetrance and variable expressivity. The first and most critical genetic locus identified…

…failure is common among these individuals. The majority of the mutations are inherited in an autosomal dominant manner with variable penetrance and expressivity. Autosomal recessive…

…SCORE2 and SCORE2 OP are intended for apparently healthy people or for individuals with elevated BP who do not already have a condition conferring sufficiently…

…million individuals worldwide. In developed nations, the prevalence of HF is approximately 1–2% in the general adult population, but this figure rises steeply with…

…Ezzati et al, Lim et al ). Approximately 90–95% of individuals with hypertension have essential hypertension , also referred to as primary hypertension . Essential hypertension is…

…of therapy : Premature discontinuation of antiplatelet therapy, including prasugrel, in ACS patients treated with PCI can increase the risk of thrombosis, myocardial infarction, or death…

…BMI is a population measure that performs poorly at the level of the individual: it does not distinguish muscle from fat and takes no account…

Info This drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is…

Cardiology This drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is…

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiological rationale Dual antiplatelet therapy (DAPT) denotes treatment with aspirin plus a P2Y12 receptor inhibitor. In the…

…and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS)…

…shown in Table 1, BLS is an exceptionally effective treatment, with a very low number needed to treat (NNT), indicating high effectiveness. Although BLS is…

…Upon recognition of a cardiac arrest in a pregnant individual, either within or outside the hospital, prompt communication with an obstetrician and neonatologist is critical…

…common in women (70% are women) and elderly individuals. Clinical characteristics and ECG changes in takotsubo cardiomyopathy The typical patient presents with severe chest pain…

…As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with vasculitis Individual assessment Repeat the ABI every three to six months during ongoing…

…on a clear indication and with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment Hypertrophic cardiomyopathy with outflow tract obstruction Caution Tachyarrhythmia…

…The HCM Risk SCD score aims to identify individuals with a high risk of SCD and determine whether an implantable cardioverter defibrillator (ICD) is warranted…

…of cardiovascular disease (CVD), cardiovascular risk factor clustering, disability and premature mortality. Cardiovascular conditions associated with obesity include hypertension, dyslipidaemia, coronary artery disease (CAD), atherosclerosis…

…the whole community through healthier environmental defaults, whereas individual level prevention focuses more intensively on people with elevated risk. These approaches are not alternatives: both…

…of follow up in a prospective study of patients with acute coronary syndrome. Thus, an individual plaque’s morphology does not reliably establish that it…

…Stephen et al.). Figure 1 illustrates the decline in cardiopulmonary function and consciousness with decreasing body temperature. There appears to be a linear relationship between…

…tolerant with alcohol. They therefore treat the central mechanism underlying withdrawal, unlike, for example, beta blockers, alpha 2 agonists and antipsychotics, which mainly affect individual…

…creatinine ≥133 µmol/L Rivaroxaban 20 mg once daily with food 15 mg once daily at eGFR 15 49 mL/min Edoxaban 60 mg once…

…hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick reference for dosing in impaired renal function. Respiratory tract…

…and urogenital tumours Marked renal failure Low molecular weight heparin with dose adjustment, or warfarin Subsegmental pulmonary embolism without deep vein thrombosis An individual assessment…

…systemic disease, for example rheumatoid arthritis or scleroderma, and during treatment with pulmonary toxic drugs. Contraindications Forced expiration raises the pressure in the thorax, the…

…insufficient kidney function, and treatment with antiplatelet agents. Research indicates that the ORBIT score may offer better discrimination and calibration for major bleeding events compared…

…s formula. Note that a QTc interval 480 is always considered pathological. For patients with bundle branch blocks, the corresponding figure is 500 ms. The…

…lead to misclassification. Blood pressure should be measured with a validated and calibrated device using a consistent method for the individual patient. The recommended procedure…

…precisely, FFR compares the pressure driving flow distal to a stenosis with the pressure that would be available in the absence of that stenosis. The…

…Pre participation screening should follow applicable cardiovascular exercise screening guidance. In individuals with cardiovascular disease, an exercise test may provide objective information on peak exercise…

…in Brugada syndrome Brugada syndrome is a rare channelopathy (an electrical disorder caused by mutations in cardiac ion channels) which predisposes the individual to syncope…

…more frequently, as individually appropriate. 3 Important study: Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock (N Engl J Med 2021; 385…

…the aorta, the greater the load on individual muscle fibers. Also, the load on individual fibers is positively correlated with left ventricular volume, meaning that…

…the primary and secondary prevention of atherosclerotic cardiovascular disease, both at the population and individual levels. Several prediction models have been developed and validated for…

…or a haemoglobin below the applicable transfusion threshold (see below). Ongoing bleeding with haemodynamic compromise, whatever the current haemoglobin — haemoglobin falls late in acute haemorrhage…

…through statements made to the next of kin. Active malignancy with a risk of transmission (an individual assessment; certain tumour types are not a bar…

…estimate of atherogenic cholesterol than LDL C alone. It is particularly informative when triglyceride rich lipoproteins are increased, as commonly occurs with obesity, diabetes, prediabetes…

…the reduction in a subgroup with diabetes was approximately 19.1%. The drug also lowers hsCRP. In a population of individuals unable or unwilling to…

…who were described as frail generally had no more than mild frailty, limiting the applicability of trial findings to people with substantial functional impairment, multimorbidity…

…output is insufficient. Aortic regurgitation may cause myocardial ischemia because cardiac output diminishes in parallel with increasing myocardial load (and hence oxygen demand). The most…

…troponin levels, as compared with individuals with normal GFR. Men have approximately twice as high troponin, as compared with women (Mueller et al, Boeddinghaus et…

…branches, and thus more myocardium, as compared with a distally located thrombus. The duration of the ischemia: the longer the duration of the ischemia, the…

…Although the required skills, complexity and costs of interventions increase with each step in the chain of survival, it is the first 3 actions that…

…cardiac arrest (IHCA). Initiating or withholding CPR In cases of an unexpected cardiac arrest in an individual with any likelihood of survival, cardiopulmonary resuscitation (CPR…

…particularly in patients with irregular heart rhythms or low blood pressure. Additionally, individual variations in arterial compliance and pulse pressure can affect the accuracy of…

…selected individuals at intermediate risk, rather than as a universal population screening test. It may also be considered in selected lower risk individuals with a…

…low workload), followed by a successive (graded) increase in workload. The increase in workload occurs with predefined time intervals. A recovery period, during which the…

…for chest compressions. ECMO is considered in individuals who can survive with satisfactory quality of life if the circulation is temporarily supported by ECMO. Furthermore…

…at Higher GFR Levels: The MDRD equation tends to underestimate GFR in individuals with near normal or mildly reduced kidney function (eGFR 60 mL/min…

…with mildly reduced ejection fraction (HFmrEF; LVEF 41–49%) and heart failure with preserved ejection fraction (HFpEF; LVEF ≥50%). Patients with HFmrEF may represent individuals…

…available, PET MPI is recommended in individuals with suspected chronic coronary syndrome and a moderate or high pre test likelihood of obstructive coronary artery disease…

…stress testing in patients with previous acute coronary syndromes (myocardial infarction), women, elderly and revascularized individuals Clinicians should be familiar with the special challenges posed…

…Pauses up to 4 seconds in patients with atrial fibrillation. Bradycardia in atrial fibrillation (bradycardia–tachycardia syndrome) Individuals with sick sinus syndrome (sinus node dysfunction…

Procedurer Opioids have no standard dose. The effect varies tenfold between individuals, and the only way to find the right level is to give a…

…arrhythmic events in individuals with LQT1, LQT2, and LQT3. This model was developed using a single center longitudinal cohort and subsequently validated with an independent…