Indications Acute myocardial infarction. Unstable coronary artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA…

…system. The underlying pathophysiology varies widely and may involve intrinsic cardiac disease, extrinsic systemic conditions, or pharmacologic effects. Inflammatory heart disease, caused by infections (viral…

…outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections…

…between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes. Mechanisms of action Colchicine Colchicine appears to exert several anti inflammatory…

…progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental pathophysiological substrate for acute coronary syndromes (ACS), including…

…Endothelial dysfunction may contribute to both microvascular and epicardial vasomotor disorders. Endothelial activation can promote the release of adhesion molecules, inflammatory cytokines, and vasoconstricting mediators…

…zone and contributes to ventricular failure. Mechanisms of Shock The central consequence of extensive infarction is loss of contractile myocardium, with reduced cardiac output and…

…of cardiovascular risk reduction was considered similar to that achieved with statins for a comparable absolute degree of LDL C lowering. Diabetes and glycaemic outcomes…

…Myocardial free wall rupture after infarction Anticoagulant associated bleeding Renal failure Systemic inflammatory disease Catheter based electrophysiological and structural cardiac procedures In patients with acute…

…consumption Natriuresis and diuresis Reduction in plasma volume, preload and afterload Lower left ventricular wall stress Reduced sympathetic nervous system activity Improvement in cardiac metabolic…

…an acute myocardial infarction during long term follow up. Moreover, several potentially high risk plaques may coexist within one coronary tree, and inflammatory activity may…

…lead to death ( Stone, Libby et al. ). As the atherosclerotic plaque increases in size, it bulges into the artery lumen and causes stenosis (reduction of…

…established ASCVD, its potential reduction in non fatal myocardial infarction and ischaemic stroke must be weighed against clinically important gastrointestinal and intracranial bleeding. Evidence in…

…confused: replacement therapy in adrenal insufficiency (which must be increased under stress) and pharmacological anti inflammatory treatment (which must be tapered in a controlled fashion)…

…thickness unmeasurable and staging therefore impossible; a superficial punch in a case of bullous dermatosis misses the subepidermal split. Choose the technique according to the…

…to press the remaining fluid down. 5. If a corticosteroid is to be given: hold the needle still, change the syringe and inject. The injection…

…neuroborreliosis, neurosyphilis or another CNS infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome, autoimmune encephalitis. Meningeal carcinomatosis and CNS involvement in haematological malignancy. Investigation…

…QRS complexes vary from one beat to another (in the same lead). This is due to the swinging back and forth of the heart in…

…survival. It includes diagnosis of post cardiac arrest syndrome (PCAS), optimization of ventilation, oxygenation, hemodynamics, antiischemic treatment, temperature treatment, treatment of seizures, and infections. However…

…weeks. The pathogenesis is presumed to be immune mediated. Pericardial injury, necrosis, bleeding, or pleural incision may expose cardiac antigens and initiate an inflammatory response…

Introduction to Coronary Atherosclerosis, Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by…

…thickness, early plaque formation and coronary microvascular dysfunction. Women with RA were reported to have approximately twice the myocardial infarction risk of age matched controls…

…segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS), acute coronary syndrome (ACS), myocardial infarction, and repeat target lesion revascularization…

…Lp(a) is independently associated with first and recurrent atherosclerotic cardiovascular disease events. The strongest observed associations are with myocardial infarction and aortic valve stenosis…

…injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin…

…exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy…

…parallel and must not wait for complete diagnostic certainty. Sepsis is defined as life threatening organ dysfunction caused by a dysregulated host response to infection…

…zero, and several syndromes can overlap [1,4]. Time after a clear reduction or the last intake Common clinical picture : : 4 to 12 hours Tremor…

…according to the national programme. Checking an intrauterine device or a pessary. Assessment of prolapse. Sampling for a suspected sexually transmitted infection — although chlamydia and…

…5. Aspiration: advance the needle with the stylet in place perpendicular to the bone surface, angled slightly anteriorly and medially. Rotate under steady pressure until…

…Suction and oxygen to hand. The patient sits leaning forward with the arms on a table for diagnostic and therapeutic aspiration; for drain insertion the…

…infection at the puncture site, known thrombosis in the target vein. With a mechanical tricuspid prosthesis the lead must not be passed through the valve…

…a field block in healthy skin around the abscess instead of injecting into it, and expect the procedure to hurt even so. Offer nitrous oxide…

…and does not delay treatment Saturation Give oxygen in hypoxia, not routinely to a normoxic patient Temperature Treat fever and look for an underlying infection…

…the eyelids, conjunctiva, cornea and anterior chamber. Note the pupil size, shape and reaction to light. A teardrop shaped or peaked pupil suggests perforation. Look…

…an antihistamine, oxygen, and the ability to lay the patient down. Injection Needle Angle Maximum volume per site : : : : Deltoid, adult 23–25 G, 25 mm…

…Infection or burns over the puncture site. Osteogenesis imperfecta and severe osteoporosis (relative). An inability to identify the landmarks. Choice of vein and cannula size…

…renal insults. Infection, hypovolaemia, cardiac dysfunction, haemodynamic instability, anaemia and other nephrotoxic exposures may contribute to tubular injury, making attribution to contrast alone difficult. In…

…C reduction, including modulation of inflammation, oxidative stress, endothelial function, plaque stability, thrombogenic responses and immune activity. Statin intolerance refers to adverse effects attributed to…

…by an mPAP/cardiac output slope greater than 3 mmHg/L/min from rest to exercise. This response is age dependent and may rarely occur…

…in the presence of clinical signs of infection — all chronic wounds are colonised, and a culture taken without clinical suspicion leads only to unnecessary antibiotics…

…benefits relevant to clinical cardiology include: Clinical setting or outcome Reported benefit of cessation Cardiovascular disease overall Substantial reduction in cardiovascular events and mortality Established…

…unless there is an absolute contraindication. The agent and dose are according to the local protocol. Alternatives when there is a contraindication: catheter directed treatment…

…valves, patients with valve prostheses or other cardiac devices (pacemaker, CRT, ICD). In addition to staphylococcus aureus , hemolytic streptococci and pneumococci cause acute endocarditis. Other…

…ulnar pulse and a warm, well perfused hand carry more weight. Choice of vessel The radial artery is the first choice : superficial, easy to compress…

…fluid and a vasopressor according to the sepsis pathway when needed 9 Contact the haematologist or oncologist. Contact an infectious diseases physician early in a…

…Mix the corticosteroid and the lidocaine in the same syringe. The anaesthetic confirms that the injection has gone to the right place — immediate pain relief…

…Condition Recommended delay : : Myocardial infarction or unstable angina 1 month Pneumothorax 1 month after resolution Pulmonary embolism, until anticoagulated and stable An individual assessment Eye…

…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…

…level of consciousness and circulation. 2. Give controlled oxygen with a target of 88 to 92 percent until the risk of hypercapnia has been assessed…

…technique is designed to make sure that never happens, and to make sure the catheter does not become the patient's next focus of infection…

…mmol/L Triglycerides < 1.7 mmol/L 10 carries a risk of pancreatitis Cardiac markers and coagulation Test Reference Comment : : : High sensitivity troponin T…

…conceal markedly reduced renal function. Acute kidney injury changes clearance from day to day. Reassess the dose daily and follow creatinine. Underdosing in sepsis is…

…develops total brain infarction An intensive care patient in whom life sustaining treatment is withdrawn and total brain infarction is not expected to occur Death…

…anaphylaxis, deep neck infection, an expanding haematoma, facial trauma. An anticipated course requiring a secured airway — transfer, heavy sedation, surgery — and cardiac arrest. Contraindications There…

…In impaired consciousness or DKA: remove the pump and change to an infusion or injections Drugs for type 2 diabetes in inpatients Agent The acutely…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…selective intracoronary contrast injection under fluoroscopy. The procedure is performed by advancing guidewires and diagnostic catheters from a percutaneous arterial access site to the aortic…

…of cardiac cells. Through the guanine nucleotide regulatory proteins Gi and Go, adenosine activates potassium channels (IK.Ach, K.Ado) in a manner analogous to…

… please refer to theCauses of AV blocks) and physical examination. It is also reasonable to analyze cardiac troponins if there is any probability of myocardial…