…min). Patients with mild to moderate heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function)…

…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…

…ischemia and infarction Definition and Pathophysiology Angina with non obstructive coronary arteries (ANOCA) describes anginal symptoms in patients whose epicardial coronary arteries are normal or…

…interstitial edema, and inflammatory extravascular compression. This impaired tissue perfusion can extend injury beyond the initial ischemic zone and contributes to ventricular failure. Mechanisms of…

…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…

…ascending or type A aortic dissection Myocardial free wall rupture after infarction Anticoagulant associated bleeding Renal failure Systemic inflammatory disease Catheter based electrophysiological and structural…

…HFrEF), with or without diabetes Heart failure across the ejection fraction spectrum, according to the guideline key points Patients with renal insufficiency and cardiovascular disease…

…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…

…at a dose according to the local protocol. Usually a bolus followed by repeated doses or an infusion Suspected adrenal crisis Give the corticosteroid immediately…

…then been passed and you are in the subcutis. 5. Lift the specimen gently with a needle tip or fine forceps applied to its edge…

…passes through muscle without major vessels or nerves, and the landmark — the posterior corner of the acromion — is easy to palpate even in a large…

…normal or non diagnostic CT. Suspected neuroborreliosis, neurosyphilis or another CNS infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome, autoimmune encephalitis. Meningeal carcinomatosis and…

…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…

…stunning. The systemic response to reperfusion and ischemia causes a state similar to SIRS (systemic inflammatory response syndrome) with risk of disseminated intravascular coagulation, hypotension…

…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…

…with apolipoprotein(a) structure and kringle IV repeat number. Assays show substantial variability, partly because apolipoprotein(a) isoform size can lead to underestimation or ov

…and radiation. Onset and temporal pattern. Duration and recurrence. Provoking and relieving factors. Associated symptoms. Similarity to previous documented angina or myocardial infarction. Atherosclerotic and…

…head and neck Fragile skin, poor healing Ear canal stenosis or exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A…

…observational and the results must not be taken to mean that an electronic alert replaces clinical judgement [5]. Recognising sepsis Suspected or confirmed infection together…

…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…

…not the skin. Aspiration needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe…

…Scan in the position in which the patient is to be punctured. Identify the diaphragm, the liver or spleen, the lung and the fluid level…

…in order to try yet another dose. Chronotropic support is given as an infusion of isoprenaline, adrenaline or dopamine according to local practice, and does…

…injecting into it, and expect the procedure to hurt even so. Offer nitrous oxide, oral or intravenous analgesia, or procedural sedation in advance. Inadequate analgesia…

…Measure immediately and correct marked hypoglycaemia Time of onset Document the exact clock time of symptom onset or the time last known to be well…

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

…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…

…contrast exposure and other ischaemic or nephrotoxic stresses. The kidney is particularly vulnerable to toxic injury because of its high blood flow and the concentration…

…Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency Concomitant interacting medications The SLCO1B1 rs4149056 polymorphism is associated with higher statin concentrations and may…

…to left heart disease Group 3: PH due to chronic lung disease, hypoxia, or sleep disordered breathing Group 4: Chronic thromboembolic pulmonary hypertension (CTEPH) and…

…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…

…contraindication. The agent and dose are according to the local protocol. Alternatives when there is a contraindication: catheter directed treatment or surgical embolectomy where available…

…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…

…as part of fluid management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation to the hand. Vascular disease in the limb…

…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…

…tendon and the patellar tendon — do not inject into or beside them. Anticoagulant treatment is not a contraindication to these superficial injections. Preparation and equipment…

…the skull and the eyes. Postpone the test in: Condition Recommended delay : : Myocardial infarction or unstable angina 1 month Pneumothorax 1 month after resolution Pulmonary…

…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…

…COPD or another clear risk of hypercapnic respiratory failure 88 to 92 percent No risk of hypercapnia and a normal blood gas Usually 94 to…

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

…homocysteine or methylmalonic acid Folate 7 nmol/L Electrolytes and renal function See the renal parameters for the eGFR stages and albuminuria. Inflammation and infection…

…2026 and are given for absolute eGFR in mL/min , not eGFR relative to 1.73 m². Recalculate in patients who are markedly larger or…

…tumour types are not a bar). Untreated generalised infection, or certain transmissible agents according to the current transmission risk assessment. In DCD: patients in whom…

…a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury, anaphylaxis, deep neck infection…

…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…

…to interpret. Skin and soft tissue Diagnosis Agent Dose Duration : : : : Erysipelas phenoxymethylpenicillin 1 g × 3 (2 g × 3 if weight 90 kg) 10 days or…

…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…

…or less successfully terminate 92% of supraventricular tachycardias (SVTs), usually within 30 seconds. Doses higher than 18 mg are unlikely to revert a tachycardia and…

…1, β 2 agonist Start infusion at 4 μg/min and titrate to desired result T½ 1 min • May cause ventricular arrhythmias (dose dependent)…