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…

…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…

…ratio was 0.83, with a 95% confidence interval of 0.72–0.95 and an absolute risk reduction of 2.4%. There was no…

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

…inflammation and fibrosis Reduction in body weight and haemoglobin A1c Increased uricosuria, with plasma uric acid reduction of approximately 10% to 15% Possible effects on…

…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…

…Sterile gloves, sterile gauze, and a fenestrated drape for injection. A needle of 0.8–1.2 × 50 mm for large joints (knee, shoulder), 0…

…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…

…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…

…inflammatory response. The presence of antibodies directed against cardiac tissue, the latent interval of several weeks, improvement with anti inflammatory treatment, and the tendency to…

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…

…Its biological effects appear to differ from those of LDL, and elevated Lp(a) may confer greater risk per particle or unit of cholesterol than…

…myocardial infarction remains consequential, and historically 2–6% of patients discharged with presumed non ischaemic chest pain were subsequently found to have had an infarction…

…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…

…praecordium to the left of the sternum, the other on the back between the left scapula and the spine. The anterolateral position also works and…

…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…

…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…

…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 and this is a serious condition. The focus of infection on the flap is called vegetation. As a rule, some kind of damage to…

…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…

…Catheter length: the right internal jugular vein requires the shortest catheter, while left sided and femoral insertions require longer ones — check the length in the…

…acid Folate 7 nmol/L Electrolytes and renal function See the renal parameters for the eGFR stages and albuminuria. Inflammation and infection Test Reference Comment :…

…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…

…be ready before induction , not looked for afterwards. Monitoring: ECG, pulse oximetry and blood pressure at short intervals. Tube size and depth Patient Internal diameter …

…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…

…initial dose should be reduced to 3 mg. Heart transplant patients: Due to denervation, which makes the sinus and AV nodes supersensitive to the drug…

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