…MELD Na is used for transplant prioritisation; both are available among the calculators. Fibrosis markers Index Calculation Interpretation : : : FIB 4 (age × AST) / (platelets × √ALT) <…

…the past century. Initial post mortem observations in the late 19th century first linked thrombotic occlusion of a coronary artery with myocardial necrosis. Although early…

…is not automatically attributable to Dressler syndrome. A pericardial effusion measuring more than 10 mm at end diastole after AMI should prompt investigation for possible…

…haemoglobin — haemoglobin falls late in acute haemorrhage and a normal value does not exclude significant blood loss. Massive haemorrhage meeting the criteria for activation of…

…Beta blockers, particularly non selective agents like nadolol and propranolol, are the first line treatment for reducing arrhythmic risk across all LQTS genotypes. These medications…

…Beta blockers, particularly non selective agents like nadolol and propranolol, are the first line treatment for reducing arrhythmic risk across all LQTS genotypes. These medications…

…underlying conditions increase a patient's sensitivity to digitalis related arrhythmias. The clinician must evaluate for the presence of worsening renal function, advanced age, hypokalemia…

…after infarction. VSR may also occur as late as 2 weeks after infarction. Predisposing features Risk features vary by lesion but include: Older age. Female…

…sensitivity for detecting coronary thrombus. Drug eluting stents (DES) may prolong the period of susceptibility because their antiproliferative agents can inhibit endothelialization. Very late thrombosis…

…aorta can be regarded as a cylinder, and the same assumption can be made for the other valves. The area is calculated by measuring the…

…course, not on a single eGFR. Step 1: confirm the course and assess severity Establish the baseline Look for previous creatinine values in the record…

…A low NIHSS does not exclude a disabling deficit, for example aphasia, hemianopia or hand paresis in a person of working age Blood pressure Measure…

…the corticosteroid immediately. Do not wait for laboratory results. Take a serum cortisol and ACTH first only if this does not delay treatment. Plus fluid…

…antiemetic prescribed at the same time as the opioid — not afterwards. A current creatinine with the eGFR, the weight, the age and the medication list…

…not formalin Suspected vasculitis 4 mm punch from a lesion less than 48 hours old Also take a biopsy for immunofluorescence Panniculitis Excision or a…

…infarction. IIa B Routine blood sampling for serum markers is indicated as soon as possible in the acute phase but should not delay reperfusion treatment…

…and later restenosis. Coronary stents provided a scaffold that tacked down dissection flaps, counteracted elastic recoil, reduced emergency vessel closure and decreased the need for…

…may indicate procedural myocardial injury. Late gadolinium enhancement cardiac magnetic resonance imaging has demonstrated procedural injury in patients undergoing either procedure, and postprocedural cTnI elevation…

…has increased in parallel with older maternal age at first childbirth and the rising prevalence of obesity. Gestational hypertension is defined in the supplied guideline…

…greater risk of bleeding and myocardial rupture. Late presentation For patients presenting more than 12 hours after symptom onset, PPCI is recommended when there are…

…in its appropriate use, although specific dosing instructions are not provided in the source material. Delayed help seeking is associated with older age, female sex…

…al). ARVC is more malignant in men, the reason for which remains elusive. Gene mutations can be confirmed in roughly 60% of individuals with ARVC…

…The ECG is a useful tool for detecting hypertrophy/dilatation but echocardiography and magnetic resonance imaging (cardiac MRI) are superior to the ECG in terms…

…may be accompanied by already impaired ventricular function, does not allow for adequate filling of the ventricles, which results in reduced stroke volume and reduced…

…tissues and organs. A few decades later Cohnheim demonstrated that ligation of the left anterior descending artery in dogs resulted in myoardial infarction. An important…

…simply. Life in the Fast Lane Australian site with one of the most impressive ECG libraries available. A must for anyone interested in ECG interpretation…

…can precipitate ventricular fibrillation, and cardioversion of fibrillation of unknown duration without anticoagulation can cause a stroke hours to weeks later. Everything else in the…

…measure in decontamination, and gastric lavage is today a rare procedure reserved for very serious poisonings in which the patient reaches hospital early. The benefit…

…inject later. Preparation and equipment Chlorhexidine in alcohol 5 mg/mL: clean with 3–4 swabs in wide circles and let it dry for a…

…be given dexamethasone. That is the practical key: the patient does not have to be left unprotected for the test to be interpretable. Procedure 1…

…catheter is not, however, indicated for incontinence as the sole reason, for convenience where the workload is heavy, or as a substitute for mobilisation and…

…intima, and thrombus formation. Atherosclerosis is therefore not simply a disorder of lipid storage. Its biology includes: accumulation and modification of lipids within the intima…

…have greater consequences in frail patients. Clinical Assessment Frailty and Functional Status Treatment decisions should not be based on age alone. Assessment should include: Degree…

…risk. Pathophysiology and genetic principles Penetrance and variable expression A pathogenic variant does not invariably result in clinical disease. Penetrance is incomplete and age dependent…

…10 years later in females. Untreated HoFH is associated with extensive premature and progressive ASCVD; CAD and aortic stenosis may occur before the age of…

…wide QRS complex (QRS duration ≥0.12 s). Refer to Figure 1 for an example. The premature ventricular impulse replaces a sinus beat and induces…

…healthy and diseased individuals. For example, roughly 90% of males aged <30 years display concave ST segment elevations in leads V2–V3. This explains why…

…This is done by analyzing the time it takes for the sound to return to the transducer and thus calculating the distance to the structure…

…ECG) become apparent. In contrast, modalities like echocardiography and ECG typically identify ischemia at later stages, when functional or electrical alterations are evident. Subjective symptoms…

…level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not merely detoxification. Benzodiazepines reduce the…

…Where serious poisoning is suspected, blood and urine can be saved early for later targeted analysis. Initial monitoring and investigations Investigation Comment : : Plasma glucose Taken…

…assessed for tendon and nerve injury will heal badly however neatly the suture is placed. The commonest cause of wound infection is retained contamination, not…

…age 65, and concomitant drug/alcohol use. Some studies suggest HAS BLED has comparable or slightly superior predictive capability for major bleeding compared to ATRIA…

…factor for stroke in AF patients. Evidence suggests that the increased stroke risk in women is more closely associated with other comorbidities and age rather…

…schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation. Am Heart J . 2006;151(3):713 719. 2. Apostolakis S, Lane DA…

…associated with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational diabetes Small for gestational age delivery…

…and anti inflammatory agents from the stent surface and have substantially reduced this process compared with BMS. Neoatherosclerosis Neoatherosclerosis is a later pathological process in…

…and therefore the worse the prognosis. This does not always hold true. For example, in cardiac arrest due to pulmonary embolism the initial rhythm is…

…All available ECG criteria for acute myocardial infarction and ischemia are based on conventional 12 lead ECG. Established ECG criteria do not apply to mathematicallyderived…

…Infections are difficult to heal because the heart valves are not vascularized and therefore it is difficult for the immune system to reach the bacteria…

…individual variation in the coronary artery anatomy. These details will be discussed in later chapters. As for now, it is sufficient to note that the…

…predictors of risk for future adverse events in virtually all patient populations, including apparently healthy individuals. Exercise stress testing in the age of non invasive…

…later). Second degree AV block Synonyms: AV block 2, AV block II In second degree AV block, some impulses are completely blocked, such that not…

…Figure 1. The sinoatrial (SA) node and atrioventricular (AV) node are located in the atria and are not part of the ventricular conduction system. The…

…rescue PCI. For the purpose of assessing ST segment return, one should preferably use continuous ST segment monitoring. If monitoring equipment is not available, 12…

…to calculate the distance that the myocardium moves during the cardiac cycle. The predominant technique for tissue tracking is speckle tracking, which is discussed later.