…gastrointestinal disorders. Patients with severe kidney disease (glomerular filtration rate < 30 mL/min). Patients with mild to moderate heart failure, kidney or liver disease…

…complications. Seizures in a patient with preeclampsia indicate eclampsia. Postpartum disease is clinically important. Hypertension is most frequent in women who had antenatal hypertensive disorders…

…distinct and uncommon form of precapillary PH. It is defined haemodynamically by precapillary PH in the absence of CTEPH, lung disease, or another explanatory cause…

…of increasing frequency of hospitalizations and visits for heart failure without disease recognition in the 3 years preceding diagnosis is also a notable red flag…

…completely different. It took roughly 50 years for researchers to finally conclude that high cholesterol levels caused coronary artery disease and atherosclerosis in general. This…

…and the speed of the course. An AST/ALT ratio 2 with moderately raised values suggests alcohol related liver disease; a ratio < 1 suggests…

…when additional LDL C reduction is required, including in patients with atherosclerotic cardiovascular disease (ASCVD) or heterozygous familial hypercholesterolaemia. The broader therapeutic principle is that…

…regurgitation Jet size < 5cm² 5 10 cm² 10 cm² size vena cava inferior < 2,1 cm and compressible in between 2,1 cm…

…therapy 18% Fixed dose combination with ezetimibe 38% Pooled analyses across different background therapies 17%–25% In patients with atherosclerotic vascular disease or familial hypercholesterolaemia…

…acid is recommended in the relevant guideline setting; combination with a PCSK9 inhibitor is also described for high risk patients with atherosclerotic peripheral arterial disease…

…electrolytes, liver function tests, albumin, urea and a blood gas with lactate 5 Give crystalloid in small boluses with frequent reassessment. Give blood according to…

…for example in newly diagnosed venous thromboembolism. 1. Check the INR before the first dose. A raised baseline value suggests liver disease or vitamin K…

…clinical factors: Anemia: Hemoglobin <13 g/dL in men or <12 g/dL in women (3 points) Severe Renal Disease: Estimated glomerular filtration rate (eGFR)…

…score is an acronym that stands for: H ypertension A bnormal renal/liver function S troke B leeding history or predisposition L abile INR (International…

…History of stroke or transient ischemic attack (TIA). Severely impaired liver function classified as Child Pugh Class C. Dosage Adults Initial dose : A single loading…

…cm 1.5–2.1 2.2–2.5 2.6–2.9 3.0 RV SIZE AND FUNCTION (MEASURED IN A4C) RV diastolic area…

…liver impairment. Concurrent administration of ticagrelor with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, nefazodone, ritonavir, and atazanavir) can lead to a significant increase in…

…50 times those found in plasma. Plasma clearance is low, renal excretion is negligible, and doses do not require reduction in patients with renal disease…

…in a single intermediate marker such as cholesterol. Dietary composition may influence blood pressure, glucose–insulin homeostasis, lipids and apolipoproteins, endothelial function, systemic inflammation, liver…

…atrial appendage, although competing mechanisms such as large artery atherosclerosis and small vessel disease may also contribute to stroke in patients with AF. Stroke risk…

…pathway when needed 9 Contact the haematologist or oncologist. Contact an infectious diseases physician early in a high risk course, in instability, with resistance problems…

…head injury with impaired consciousness, biliary tract disease. There is no contraindication to analgesia in the acute abdomen . The notion that an opioid masks the…

…to approximately 40–50 mg of oral morphine per day. Patches have no place in acute, unstable pain: the onset takes 12 to 24 hours…

…distance from the skin is shortest, and where no liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment…

…liver, spleen or internal thoracic artery increases. For diagnostic aspiration the point chosen is instead where the ultrasound shows the most fluid, usually in the…

…Investigation Comment : : Plasma glucose Taken immediately and repeated in impaired consciousness, or with insulin, a sulfonylurea, a beta blocker or liver failure Blood gas pH…

…or a rising lactate Kidney A rise in creatinine, oliguria, or a urine output below 0.5 mL/kg/h Liver A rise in bilirubin,

…does not convert atrial flutter to sinus rhythm. Vernakalant is only administered in a monitored clinical setting appropriate for cardioversion. Administration of vernakalant Vernakalant (Brinavess)…

…in some cases, fatty liver disease. Interpretation of the Agatston Score The score should be interpreted both by its absolute value and in relation to…

…extent of weight loss, the reductions in hard cardiovascular outcomes (MI, stroke) and metabolic liver disease involve significant weight independent pathways. 15 Metabolic Reprogramming and…

…failure, particularly when left ventricular function is impaired Haemodynamic or electrical instability in advanced or acute presentations Left main disease may be clinically silent, and…

…and renal pathophysiology in insulin resistance. Metabolic Dysfunction Associated Fatty Liver Disease Insulin resistance increases free fatty acid delivery to the liver and reduces intrahepatic…

…and improves walking distance. The role of PCSK9 inhibition in thoracic or abdominal aortic aneurysmal disease remains an emerging area of research. Pharmacological Classes and…

…systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical cul de sac [19] …

…already made and failed elsewhere. A child who cannot be kept still without sedation. Suspected tympanic membrane perforation. Irrigation is contraindicated in: suspected perforated tympanic…

…the diagnosis of HF Estimating disease severity and prognosis Contributing to longitudinal assessment and risk stratification They are useful in both acute and ambulatory presentations…

…Cardiac troponin levels are extremely low in healthy subjects; the 99 th percentile is less than a few nanograms per liter of blood (typically <5…

…occurs in approximately 1% of live births, and 10% of aborted fetuses, with no significant geographical variations. Roughly 25% of children with congenital heart disease…

…infarction. Ebstein's anomaly (Figure 1). Carcinoid heart disease. Endocarditis (common in intravenous drug addicts). Myxomatous degeneration. Rheumatic heart disease. Dilatation of the right ventricle…

…ataxia Posterior circulation stroke Unilateral hearing loss or tinnitus Ménière's disease, vestibular schwannoma, labyrinthitis Continuous vertigo that does not come in attacks Vestibular neuritis…