…be removed in general practice or in the emergency department with simple equipment. Two principles determine the outcome: the first attempt is the best attempt …

…low pressures. No smoking or coffee in the preceding hour. Remove socks and any compression stockings. Avoid measuring the arm pressure on the side with…

…75 years without diabetes and with LDL C between 70 and 189 mg/dL, 10 year risk of a first hard ASCVD event—fatal or…

…hypertension Pulse pressure 40–60 mmHg A narrow pulse pressure suggests a low stroke volume Capillary refill < 3 s A simple and validated marker…

…morphology, which replaces the sharp negative S wave seen in the low risk beat — the previously undescribed biomarker identified by the deep learning model. Predicting…

…rationale Bempedoic acid is an oral, small molecule lipid lowering agent used to reduce low density lipoprotein cholesterol (LDL C), particularly when statins cannot be…

…Familial hypercholesterolaemia (FH) is an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess…

…Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a hepatic protein that regulates the availability of the low density lipoprotein receptor (LDL receptor) on hepatocytes…

…left and right ventricle is rather common. The ECG has low sensitivity with respect to detecting biventricular hypertrophy. This is because the strong and oppositely…

…recovery. A patient who stops at a low workload with a fall in blood pressure is a high risk patient even with normal ST segments…

…damage. Conversely, a rapid rise in blood pressure from a previously low level can cause organ damage at lower values, for example in pregnancy, acute…

…disorder is defined primarily by Whipple's triad : 1. Symptoms or signs consistent with hypoglycaemia. 2. A documented low plasma glucose during the symptoms. 3…

…risk than one with an eGFR of 50 and A1. Estimating renal function Formula Used for : : CKD EPI 2021 (creatinine) The first choice for eGFR…

…The quality of the test determines its entire value: a poorly performed manoeuvre gives a falsely low FVC and thus a falsely normal FEV₁/FVC…

…in meters. BMI is relevant for medical prognostication as it serves as a quick, low cost, and reliable screening tool for body composition, risk of…

…risk in women based solely on gender. This aims to prevent unnecessary anticoagulation in low risk female patients, thereby reducing the potential for bleeding complications…

…despite normal or low LDL C or non HDL C Relatively low apoB despite higher cholesterol concentrations When apoB is discordant with LDL C or…

…also an appropriate first line pharmacological option when a patient is unable to tolerate any statin regimen. The treatment sequence for patients with chronic coronary…

…the preferred first line pharmacological therapy for patients at increased ASCVD risk. Ezetimibe is appropriate when the LDL C goal is not achieved with statin…

…taking low or moderate intensity statins should have treatment intensified. The 2025 ACS guideline recommendations include: High intensity statin therapy for all patients with ACS…

…SGLT2 is a high capacity, low affinity transporter situated in the S1 and S2 segments of the renal proximal tubule. It accounts for approximately 90…

…Structures with high echogenicity will reflect more ultrasound and appear brighter on the image. Structures with low echogenicity reflect less ultrasound and become darker in…

…shown in Table 1, BLS is an exceptionally effective treatment, with a very low number needed to treat (NNT), indicating high effectiveness. Although BLS is…

…coronary angiography is the first line option. Coronary computerized tomography angiography (CCTA) is currently the first line investigation for patients with low risk of CAD…

…of mitral regurgitation in low and middle income countries. Rheumatic heart disease typically results in thickening of the leaflets and may coexist with mitral stenosis…

…fine (low amplitudes). ECG 6 . Ventricular fibrillation, coarse. ECG 7 . Ventricular fibrillation, coarse. ECG 8 . Ventricular fibrillation. ECG 9 . Delivery of shock (red arrow), with…

…CPR) should be performed per standard guidelines. Cardiac arrests due to trauma are characterized by very low survival rates. In the nationwide Swedish Registry for…

…the same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure…

…the pH is normal, if the HCO₃ is low or the clinical picture raises suspicion 5 With a raised anion gap, is there a further…

…needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe for the first aspirate…

…hours Prednisolone 5 mg Moderate Intermediate, 12–36 hours Methylprednisolone 4 mg Low Intermediate Betamethasone 0.6 mg None Long, 36–54 hours Dexamethasone 0…

…First degree AV block: PR 220 ms. A PR interval 300 ms may become haemodynamically significant. Pre excitation: PR < 120 ms with a delta…

…when the shock is delivered, and that the thromboembolic risk has been dealt with before the atria begin to contract again. An unsynchronised shock that…

…needle at the same angle and press with a dry swab. Do not massage. Intramuscular — ventrogluteal The first choice for larger volumes and depot preparations…

…Inotropes increase myocardial contractility. There are several synthetic and endogenous agents with inotropic and vasopressor effects, and they often need to be combined in order…

…possible Thromboprophylaxis Low molecular weight heparin unless contraindicated Head of the bed 30–45° Stress ulcer prophylaxis During mechanical ventilation, in coagulopathy, or with a…

…and one below. Second generation masks with a separate drainage channel (i gel, LMA Supreme, LMA ProSeal) are the first choice in emergencies, since they…

…pattern: a reduced TLC — this cannot be established with spirometry alone, but is suspected when the FVC is low with a normal or high ratio…

…the only absolute indication, and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy…

…miss a posterior dislocation. The exceptions are an obvious recurrent dislocation in a patient with known instability and a low energy mechanism, and a neurovascularly…

…who have low BSA or severe extra aortic features 45 mm • Patients who are undergoing aortic valve surgery • Patients with Marfan syndrome who have additional…

…reduce the antiplatelet effect of acetylsalicylic acid. Use with caution in patients on low dose acetylsalicylic acid for cardioprotection. Pharmacokinetic interactions Methotrexate: NSAIDs inhibit tubular…

…Low risk 0 3 0.8% Intermediate risk 4 2.6% High risk 5 or more 5.8% Interpretation of ATRIA risk score. Comparison with…

…Evidence 0 No treatment Low No treatment High 1 Oral anticoagulation (warfarin or NOAK 1 is considered for male patients with a score of 1…

…widely recognized and validated tool used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF) who are taking anticoagulants…

…Low 2.5 2 Intermediate 5.3 3 Intermediate 8.4 4 High 10.4 ≥5 High 12.3 Interpretation of HEMORR₂HAGES score. Comparison with…

…low doses. Alpha effect pronounced at higher doses. Coronary flow enhanced. Pulm vasoconstriction. Increased pulmonary blood flow. Ventricular arrhythmias Severe hypertension resulting in cerebrovascular hemorrhage…

…low dose, or low intensity lipid lowering therapy: • Start high potency, high dose statin therapy (Class I recommendation). • Immediate combination with ezetimibe can be considered…

…stratifies patients into low, intermediate, and high risk categories. Clinical applications The SYNTAX Score is primarily used to: Guide Revascularization Strategy : Patients with low scores …

…stable patients with both RV dysfunction on imaging and elevated cardiac biomarkers. Intermediate low risk PE includes stable patients who are not low risk but…

…and incompletely absorbed after oral administration, with systemic bioavailability ranging from 25% to 65% and minimal hepatic first pass extraction. Following a single oral dose…

…prevention trials involving individuals with an estimated 10 year cardiovascular risk of 10%. Approximately 12% reduction in non fatal myocardial infarction with low dose aspirin…

…when the sinus rate is extremely low—such as less than 40 to 50 beats per minute in the first 4 to 6 hours after…

…10]. Physical examination may reveal a normal or low pulse pressure, an elevated jugular venous pressure with a paradoxical rise on inspiration (Kussmaul sign), and…

…disease, defined as atherosclerosis affecting at least two vascular beds. Carotid disease therefore commonly coexists with coronary artery disease (CAD), peripheral artery disease (PAD), and…

…Despite this relatively low prevalence, missed myocardial infarction remains consequential, and historically 2–6% of patients discharged with presumed non ischaemic chest pain were subsequently…

…Patients with stable or chronic atherosclerotic coronary disease, many of whom have a previous acute coronary syndrome. The available evidence supports consideration of low dose…

…60 mL/min, the risk is low. In patients undergoing percutaneous coronary intervention, even mild baseline renal dysfunction is associated with worse outcomes. The risk…

…is recommended as an initial test for diagnosing CAD in stable patients with: Low clinical likelihood or no previous diagnosis of CAD Characteristics suggesting that…

…the dose of prasugrel; extending DAPT beyond 12 months in carefully selected patients with high ischemic risk and low bleeding risk. These strategies are intended…