…Depression, schizophrenia, schizoaffective disorder, HIV infection or other circumstances that may affect cessation or treatment monitoring. Single question screening can identify unhealthy drug use requiring…

…Psychological and social factors also influence prognosis. Major depression after infarction is associated independently with increased mortality, while inadequate emotional support is associated with recurrent…

…only on a clear indication and with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment Hypertrophic cardiomyopathy with outflow tract obstruction Caution…

…not to increase the dose. Contraindications Ongoing respiratory depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus…

…2 diabetes, coronary disease, stroke, peripheral arterial disease, heart failure, depression, dementia and osteoporosis. It also improves functional capacity, skeletal health, muscular strength, quality of…

…capillary glucose. 3. Exclude immediately treatable threats without delay: hypoxia, hypoglycaemia, circulatory failure, sepsis, stroke, intracranial haemorrhage, seizure, poisoning and severe withdrawal. 4. Establish whether…

…examination directed toward both alternative diagnoses and high risk features of acute coronary syndrome. The physical examination should include: Assessment of all major peripheral pulses…

…failure. The rapid advances in the 1970s and 1980s were followed by almost two decades without any major breakthrough in the management of heart failure…

…failure. The rapid advances in the 1970s and 1980s were followed by almost two decades without any major breakthrough in the management of heart failure…

Cardiology Pharmacology & dosing Definition and Therapeutic Rationale Hypertension is a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It…

Cardiology Emergency medicine Surgery & trauma Definition and Pathophysiology Aortic dissection is a major form of acute aortic syndrome (AAS), alongside intramural haematoma, penetrating atherosclerotic ulcer…

Arrhythmias and arrhythmology Pharmacology & dosing Definition and pathophysiology Atrial fibrillation (AF) is a major independent risk factor for thromboembolism, including ischaemic stroke. This risk applies…

Cardiology Endocrinology & metabolism Definition and Pathophysiology Type 2 diabetes mellitus (T2DM) is a major cardiovascular risk condition. It is associated with a two to four…

…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…

…HEMORR₂HAGES bleeding risk score is a clinical tool developed to assess the risk of major bleeding in patients with atrial fibrillation (AF) on anticoagulation therapy…

…health status, but it should not be undertaken when symptoms are present without anatomical or physiological criteria supporting revascularization. In less severe coronary disease, PCI…

…in: a reduced level of consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged endoscopic intervention a…

…Fibrillation) Bleeding Risk Score is a clinical tool designed to estimate the risk of major bleeding in patients with atrial fibrillation (AF) undergoing anticoagulation therapy…

…Despite this prolonged course, its major complications—including myocardial infarction, unstable angina and stroke—may occur abruptly and without preceding warning. Initiation and progression of…

…therapy alongside standard treatment. Interleukin 1β inhibition Canakinumab reduced inflammatory biomarkers without affecting lipids or other major coronary risk factors. In patients with previous…

…with corroborating evidence of infarction caused by ischaemia, and no obstructive stenosis in a major epicardial coronary artery. Non obstructive disease is generally defined as…

…eclampsia. Clinical presentation and symptoms The clinical spectrum ranges from hypertension without apparent organ injury to severe multisystem disease. Severe features include: Severe hypertension, defined…

…death (SCD), Brugada syndrome (BrS) has evolved from an obscure electrocardiographic curiosity into a major focus of contemporary cardiac electrophysiology [1] . Recognized as a primary…

…The 2021 Universal Definition of Heart Failure, endorsed by major global cardiovascular societies, defines HF as a clinical syndrome corroborated by elevated natriuretic peptide levels…

…cardiovascular medicine. As a primary driver of sudden cardiac death (SCD) and a major cause of morbidity in patients with structural heart disease, VT necessitates…

…not delay reperfusion. 5. Give aspirin if acute coronary syndrome is likely and aortic dissection or active major bleeding is not suspected. 6. Call the…

…Repeated blood gases, for example during mechanical ventilation or severe metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom…

…where needed, coagulation expertise at the same time [1]. Activate the local major haemorrhage protocol early. Protocols improve above all the logistics, the communication and…

…on a surgical ward. Decompression in severe vomiting where the stomach does not empty. Intraoperatively and postoperatively after major abdominal surgery, according to local practice…

…the patient gets too little oxygen but that the prescription has no target — the nasal cannula stays in place for days without anyone asking why…

…venous access is not immediately available. Shock, severe trauma, burns or status epilepticus when peripheral access fails or is judged futile. Children in an emergency…

…moderate Aveed TESTOSTERONE UNDECANOATE TESTOSTERONE UNDECANOATE Heart Damage wp most major adverse cardiovascular events (MACE) severe ARISTADA ARIPIPRAZOLE LAUROXIL aripiprazole lauroxil Mixed wp less hypotension…

…Non Sustained Ventricular Tachycardia (NSVT) : Episodes of VT are a strong predictor of SCD. Unexplained Syncope : Syncope without a clear cause may indicate underlying arrhythmias…

…23–32) require careful consideration by a heart team. Predict Outcomes : The score has been validated to predict major adverse cardiac events (MACE) , including mortality…

…profile. Predicting Outcomes : It predicts 10 year mortality and 5 year major adverse cardiac events (MACE) with greater accuracy than the original SYNTAX Score. Heart…

…it may herald rupture and constitutes a medical emergency. Rupture may occur without preceding symptoms. Typical acute manifestations include severe pain, hypotension and abdominal tenderness…

…Sustained episodes may eventually degenerate into ventricular fibrillation (VF). Proarrhythmia, defined as a drug induced or drug exacerbated cardiac arrhythmia, constitutes a major clinical problem…

…paralysis, muscle rigidity and ultimately major tissue loss. Reperfusion after severe or prolonged ischaemia may be accompanied by rhabdomyolysis, with potential renal failure and increased…

…Following a single oral dose, plasma concentrations peak within 3 to 6 hours. The agent undergoes extensive hepatic metabolism, yielding desethylamiodarone as a major active…

…inhibitor produces dual antiplatelet therapy (DAPT), while treatment with one antiplatelet drug constitutes single antiplatelet therapy (SAPT). The benefit of antiplatelet therapy must always be…

…other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic cardiovascular disease (ASCVD), coronary artery…

…disease may be obstructive or non obstructive. Atherosclerotic plaque accumulation in the epicardial arteries is a major pathological substrate, but ischaemia may also result from…

…recurrent symptoms, myocardial infarction, or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular…

…and procedural complexity. Overall incidence and major complications Complications during diagnostic coronary angiography occur in approximately 2% of patients. Serious events such as stroke and…

…non contrast, electrocardiographically gated computed tomography (CT) scan. Image acquisition generally requires a single breath hold and does not require intravenous access, premedication, or special…

…Within the ARC HBR framework, HBR is defined by the presence of at least one major criterion or two minor criteria. The source material does…

…consider both cardiac and non cardiac etiologies [1]. Cardiac Causes The primary differential diagnoses include conditions that directly affect the myocardium or major vessels. 1…

…in patients who: Have tolerated DAPT without significant bleeding. Have high ischaemic risk. Do not have a high risk of major or life threatening bleeding…

…agents to become essential tools for cardiovascular risk reduction, offering profound benefits in major adverse cardiovascular events (MACE), heart failure with preserved ejection fraction (HFpEF…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Ischemic cardiomyopathy is severe myocardial dysfunction caused by coronary artery disease (CAD). The clinical syndrome may resemble…

…populations, reflecting differences in fat distribution and ethnicity. Abdominal obesity is a major driving force. Visceral adipose tissue is metabolically active and produces proinflammatory mediators…

…Myocardial ischemia and infarction Definition and Clinical Purpose Myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) or positron emission tomography (PET) is…

…the criteria for type 1 MI. Procedural myocardial injury may also occur without satisfying the diagnostic threshold for periprocedural MI. This distinction is clinically important…

…patients with resistant or severe hypertension and associated clinical features. Clinical presentation and symptoms The usual clinical manifestation is hypertension, often severe or resistant to…

Cardiology Clinical medicine Definition and Scope Primary prevention aims to prevent the clinical manifestation of cardiovascular disease (CVD) in individuals without established clinical CVD. It…

…shock, respiratory failure, severe anaemia, sustained bradyarrhythmia, tachyarrhythmia, or severe hypertension with or without left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately…

…reperfusion therapy. This approach fails to identify a substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting…

…uterus to the left. Consider tilting the patient at a 15–30° left lateral angle to relieve pressure on the major vessels. A large uterus…

…The pacemaker is commonly implanted under the clavicle, between the skin and the pectorialis major. The pulse generator has a shell of titanium which is…

…observed among cases with the most complex malformations. Indeed, even the most severe malformations have become routine practice. The treatment repertoire includes surgery, catheter interventions…