…The biological differences between females and males arise partly from the chromosomal distinction between XX and XY individuals and are reflected in cardiovascular structure and…

…Each recording presents two leads recorded simultaneously. Sex : Male Age : 43 years History : None Medications : None ECG 1 . Sinus rhythm interrupted by rapid ventricular tachycardia…

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

…scarce). Indeed, the strongest risk factor for developing atrial fibrillation is age. Other significant risk factors are as follows: male sex, hypertension, left ventricular hypertrophy…

…are associated with atherosclerotic pathology. AAA prevalence increases with age and is approximately five times higher in males than females, although the sex difference becomes…

…Factors associated with increased gastrointestinal bleeding include: Older age, with risk increasing particularly after 70 years Male sex Previous upper gastrointestinal disease Hepatic or renal…

…positively correlated with societal economic development, age, alcohol intake, body weight, male sex and salt intake. Population blood pressure increases in parallel with economic development…

… male sex, subtle electrocardiographic abnormalities and particular genes may predict earlier disease expression. In many cardiomyopathies, women manifest disease later than men, with the timing…

…formula: Expected maximum heart rate according to age and sex. Accordingly, a 65 year old male is estimated to have a maximum heart rate of…

…sufficient to make a diagnosis or identify a few likely diagnoses. The table below shows a systematic history taking in patients presenting with chest pain…

…evidence of impaired filling, make the diagnosis more likely. HFpEF and HFmrEF together account for approximately half of patients with symptomatic HF. The distinction is…

…the source material as at least eight drinks weekly in females or at least 15 drinks weekly in males, or binge drinking in either sex…

…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…

…and cerebrovascular consequences of unrecognized PA make early case detection clinically important. Current European recommendations advise screening adults with confirmed hypertension by measuring renin and…

…closely than HFpEF. Patients are more commonly male and younger than those with HFpEF and have a greater likelihood of coronary artery disease, which is…

…s formula. Note that a QTc interval 480 is always considered pathological. For patients with bundle branch blocks, the corresponding figure is 500 ms. The…

…and dangerous in a few. The male urethra is about 25 cm long with two curves and a prostate that can grip; the female urethra…

…did not reveal structural cardiac abnormalities, nor coronary artery disease. Another male patient, with similar ST segment changes, experienced syncopal episodes, ventricular tachycardia (including torsades…

…is associated with 5 times as great a risk of ventricular fibrillation and sudden cardiac death), but instead they display an ECG with male/female…

…ventricular fibrillation, in any situation. ECG features of ventricular fibrillation The ECG shows irregular waves with varying morphology and amplitude. No P wave, QRS complex…

…C remains above the recommended goal despite maximally tolerated statin therapy, generally with ezetimibe where appropriate. Established clinical atherosclerotic cardiovascular disease (ASCVD) and FH are…

…depolarize and repolarize the ventricles ( Figure 1 ). The length of the QT interval correlates strongly with the risk of potentially life threatening ventricular arrhythmias. Therefore…

…Table 2. Reference values for the most important parameters (Rijnbeek et al) Numbers are medians with 2 nd and 98 th percentile in parenthesis. These…

…books will realize their shortcomings at their first encounter with an ECG in reality. Books that claim to make it "simple" can provide a quick…

Referensvärden A child's ECG changes continuously with age: the heart rate, the electrical axis and the waveform in the newborn differ markedly from adult…

Referensvärden A diagnosis of hypertension is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by…

Procedurer CPAP and NIV are two different treatments with different physiology, and the commonest source of error is confusing them. CPAP delivers a constant pressure…

…easy to trust too much. Two errors make the reading useless without anyone noticing: the transducer is at the wrong height , and the system is…

…shock, or when sepsis is judged certain or highly likely. With possible sepsis without shock, a rapid targeted assessment is made. If the suspicion persists…

Echocardiography Cardiomyopathy caused by tachycardia A prolonged tachycardia can cause cardiomyopathy with left ventricular dilation. This type of cardiomyopathy, referred to as tachycardia induced cardiomyopathy…

…made. Otherwise, continue to next criteria. Assess the QRS morphology in V1, V2, V5 and V6 (see below). If the QRS morphology is compatible with…

…starts with assessment of the P wave. The P wave is a small, positive and smooth wave. It is small because the atria make a…

ECG Myocardial ischemia and infarction ST segment elevation in acute myocardial ischemia ST segment elevations with straight (horizontal, upsloping, or downsloping) or convex ST segment…

…tools for cardiovascular risk reduction, offering profound benefits in major adverse cardiovascular events (MACE), heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD…

…4. Make a small skin incision with the scalpel. 5. Aspiration: advance the needle with the stylet in place perpendicular to the bone surface, angled…

…majority of cases, and the great majority of objects can be removed in general practice or in the emergency department with simple equipment. Two principles…

…followed all the way in, which has made the procedure considerably safer than the blind subxiphoid technique still described in older textbooks. Indications Cardiac tamponade …

…report. A shave biopsy of a pigmented lesion that turns out to be a melanoma can make the Breslow thickness unmeasurable and staging therefore impossible…

…a potential interaction, and that there is a ready made plan for what happens when the INR runs away or the patient bleeds. In Sweden…

…and from secondary prevention, which addresses patients with established disease to reduce recurrent events and mortality. Risk factor modification is therefore directed at identifying individuals…

…vasovagal syncope is reported to occur in over 40% of females and 30% of males due to a lack of effective reflex response to posture…

ECG Myocardial ischemia and infarction Acute myocardial infarction (AMI) always affects the left ventricle Myocardial infarction is virtually synonymous with left ventricular infarction . All myocardial…

…pain. This syndrome presents with a dry or minimally productive cough and a tickle or sensitivity in the throat, and is made worse with talking…

…can develop despite a measurable or high blood alcohol concentration, particularly in patients with marked tolerance. The most important measures in severe or complicated withdrawal…

…closed circumferential cast , and the patient must leave with clear information about the symptoms that should make them seek help immediately. Indications An undisplaced or…

…should be changed or removed once the situation has stabilised. Preparation and equipment A central line set with a triple lumen catheter, usually 7 Fr…

…on a donor card, or through statements made to the next of kin. Active malignancy with a risk of transmission (an individual assessment; certain tumour…

…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…

…treatment effect, the medication is continued — abrupt withdrawal carries a risk of rebound. The referring physician should have made this decision; document which applies. Nitroglycerin…

…in which the patient reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and both can harm the patient…

…the tube is safe. A misplaced tube in the airway produces no reliable symptoms in a patient with an impaired cough reflex, and the first…

…list. Always dilute morphine 10 mg/mL to 1 mg/mL (1 mL made up to 10 mL with sodium chloride) before intravenous titration. Half…

…in the SYNTAX trial, patients with high scores had significantly higher mortality and MACE rates compared to those with low scores. Monitor Quality of Care…

…driven atherothrombosis, while interruption of antiplatelet therapy after recent stenting is associated with increased risk of major adverse cardiovascular events (MACE) and stent thrombosis. Premature…

…during the third or fourth decade in males and approximately 10 years later in females. Untreated HoFH is associated with extensive premature and progressive ASCVD…

…B. Every effort should be made to initiate and up titrate beta blocker therapy to guideline recommended or maximally tolerated doses before ivabradine is considered…

…These require a QRS duration exceeding 140 msec in males and 130 msec in females , along with slurring or notching of the mid QRS in…

…wall motion abnormality (RWMA) during stress. A fixed abnormality that remains unchanged with stress generally indicates previous infarction. Extensive ischaemia may produce a reduction in…

…Diagnosis of a tension pneumothorax can be made via auscultation, where asymmetric lung sounds are noted, specifically with an absence of sounds on the affected…

…thus better image resolution. If possible, the width of the image is also reduced, which likewise results in increased image resolution. It is also possible…