…vascular dementia, and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS have more comorbidities and a higher…

…neutropenic fever is limited, but delayed antibiotics are associated with a worse outcome in sepsis and in several studies of neutropenic patients. In septic shock…

…used: Grade Clinical picture Management : : : Mild allergic reaction Skin or mucosa only, stable breathing and circulation Observation, a non sedating antihistamine for symptoms Anaphylaxis Objective…

…management. In patients with a very low probability of obstructive CAD, testing may generate false positive results and unnecessary downstream procedures. In patients with a…

…establish whether the presentation represents ACS and whether the patient is clinically unstable. Particular attention is required for evidence of: Ongoing or recurrent chest discomfort…

…sheath, and a cell count plus albumin on the sample. Indications Diagnostic paracentesis: Newly detected ascites — always. Every admission of a patient with known ascites…

…new bradycardia and acute kidney injury may be at greater immediate risk than a stable dialysis patient with a plasma potassium of 6.6 mmol…

…medicine is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed, with clinicians focusing primarily…

…symptoms New confusion Severe headache Persistent nausea Moderately reduced consciousness Marked gait instability The specificity of the symptoms is limited. In a patient with moderate…

…coronary and renal perfusion, particularly in patients with long standing hypertension and a rightward shifted autoregulation [1,3]. The term hypertensive urgency is best avoided…

…with continuing ischaemia, shock, serious arrhythmia or acute heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic patient…

…one of the strongest risk markers for a new complicated withdrawal. Benzodiazepines enhance the function of the GABA A receptor and are cross tolerant with…

Cardiology Myocardial ischemia and infarction Definition and Purpose Cardiac rehabilitation is a comprehensive, multidisciplinary secondary prevention intervention for patients with cardiovascular disease, including those recovering…

…laboratory abnormalities indicate end organ injury. Eclampsia is the occurrence of new onset seizures or coma in a pregnant woman with preeclampsia. HELLP syndrome—haemolysis…

…The cause of death in these victims is not explained on the basis of morbid anatomy. This is not a new experience for either the…

…This approach fails to identify a substantial subset of patients with acute coronary occlusion (ACO) who do not meet the established ECG criteria for STEMI…

…half of all patients with heart failure die suddenly, as a result of ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation). Early diagnosis and aggressive management can…

…For example, exercise stress testing is no longer recommended in the initial evaluation of patients with suspected coronary artery disease (i.e. CCS). The new…

…For example, exercise stress testing is no longer recommended in the initial evaluation of patients with suspected coronary artery disease (i.e CCS). The new…

…half of all patients with heart failure die suddenly, as a result of ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation). Early diagnosis and aggressive management can…

…The cause of death in these victims is not explained on the basis of morbid anatomy. This is not a new experience for either the…

…of an intimal tear or flap. AAS is classified anatomically according to involvement of the ascending aorta: Stanford type A: involves the ascending aorta, with…

…guides the management of non acute or asymptomatic bradyarrhythmia. In patients presenting with intermittent symptoms of bradycardia, it is fundamental to establish a temporal correlation…

…to a PCI capable centre. I C Reperfusion therapy Management Recommendation Level of evidence Reperfusion is indicated in all patients with symptoms of ischaemia of…

…highest with AV block 2 Mobitz type 2 and AV block 3. The only treatment with a class I recommendation for the management of acute…

…period of anticipated EMI. The perioperative strategy should also recognize that CRT patients may rely on continuous biventricular pacing for haemodynamic stability. In patients with…

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

…of serious morbidity or mortality, underscoring the need for a structured and guideline directed approach. This chapter focuses on practical diagnostic and therapeutic considerations, with…

…waves) do not affect the management of cardiac arrest. Recurrent VT or VF after ROSC in a patient with a coronary risk profile should lead…

…or a rise of at least 26.5 µmol/L Below 0.5 mL/kg/h for 6 to 12 hours 2 2.0 to…

…of inert cholesterol debris, modern vascular biology has redefined atherosclerosis as a dynamic, immune mediated fibroproliferative response to endothelial injury [2] . The process initiates with…

…the management of heart failure, digoxin improves hemodynamics without increasing heart rate or decreasing blood pressure, making it a consideration for patients with low blood…

…treatment protocols that are available where you practise. Initial management of all poisonings ABCDE Step Assessment and action : : A Assess the airway, the pharyngeal reflexes…

…with varying degrees of occlusion that may provide a window of opportunity for reperfusion. In addition, some patients present with severe LMCA stenosis exacerbated by…

…is intentionally slow (due to the low concentration of gap junctions in AV nodal cells), which allows for ventricular filling to complete prior to ventricular…

…of a neurologically compromised patient. Continuous glucose monitoring reflects interstitial glucose and lags behind the blood glucose during rapid changes. Pressure on the sensor, for…

…risk of terminating the medication as compared with implanting a permanent pacemaker and continuing the treatment. Commonly, patients with bradycardia have a strong indication for…

…is required. Patients with suggestive symptoms, signs or a medical history indicating possible secondary hypertension should undergo appropriate screening for an underlying secondary cause. Evaluation…

…and atypical disease Fewer than half of patients with PAD have typical symptoms. Many have impaired walking or a slow gait without describing classic claudication…

…on ASCVD prevention and reduction of LDL C, non HDL C and apolipoprotein B. Causes and secondary contributors A search for secondary contributors is an…

…practice, beginning with a discussion of the underlying mechanisms of cardiac arrhythmias. While a detailed understanding of these mechanisms is not essential for all clinicians…

…with similar clinical settings and frequently coexist in the same patient population. AF can act as a trigger for atrial flutter, and the development of…

…in T2DM. Cardiovascular benefit depends substantially on comprehensive risk factor management and, in appropriate patients, selection of glucose lowering therapies with demonstrated cardiovascular effects. Diabetes…

…of ventricular arrhythmias and sudden cardiac death is considerably lower than the risk among patients with Brugada syndrome. It follows that Brugada syndrome is a…

…communities. Late presentation is clinically important: Within 12 hours of symptom onset: reperfusion therapy is recommended for all patients with a working diagnosis of STEMI…

…or mechanical circulatory support remains a viable therapeutic pathway [4]. Furthermore, in the peri operative setting, patients at high risk for malignant arrhythmias should undergo…

…stressor superimposed on the patient's baseline cardiovascular state. For instance, a patient with stable CAD may present with clinical manifestations of myocardial ischaemia following…

…levels of myocardial proteins. These proteins are cardiac troponins (henceforth referred to only as troponins). When elevated troponin levels are confirmed in patients with STE…

…lower leg in a patient with peripheral arterial disease or diabetes — the wound may not heal. Over superficial nerves (the lateral aspects of the fingers…

…and guide appropriate management strategies. For instance, administering nitroglycerin to alleviate ischemic chest pain may lead to hemodynamic collapse in patients with right ventricular ischemia…

…Hence, whenever a patient with a pacemaker presents with tachyarrhythmia and the QRS complexes appear with a left bundle branch block pattern, always suspect pacemaker…

…In patients presenting with angioedema, a rapid assessment of the airway is paramount to evaluate for impending respiratory compromise. Diagnostics The diagnosis of ACE inhibitor…

…collateral circulation is adequate. For example, a patient with acute graft occlusion may report an abrupt reduction in walking distance before claudication, accompanied by moderate…

… those with a family history of high Lp(a); individuals with cardiovascular disease that is not explained by major conventional risk factors; patients at moderate…

…MINOCA accounts for approximately 1–14% of ACS presentations in different series and approximately 5–10% of patients presenting with myocardial infarction in other reports…

…the patient stable without high risk characteristics and therefore potentially suitable for a selective invasive approach? Is the clinical likelihood of true NSTE ACS low…

…tightened the former 48 hour rule for patients with risk factors. Check what applies in your own region. The time limit is not a guarantee…

…suitable for stable (hemodynamically and respiratory) and fully conscious patients who experienced a brief cardiac arrest. Post resuscitation care is an integral component of the…

…criteria for left bundle branch block (LBBB) Diagnosing left bundle branch block is relatively straightforward. The hallmark of LBBB is the prolonged QRS duration. A…

…or cerebrovascular accident at a young age in the patient or family Hypertensive first degree relatives of patients with PA Patients with hypokalaemia may develop…