…may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and…

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

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

…adrenaline never replace intramuscular adrenaline [1,2]. Delayed administration of adrenaline is associated with more severe and more protracted reactions, biphasic courses and fatal outcome…

…Presentation and Symptoms The clinical spectrum of ACS is broad. Patients may be asymptomatic at presentation, have persistent chest discomfort, or present with cardiac arrest…

…A patient with a plasma potassium of 6.2 mmol/L, new bradycardia and acute kidney injury may be at greater immediate risk than a…

…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…

…For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed, with clinicians focusing primarily on hemoglobin A1c (HbA1c) reduction, blood pressure…

…raised blood pressure together with ongoing or new organ damage in which immediate, controlled blood pressure lowering can limit the damage. The choice of drug…

…Diagnostic paracentesis: Newly detected ascites — always. Every admission of a patient with known ascites. Clinical deterioration in a cirrhotic patient with ascites: fever, abdominal pain…

…unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach…

…or cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration, particularly in patients with marked…

…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…

…individuals with heart failure ( Packer et al ) and 30% of people with diabetes ( Cavallari et al ). Organizational challenges in cardiac arrest Optimal management of sudden…

…or recreational exercise Frailty or loss of muscle mass, particularly in older adults Patients require individualized progression because new symptoms during exercise may signal an…

…not yet formally incorporated into major clinical guidelines, it aligns with their emphasis on early angiography in high risk patients regardless of ECG findings. Thush…

…no longer recommended in the initial evaluation of patients with suspected coronary artery disease (i.e. CCS). The new guidelines are based on data derived…

…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…

…no longer recommended in the initial evaluation of patients with suspected coronary artery disease (i.e CCS). The new guidelines are based on data derived…

…Predicting sudden cardiac arrest The purpose of discovering and measuring risk factors is to obtain estimates of risk, tailor management according to the risk and…

…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…

…patients with high suspicion of posterior acute myocardial infarction (e.g due to reciprocal ST segment depressions in V1, V2, V3). IIa B In patients…

…and presence of high risk arrhythmias on ECG guides the management of non acute or asymptomatic bradyarrhythmia. In patients presenting with intermittent symptoms of bradycardia…

Overview of diagnosis, classification and management of heart failure

…group is associated with high mortality when malperfusion or rupture develops; surgery or endovascular treatment is therefore generally favoured within 14 days of symptom onset…

…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…

…ECG Management and treatment of AV blocks (AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical history (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 the tachycardia. The cause may range from benign to highly malignant, which is why expeditious management is warranted. Initial management includes assessing the patient…

…and third degree AV blocks. Readers already familiar with the basics of AV blocks can proceed directly to the subsequent chapters, which provide detailed discussions…

…The ASCVD implications of chylomicronaemia itself remain uncertain, whereas moderate HTG, approximately 150–500 mg/dL, is associated with increased ASCVD risk. Management in this…

…early with the poison control centre and with anaesthesia or intensive care. If intubation is necessary, a high minute ventilation and careful control of the…

…common to provide the patient with a permanent pacemaker to continue optimal medical treatment. Sick sinus syndrome (sinus node dysfunction), a common cause of brady

…fifth of adults during a hospital episode in international studies and is linked to substantial mortality, even though incidence and prognosis vary widely between patient…

…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…

…of arrhythmias, particularly tachyarrhythmias, is often considered challenging, separate chapters are dedicated to their diagnosis and management. The recommendations presented throughout this section align with…

…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…

…therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial…

…10€) and may reduce morbidity and mortality substantially in patients with acute coronary syndromes. Importantly, the ECG findings dictate the management of acute coronary syndromes…

…be checked with a capillary or venous measurement [5]. Treatment The awake patient who can swallow safely Give 15 to 20 g of rapid acting…

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

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

…of acute or chronic heart failure are often better categorised as myocardial injury. Clinical Presentation and Symptoms Patients with Type 2 MI frequently present with…

…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…

…prognostic implications, and management strategies. In the GRACE ECG substudy of 5000 patients with non ST elevation ACS (Yan et al), ST elevation in lead…

…resuscitated patients. Figure 1. The chain of survival in out of hospital cardiac arrest. Although the required skills, complexity and costs of interventions increase with…

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

…setting, patients at high risk for malignant arrhythmias should undergo continuous electrocardiogram monitoring throughout the entire peri operative period to assess rhythm stability [10]. References…

…syndromes (NSTE ACS). The division into STE ACS and NSTE ACS has profound implications for management and treatment of patients with acute coronary syndromes. Moreover…

…includes patients with a confirmed NSTEMI, patients with a working diagnosis of NSTE ACS and a high probability of unstable angina (UA), and patients whose…

…for patients with risk factors. Check what applies in your own region. The time limit is not a guarantee. Where the stroke risk is high…

…for sedation, analgesia and control of shivering. Procedure 1. Start temperature management early — within the first hour after ROSC, in parallel with coronary angiography, the…

…Fever. Atrial fibrillation. Worsening of heart failure. Caution • Used cautiously in patients with acute heart failure. • Clevidipine can cause reflex tachycardia. • Contraindicated in severe aortic…

…threatening ischaemia (CLTI). Clinical presentation and symptoms Asymptomatic and atypical disease Fewer than half of patients with PAD have typical symptoms. Many have impaired walking…

…Patients with hypotension, marked low output, or persistent severe symptoms require close monitoring and consideration of invasive haemodynamic assessment when precise measurements are needed to…

…Identification of life threatening arrhythmias. Assessment for high risk mechanical complications. Determination of symptom onset time and anticipated time to primary PCI. Patients with STEMI…

…and management Atrial fibrillation is the most common abnormal tachyarrhythmia (only sinus tachycardia is more common). The prevalence of atrial fibrillation correlates strongly with age…