…or previous angina. Patients should be advised to seek emergency medical assistance rather than self presenting to an emergency department or contacting primary care first…

…results from abrupt reduction in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery. Plaque erosion or rupture exposes thrombogenic material to…

…symptoms may be challenging to differentiate from normal physiological changes of pregnancy. Evaluation and Physical Examination The source material does not provide a detailed description…

…dyspnoea improves and sympathetic activation subsides, making it difficult to determine whether AF initiated the deterioration or resulted from it. AF has important consequences beyond…

Arrhythmias and arrhythmology Critical care Pharmacology & dosing Definition and Pathophysiology Bradycardia and conduction disorders arise from dysfunction within the sinus node, the atrioventricular node (AVN…

…a fresh injury, acute swelling, after reduction and before surgery. The slab allows the volume to increase. A circumferential cast gives better stability, but only…

…of office measurement is consequently central to diagnosis and long term management. Clinical presentation and symptoms The source material does not describe the typical symptoms…

…heterogeneous, and some patients may benefit from a more individualized selection strategy. When to Initiate Pharmacological Treatment Lifestyle intervention is an essential component of care…

…compartments Orthopaedic surgeon Close to large vessels, in the groin or on the neck Bleeding, vascular injury, pseudoaneurysm Surgeon, ultrasound first Other situations that argue…

…body drape. Lidocaine 10 mg/mL for local anaesthesia, normal saline to flush all lumens, suture material or a securement device, transparent dressing. Monitoring throughout…

…the face and scalp — where the blood supply is good and a scar is stigmatising — up to about 24 hours is accepted in Swedish practice…

…primary care. Before investigating secondary causes, pseudo resistance must be excluded. This includes: Poor adherence to antihypertensive treatment White coat hypertension Other contributors to apparently…

…of Anaesthesiology and Intensive Care Medicine (SFAI), together with the antidotes. Material for immobilisation: a shoulder sling, a dorsal backslab, and a colleague to help…

…and Pathophysiological Basis High sensitivity cardiac troponin (hs cTn) assays detect circulating troponin released from injured cardiomyocytes at substantially lower concentrations than earlier generation assays…

…3 compression stocking. Tape measure for ankle circumference — this governs the choice of material and bandaging technique. Procedure Assessment 1. History: duration, previous ulcers, DVT…

…myocardial infarction to a percutaneous coronary intervention capable hospital. The initial ECG should be interpreted in conjunction with the clinical presentation and previous tracings when…

…myocardial oxygen supply and demand. In many cases, the initiating process is plaque disruption with thrombosis; other cases result from spasm, microvascular dysfunction, embolism, dissection…

…The transition from a quiescent plaque to a highly thrombogenic surface occurs via three primary mechanisms: Plaque Rupture: Accounting for 60 70% of ACS presentations…

…foreign materials pose a high risk of infection. Approximately 20% of all endocarditis affect people with valve prostheses and among other cases 18% show significant…

…and are major contributors to maternal, fetal, and neonatal morbidity and mortality. Their incidence has increased in parallel with older maternal age at first childbirth…

…be delivered within 5 minutes following the maternal cardiac arrest. Within the context of pregnancy, hypovolemia and other etiologies of hypotension remain the predominant causes…

…skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie…

…in the available source material. Waist circumference is particularly important because intra abdominal, or visceral, adipose tissue is more closely related to insulin resistance and…

…reported prevalence ranging from 18% to 52%. They frequently occur in patients with severe coronary artery disease, defined in the source material as stenosis greater…

…agents initially developed for glucose lowering in type 2 diabetes mellitus (T2DM). The principal drugs identified in the source material are canagliflozin, dapagliflozin and empagliflozin…

…organic material that swells, batteries and magnets. Preparation and equipment A chair with a head rest, preferably an ENT chair; raise the chair to your…

…the skin folds proximal and lateral to the plate, and the cuticle is the flap of skin that extends from the proximal fold over the…

…inhibitor to prevent symptomatic hypotension. Diagnostics The source material does not cover specific diagnostic modalities such as ECG, imaging, or electrophysiology in relation to ACE…

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

…with previous vascular disease, aspirin reduced the combined incidence of non fatal MI, non fatal ischaemic stroke, and vascular death from 8.2% to 6…

…arrest, it is essential to reconfirm the rhythm in two leads if possible to distinguish true bradyarrhythmic or asystolic arrest from other tachyarrhythmic events. On…

…has declined from at least 50%. This distinction is clinically important because the strongest evidence for the four pillar disease modifying strategy applies to symptomatic…

…which the evidence and recommendations differ from those applicable to elective PCI. Clinical presentation and symptoms The source material does not describe a distinct symptom…

…from whole grains. These combined effects may improve inflammation, insulin resistance, glucose metabolism, hypertension, atherogenic dyslipidaemia, endothelial biology and platelet related pathways. The source material…

…non cardiac surgery, procedural complexity, and the relative merits of PCI and coronary artery bypass grafting (CABG). Definition and Pathophysiology From balloon angioplasty to coronary…

…level C. The European regulatory threshold described in the source material differs from the trial based threshold: ivabradine was approved for patients with HFrEF, LVEF…

…distinguished from isolated no reflow because their treatment may require immediate stenting or other procedural intervention. The clinical importance of the finding is related to…

…or ongoing chest pain despite medical treatment Acute heart failure presumed to result from ongoing myocardial ischaemia Haemodynamic instability or cardiogenic shock Life threatening arrhythmias…

…flow are appropriate. Exercise PH is defined by an mPAP/cardiac output slope greater than 3 mmHg/L/min from rest to exercise. This response…

…The source material does not cover the baseline physical examination of patients prior to sotalol initiation. Diagnostics Electrocardiography (ECG) Electrocardiographic monitoring is central to the…

…to demonstrate an intramural haematoma or double lumen Type 1 is reported in fewer than one third of cases in the pregnancy related source material…

…length Large thrombotic burdens increase procedural risk because thrombus can fragment, embolize to other coronary branches or vascular beds, propagate through gaps between stent struts…

…patient. Fixation material for the intraosseous needle. Procedure Peripheral venous cannula 1. Apply the tourniquet 10–15 cm proximal to the intended puncture site, let…

…unit, suture material, a size 11 scalpel, artery forceps. Sample tubes according to the table below, and blood culture bottles. Suction and oxygen to hand…

…but the meatus can be hard to find in older women. Two things separate the safe catheterisation from the harmful one: never forcing against resistance…

…abdominal aortic diameter exceeds 3 cm. Most AAAs are located below the renal arteries and are related to atherosclerotic disease. At least 90% of AAAs…

…other cardiovascular risk factors; smoking, hypertension, hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral arterial and aortic disease; planned surgery…

…tubular necrosis arising from the combined effects of contrast exposure and other ischaemic or nephrotoxic stresses. The kidney is particularly vulnerable to toxic injury because…

…atherosclerotic peripheral arterial disease, and other very high risk settings described in the source material. The statin should be prescribed at the highest tolerated dose…

…FH results from pathogenic variants affecting proteins in the hepatic LDL receptor pathway. Reduced cellular uptake and clearance of LDL leads to increased circulating LDL…

…not recommended in individuals with previous virological failure if it risks loss of suppression. Clinical presentation and symptoms The source material does not describe specific…

…detailed symptom to anatomy correlation. Pain may be absent, particularly in iatrogenic aortic injury. Iatrogenic lesions commonly follow cardiac surgery, coronary angiography or other invasive…

…injection under fluoroscopy. The procedure is performed by advancing guidewires and diagnostic catheters from a percutaneous arterial access site to the aortic root, engaging the…

…Diabetes status Renal dysfunction and other important comorbidities Frailty Liver cirrhosis Cognitive function and life expectancy, especially in older adults Previous sternotomy or CABG Patient…

Echocardiography Myocardial ischemia and infarction Definition and pathophysiology Left ventricular (LV) thrombus is an intracavitary clot attached to the LV endocardium, typically overlying an akinetic…

…be attributed to acute procedural injury. Even then, it may not be possible to determine precisely how much of the postprocedural increase results from the…

…the decision to test and may identify patients who require preventive therapy even when functional testing is normal. Probability categories The source material describes several…

…Other guideline formulations similarly define resistant hypertension as blood pressure above goal despite three or more antihypertensive drugs from different classes at maximally tolerated doses…

…left sided congestion—is an important clinical clue. Haemodynamic severity The presentation may range from mild right ventricular impairment to cardiogenic shock. Patients with hypotension…

…sarcoidosis Other cardiac procedures Chemotherapeutic agents Catheter ablation Critical illness Defibrillator shocks Strenuous exercise Cardiac contusion The diagnosis should therefore distinguish isolated myocardial injury from…