…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…

…microbiology request form. Drainage material: rubber dam drain, a strip cut from a glove, petrolatum impregnated packing strip or a vessel loop for loop drainage…

…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…

…is clearly established and removed. Cure is not universal, however. Delayed recognition may permit vascular remodelling and renal impairment to develop, leaving persistent hypertension despite…

…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…

…STEMI usually results from rapid thrombotic occlusion of a previously atherosclerotic coronary artery. Slowly progressive severe stenoses are less likely to cause STEMI because collateral…

…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…

…Mural vegetations are attached to the endocardium and, accordingly, less mobile. Echocardiography is the first place method for detecting vegetation in case of suspicion of…

…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…

…to the woman's left side (Figure 1). Additional offloading of the vena cava can be accomplished using a wedge board (or any hard material…

…Aspirate and biopsy answer different questions and do not replace one another: the aspirate shows cellular morphology and provides material for flow cytometry and genetics…

…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…

…Habitual heavy consumption is defined in the source material as at least eight drinks weekly in females or at least 15 drinks weekly in males…

…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…

…source material does not provide specific details regarding the physical examination or general evaluation of patients with bradycardia. Diagnostics Electrocardiographic assessment is fundamental to the…

…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…

…the first year, although the available material does not establish a significant increase in late morbidity or mortality attributable to these events. Clinical presentation and…

…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…

…manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke. The risk associated…

…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…

…By reducing intestinal cholesterol absorption, it decreases the quantity of cholesterol delivered to the liver. The resulting hepatic response includes increased expression of low density…

…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…

…material does not provide a detailed symptom to anatomy correlation. Pain may be absent, particularly in iatrogenic aortic injury. Iatrogenic lesions commonly follow cardiac surgery…

…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…

Myocardial ischemia and infarction Definition and Pathophysiology Left main coronary artery disease (LMCAD) refers to atherosclerotic narrowing of the left main coronary artery, which supplies…

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…

…referring to uncontrolled blood pressure despite five or more medications, are not included in the European guideline definition. Clinical Presentation and Symptoms The source material…

…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…

…time. Experimentally, necrosis advances from the subendocardium towards the subepicardium over several hours. The extent and tempo of injury are influenced by collateral flow, myocardial…