…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…

…segment depression or T wave inversion can occur without coronary artery disease. Proposed explanations in the source material include cardiac memory after abnormal ventricular activation…

…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…

…or after suturing over a joint. Pain relief and stabilisation for transfer in a suspected fracture. Clinical suspicion of a scaphoid fracture despite a normal…

…predictive value in patients with suspected acute coronary syndrome (ACS). Cardiac troponin is a marker of myocardial injury, not a disease specific marker of myocardial…

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

…territory. Clinical Presentation and Symptoms The source material addresses posterior infarction primarily in the context of suspected acute coronary syndrome and acute myocardial ischaemia. Patients…

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…

…presenting feature. The source material emphasizes that patients and families should be educated to recognize chest discomfort or dyspnoea as potentially indicating myocardial infarction, particularly…

…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…

Cardiology Pharmacology & dosing Definition and Therapeutic Rationale Hypertension is a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It…

…has been abandoned in the modern literature for commercial preparations at normal concentrations; be cautious nonetheless in known peripheral vascular disease and follow local practice…

…a greater likelihood of cure. When to investigate General indications Patients with suggestive signs, symptoms, or medical histories should undergo appropriate screening for secondary hypertension…

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

…screening for an underlying secondary cause. Evaluation and physical examination Standardized office measurement Accurate technique is essential because inconsistent or incorrect measurement may lead to…

…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…

…materials: two layer system, four layer system, short stretch bandage, zinc paste bandage (Unna boot), or a class 2–3 compression stocking. Tape measure for…

…account for the ischaemia. STEMI usually results from rapid thrombotic occlusion of a previously atherosclerotic coronary artery. Slowly progressive severe stenoses are less likely to…

…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…

…cases of preeclampsia may progress to eclampsia. Clinical presentation and symptoms The clinical spectrum ranges from hypertension without apparent organ injury to severe multisystem disease…

…positioned as standard, and defibrillation energy levels should remain consistent with those used for non pregnant adults. The fetus is not harmed by defibrillation, amiodarone…

…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…

…failure across the ejection fraction spectrum, according to the guideline key points Patients with renal insufficiency and cardiovascular disease, irrespective of diabetes status The clearest…

…ear canal. A 30–60 mL syringe with a soft catheter and body temperature water for irrigation. Small children need help to keep still. Sedation…

…clip for trephination. Antibiotic ointment, a non adherent dressing, gauze. The digital block Anaesthetise from the dorsal aspect, one injection medial and one lateral to…

…kidney disease (CKD). These agents interfere with the renin angiotensin aldosterone system (RAAS) by inhibiting the enzyme responsible for the conversion of angiotensin I to…

…for women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism. Alcohol dehydrogenase converts ethanol to…

…previous vascular disease, aspirin reduced the combined incidence of non fatal MI, non fatal ischaemic stroke, and vascular death from 8.2% to 6.7…

…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…

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

…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…

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

…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…

…of thrombotic or atheroembolic material, but pharmacological and mechanical strategies directed specifically at reperfusion injury have not generally demonstrated sufficient clinical benefit for routine use…

…with suspected ACS are categorized into a STEMI pathway or an NSTE ACS pathway according to the initial ECG and clinical presentation. For suspected NSTE…

…essential for identifying a precapillary pulmonary vascular component. PAWP is used to distinguish pulmonary venous hypertension caused by left heart disease from pulmonary vascular disease…

…arrhythmias for which sotalol is prescribed. Evaluation and Physical Examination The source material does not cover the baseline physical examination of patients prior to sotalol…

… may be mistaken for vasospasm or diffuse disease Type 3 Focal or tubular stenosis resembling atherosclerosis Often requires intravascular imaging to demonstrate an intramural haematoma…

…autopsy documents thrombosis and the diagnostic criteria used for type 1 myocardial infarction are fulfilled. The temporal relationship to stent implantation should always be specified…

…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…

…coagulopathy or thrombocytopenia Relative Ongoing anticoagulant treatment — plan the aspiration for the trough level or pause the drug according to local practice Relative Skin infection…

…The material determines how long the catheter may stay: all silicone and latex with a hydrogel or silicone elastomer coating may remain for up to…

…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…

…cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke. The risk associated with asymptomatic disease depends substantially on stenosis severity and…

…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…

…for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease, and other very high risk settings described in the source material…

…artery disease (CAD). FH results from pathogenic variants affecting proteins in the hepatic LDL receptor pathway. Reduced cellular uptake and clearance of LDL leads to…

…cardiovascular assessment should include review of modifiable risk factors and associated disease. The supplied material does not specify a diagnostic physical examination protocol or characteristic…

…confined to the descending thoracic aorta. Type IIIb: extends below the diaphragm. The temporal classification is also clinically relevant: Hyperacute: less than 24 hours from…

…Clinical Indications Suspected Chronic Coronary Syndrome The decision to perform ICA is based on the clinical likelihood of obstructive CAD, symptoms, findings from non invasive…

…presentations Left main disease may be clinically silent, and revascularisation recommendations are not restricted to patients with symptoms. Current guidance supports revascularisation for significant left…

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…

…the postprocedural increase results from the index MI and how much is related to the intervention. Diagnostic criteria General principles For events occurring within 48…

…or chronic chest pain attributable to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of obstructive coronary artery disease (CAD) before diagnostic testing…

…treatment. Reported risks of myocardial infarction, stroke, end stage renal disease, and death may be two to six fold higher in affected adults. True, apparent…

…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…

…rupture or erosion. The relative contributions of plaque disease and thrombus vary considerably. Thrombotic material may embolize distally and cause additional myocyte necrosis. Plaque disruption…