…activity (PEA). Evaluation and Physical Examination The source material does not provide specific details regarding the physical examination maneuvers for patients with bradycardia. Diagnostics Electrocardiography…

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

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

…a common tachyarrhythmia requiring treatment in decompensated heart failure (DHF). In the critically ill patient, AF may be pre existing, newly detected for the first…

…for days after the infusion is discontinued. Noradrenaline (norepinephrine) acts primarily as a vasopressor. While detailed receptor pharmacology is not specified in the source material…

…be initiated concurrently. In patients with a confirmed indication for treatment but blood pressure in the range of 120–139/70–89 mmHg, concomitant indications…

…Take care in impaired sensation (neuropathy, spinal cord injury) — the patient does not feel the pressure sore. Preparation and equipment Material Comment : : Stockinette Innermost against…

…first needle goes in. A wound that has not been irrigated clean, has not been inspected to its depth, and has not been assessed for…

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

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

…for hypertensive emergency. In that setting, clinical assessment must determine whether immediate blood pressure lowering treatment is required. Patients with suggestive symptoms, signs or a…

…ultrasound first Other situations that argue for the operating theatre rather than the emergency room: a very large or deep abscess, a markedly unwell patient…

…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…

…Initial hs cTn measurement Continuous cardiac monitoring The source material does not provide a detailed list of physical examination findings or a specific examination sequence…

…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…

…pattern in every case; it may represent the posterior component of a broader infarct territory. Clinical Presentation and Symptoms The source material addresses posterior infarction…

…lesion thought to be susceptible to disruption and thrombosis. Typical features include a lipid rich core, a thin fibrous cap, macrophage and foam cell accumulation…

…Accounting for 60 70% of ACS presentations, plaque rupture typically occurs in thin cap fibroatheromas (TCFAs). These vulnerable plaques possess a massive necrotic lipid core…

…Echocardiography is the first place method for detecting vegetation in case of suspicion of endocarditis. Transthoracic echocardiography (TTE) has a sensitivity of about 50% among…

…by proteinuria or evidence of maternal organ involvement. Proteinuria is defined as urinary protein excretion 300 mg over 24 hours or a protein–creatinine ratio …

…such that the vein can be fully compressed in the supine position in a cardiac arrest. For women beyond the 20 th week of pregnancy…

…with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe for the first aspirate, larger syringes for the tube specimens…

Cardiology Endocrinology & metabolism Definition and Pathophysiology Metabolic syndrome is a clustering of cardiometabolic abnormalities centred on abdominal adiposity, insulin resistance, dyslipidaemia, elevated blood pressure and…

…identified CTO without demonstrable ischaemia or viable myocardium provides a less compelling basis for intervention. The source material does not provide a distinct symptom profile…

…for glucose lowering in type 2 diabetes mellitus (T2DM). The principal drugs identified in the source material are canagliflozin, dapagliflozin and empagliflozin; sotagliflozin is a…

…Immediately — pressure necrosis across the septum A live insect As soon as possible — kill it first; the patient is in great distress Organic material (peas…

…for the block (adrenaline is safe in fingers and toes according to modern data, but there is rarely any reason to use it when a…

…and Symptoms The source material does not provide specific information on the clinical presentation and symptoms of the underlying conditions for which ACE inhibitors are…

…term heavy consumption can produce a cardiomyopathy, although the exact exposure threshold and duration required are not established. The source material identifies chronic intake of…

…the absence of contraindications, using a loading dose followed by maintenance treatment. The source material does not specify the loading dose. Efficacy and harms In…

…may also be observed as a consequence of drug toxicity, such as digitalis excess. Biomarkers and Laboratory Findings The source material does not provide information…

…Association (NYHA) classification. The source material specifically frames many pharmacological recommendations for patients with symptomatic NYHA class II–IV HFrEF. Advanced or refractory heart failure…

…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…

…the overall combinations of foods habitually consumed rather than isolated nutrients considered independently. For cardiometabolic health, the most favourable patterns generally contain more minimally processed…

…BMS now account for less than 10% of contemporary PCI procedures according to the source material. First generation DES The first widely used DES included…

…fibrillation remains uncertain, although it may have a rate reducing effect in selected circumstances. Ivabradine undergoes extensive first pass hepatic metabolism through CYP3A4. Dose adjustment…

…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…

…procedural complications and bleeding. Clinical presentation The available source material does not provide a detailed description of the presenting symptoms of NSTEMI. It does identify…

…principal haemodynamic definition uses PVR 2 Wood units. PVR is essential for identifying a precapillary pulmonary vascular component. PAWP is used to distinguish pulmonary venous…

…clearance must be assessed prior to initiation and monitored continuously during therapy. Hypokalemia is a significant risk factor for drug induced torsades de pointes; therefore…

…1 MI. It is an infrequent cause of ACS overall but represents a substantial proportion of ACS presentations in young and middle aged women. The…

…2%–0.5% per year beyond the first year, although the available material does not establish a significant increase in late morbidity or mortality attributable…

…is not enough. Lidocaine 10 mg/mL to anaesthetise the marrow cavity in a conscious patient. Fixation material for the intraosseous needle. Procedure Peripheral venous…

…and the drainage is stopped for coughing, chest pain, or when the volume limit is reached. Indications Diagnostic aspiration: a new pleural effusion of unclear…

…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…

…been reported with a substantial cumulative incidence. The source material does not provide a detailed standardized physical examination protocol beyond assessment for a pulsatile abdominal…

…assessment. A carotid bruit is an important marker of cardiovascular risk, although the source material does not provide diagnostic sensitivity or specificity for bruit detection…

…should be reserved for the smaller subgroup in which iodinated contrast is considered causally responsible. This distinction is important because AKI after a contrast study…

…is also an appropriate first line pharmacological option when a patient is unable to tolerate any statin regimen. The treatment sequence for patients with chronic…

…of tendon xanthomas, corneal arcus and xanthelasma. Potential secondary causes of hypercholesterolaemia. The likelihood of a monogenic disorder and the need for family based screening

…non HDL C and apolipoprotein B. Causes and secondary contributors A search for secondary contributors is an essential first step. Recognised causes include: Diabetes and…

…radiation may reflect the segment of aorta involved, although the source material does not provide a detailed symptom to anatomy correlation. Pain may be absent…

…coronary pressure assessment is recommended in patients with a very high clinical likelihood of obstructive CAD, defined in the source material as greater than 85%…

…haemodynamic compromise and rhythm disturbance. The source material does not provide a specific examination profile or diagnostic physical signs for LMCAD. Diagnostic Assessment Coronary angiography…

…is the principal initial imaging method for detecting LV thrombus and assessing the substrate on which it develops. The thrombus generally appears as a discrete…

…for periprocedural MI. This distinction is clinically important because cardiac troponin elevation after revascularization is common and may reflect procedural myocardial injury rather than a…

…probability is the clinician’s estimate of the probability that the patient has anatomically obstructive CAD before the result of a new test is known…

…in the European guideline definition. Clinical Presentation and Symptoms The source material does not describe a distinctive symptom profile for resistant hypertension. In clinical practice…

…inferior myocardial infarction. The available source material emphasizes the haemodynamic and physical manifestations rather than providing a separate catalogue of symptom patterns. The severity of…

…4b and 4c fulfil the criteria for type 1 MI because they represent coronary atherothrombotic events in the setting of a stent thrombosis or restenosis…