…heart failure (DHF). In the critically ill patient, AF may be pre existing, newly detected for the first time, or newly developed during management of…

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

…The physical examination should include: Assessment of all major peripheral pulses. Blood pressure measurement in both arms. Cardiac auscultation. Pulmonary auscultation. Evaluation for heart failure…

…infusion of agents to stress the AV node and His Purkinje system, such as isoproterenol and/or procainamide. EPS with isoproterenol is also recommended for…

…of initial STEMI management. The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias. Mechanical or pump failure complications , including heart…

…urgent surgical or transcatheter intervention, with temporary mechanical circulatory support (MCS) considered as a bridge. Clinical Presentation and Symptoms Symptoms of STEMI The usual symptom…

…organ perfusion or frank shock states. In the specific context of perioperative care in patients with pulmonary arterial hypertension (PAH), progression of right heart failure…

…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…

…and stabilisation for transfer in a suspected fracture. Clinical suspicion of a scaphoid fracture despite a normal radiograph. Contraindications An open fracture or a wound…

…of the cosmesis, often with antibiotic prophylaxis. Deep puncture wounds , where the base cannot be inspected or irrigated clean. Wounds with retained foreign material or…

…10 mg/mL for local anaesthesia, normal saline to flush all lumens, suture material or a securement device, transparent dressing. Monitoring throughout the procedure: ECG…

…clinical care requires diagnostic and treatment thresholds. The 2024 European guideline defines hypertension as an office systolic blood pressure (SBP) of ≥140 mmHg or diastolic…

…handled routinely in primary care or in the emergency department without contacting the appropriate specialty: Location Risk Management : : : Medial triangle of the face (nasal root…

…to local practice and the guidelines of the Swedish Society of Anaesthesiology and Intensive Care Medicine (SFAI), together with the antidotes. Material for immobilisation: a…

…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…

…Unna boot), or a class 2–3 compression stocking. Tape measure for ankle circumference — this governs the choice of material and bandaging technique. Procedure Assessment…

…pool, numerous macrophages or foam cells, and a thin fibrous cap. Disruption of the cap exposes the lipid core and extracellular matrix to circulating blood…

…complication of coronary atherosclerosis. The transition from a quiescent plaque to a highly thrombogenic surface occurs via three primary mechanisms: Plaque Rupture: Accounting for 60…

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

…severe preeclamptic phenotype or variant. Pathophysiology The precise mechanism of preeclampsia remains incompletely established. Proposed contributors include chronic uteroplacental ischaemia, an exaggerated maternal inflammatory response…

…with those used for non pregnant adults. The fetus is not harmed by defibrillation, amiodarone, or adrenaline (epinephrine). In the event of a cardiac arrest…

…the skin. Aspiration needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe for…

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

…by the occluded artery. Conversely, an angiographically identified CTO without demonstrable ischaemia or viable myocardium provides a less compelling basis for intervention. The source material…

…insufficiency and cardiovascular disease, irrespective of diabetes status The clearest and most consistent cardiovascular signal is reduction in hospitalization for heart failure. Benefits also include…

…tips of various sizes. A balloon catheter (a 5–6 Fr Fogarty or a Katz extractor). A local anaesthetic with a vasoconstrictor for the nose…

…over the base of the plate. Preparation and equipment Chlorhexidine in alcohol or an iodine solution. Lidocaine 10 mg/mL without adrenaline for the block…

…In the setting of acute heart failure, N terminal pro B type natriuretic peptide (NT proBNP) values, potassium concentrations, and estimated glomerular filtration rate (eGFR…

…fluid ounces of 40% distilled spirits. Habitual heavy consumption is defined in the source material as at least eight drinks weekly in females or at…

…MI or percutaneous coronary intervention (PCI), ischaemic risk, bleeding risk, need for anticoagulation, and whether coronary stents are present. Clinical objectives of therapy The main…

…dosing Definition and Pathophysiology Bradycardia encompasses a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within the context of acute coronary syndromes…

…and quality of life. The underlying aetiology is heterogeneous. Chronic heart failure evaluation should therefore seek reversible or treatable causes. The source material identifies coronary…

…PCI), or medical management. The standard post ACS regimen is DAPT for 12 months, generally consisting of low dose aspirin and a potent P2Y12 inhibitor…

…Pathophysiology Dietary patterns are the overall combinations of foods habitually consumed rather than isolated nutrients considered independently. For cardiometabolic health, the most favourable patterns generally…

…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…

…was related to the magnitude of heart rate reduction. Ivabradine is also a reasonable consideration when a beta blocker cannot be tolerated or is contraindicated…

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

…the urgency of management: Recurrent or ongoing chest pain despite medical treatment Acute heart failure presumed to result from ongoing myocardial ischaemia Haemodynamic instability or…

…been used in therapeutic studies of pulmonary arterial hypertension (PAH). The threshold is not absolute: patient phenotype, risk factors for heart failure with preserved ejection…

…be effective in fetal, pediatric patients, and young adults with congenital heart disease. Initiation Strategies Because of its ability to significantly prolong the QT interval…

…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…

…ACS) and confirmed by angiography or pathology. The Academic Research Consortium framework additionally distinguishes definite, probable, and possible stent thrombosis for clinical research and outcome…

…access (absolute, for the bone in question): A fracture of the bone to be punctured, or a major injury proximal to the puncture site. A…

…or when the volume limit is reached. Indications Diagnostic aspiration: a new pleural effusion of unclear cause. An effusion not confidently explained by heart failure…

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

…patients with symptomatic or asymptomatic peripheral arterial disease, in whom AAA has been reported with a substantial cumulative incidence. The source material does not provide…

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

…requiring dialysis is uncommon except in the presence of substantial pre existing CKD, particularly when congestive heart failure or other causes of ischaemic AKI coexist…

…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…

…therefore depend on the vascular territory involved and may include manifestations of coronary, cerebral or peripheral arterial disease, although the source material does not specify…

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

…sharp or stabbing. Its location and radiation may reflect the segment of aorta involved, although the source material does not provide a detailed symptom to…

…high clinical likelihood of obstructive CAD, defined in the source material as greater than 85%, particularly when one or more of the following are present…

…ischaemia, including heart failure, haemodynamic compromise and rhythm disturbance. The source material does not provide a specific examination profile or diagnostic physical signs for LMCAD…

…dysfunction. A patient may also present because of complications of the underlying infarction or LV remodeling, including heart failure, ventricular arrhythmias, or recurrent ischemic symptoms…

…and acute MI procedures. Distal embolization of atheromatous or thrombotic material is an important proposed mechanism. No reflow may produce major short and long term…

…occur at a low level of exertion, or are associated with high event risk. The apparent differences between thresholds reflect different guideline frameworks and clinical…

…Objective assessment of adherence may be undertaken where resources permit, using directly observed treatment or detection of prescribed drugs in blood or urine. The terms…

…of an inferior infarction. The presence of right sided ST segment elevation supports the diagnosis, although the source material does not provide sensitivity, specificity, or…

…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…