…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…

…cardiogenic shock. Identification of life threatening arrhythmias. Assessment for high risk mechanical complications. Determination of symptom onset time and anticipated time to primary PCI. Patients…

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

…AF may be pre existing, newly detected for the first time, or newly developed during management of an acute illness. The clinical relationship between AF…

…heart failure care capabilities, including mechanical circulatory support and transplantation, is warranted. Diagnostics Hemodynamic and functional monitoring is central to the safe administration of these…

…from a more individualized selection strategy. When to Initiate Pharmacological Treatment Lifestyle intervention is an essential component of care. In adults with elevated blood pressure…

…over a joint. Pain relief and stabilisation for transfer in a suspected fracture. Clinical suspicion of a scaphoid fracture despite a normal radiograph. Contraindications An…

…has not been assessed for tendon and nerve injury will heal badly however neatly the suture is placed. The commonest cause of wound infection is…

…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…

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

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

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

…segment elevation, immediate reperfusion assessment is required. Patients with NSTE ACS should be admitted for management of acute ischaemia. Those with possible ACS, a non…

…boot), or a class 2–3 compression stocking. Tape measure for ankle circumference — this governs the choice of material and bandaging technique. Procedure Assessment 1…

…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…

…exposes the lipid core and extracellular matrix to circulating blood. Tissue factor within the plaque and tissue factor bearing microparticles contribute to activation of coagulation…

…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…

…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…

…15% of pregnancies worldwide and are major contributors to maternal, fetal, and neonatal morbidity and mortality. Their incidence has increased in parallel with older maternal…

…For women beyond the 20 th week of pregnancy, or when the fundal height surpasses the umbilicus, the uterus should be manually displaced to the…

…for both aspiration and biopsy in adults. Here the posterior part of the iliac crest is thick, red marrow is abundant, and the distance to…

…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…

…a less compelling basis for intervention. The source material does not provide a distinct symptom profile, physical examination pattern or biomarker signature specific to CTOs…

…a class of oral agents initially developed for glucose lowering in type 2 diabetes mellitus (T2DM). The principal drugs identified in the source material are…

…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…

…with mild inflammation Splinting with a cotton wisp Ingrown nail with moderate inflammation Splinting with a strip of suture material or a drain Ingrown nail…

…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…

…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…

…coronary disease. For prolonged treatment, doses of 75–100 mg daily appear to provide similar efficacy to higher doses while reducing bleeding risk. Low dose…

…digitalis excess. Biomarkers and Laboratory Findings The source material does not provide information on biomarkers or laboratory findings specific to the evaluation of bradycardia. Treatment…

…rationale for disease modifying treatment is to reduce mortality, prevent recurrent hospitalization for worsening heart failure, and improve symptoms, functional capacity and quality of life…

…a contraindication, an indication for oral anticoagulation, or an excessive risk of bleeding. The duration and intensity may be modified according to: bleeding risk; ischemic…

…methods may also contribute. The cardioprotective effect is therefore likely to result from the cumulative influence of multiple modest dietary changes. Mediterranean type diets provide…

…shorter DAPT regimens are used. BMS now account for less than 10% of contemporary PCI procedures according to the source material. First generation DES The…

…vascular tone. Accordingly, the source material describes no haemodynamic or contractility effects attributable to ivabradine. Because its action is exerted in the sinus node, it…

…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…

…failure presumed to result from ongoing myocardial ischaemia Haemodynamic instability or cardiogenic shock Life threatening arrhythmias or cardiac arrest after presentation Mechanical complications of myocardial…

…20 mmHg ≤15 mmHg ≤2 Wood units The source material also presents a CpcPH threshold of PVR ≥3 Wood units in an overlapping clinical classification…

…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…

…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…

…complications of myocardial infarction Pericarditis Dynamic recurrence of ST segment elevation is particularly concerning for a new infarction. A pericardial rub and poor response to…

…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…

…safe pocket of fluid to puncture (no ultrasound verified fluid) Relative Uncorrected coagulopathy or thrombocytopenia Relative Ongoing anticoagulant treatment — plan the aspiration for the trough…

…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…

…are located below the renal arteries and are related to atherosclerotic disease. At least 90% of AAAs larger than 4 cm are associated with atherosclerotic…

…high risk populations, prevalence may be sufficiently high for targeted screening to be cost effective. For asymptomatic stenosis of at least 70%, the reported 5…

…up to 17% when eGFR is below 30 mL/min/1.73 m2. In patients with relatively normal renal function, defined in the source material…

…bempedoic acid in selected patients, particularly those with statin intolerance or persistent failure to reach goal. For statin intolerant patients, ezetimibe may be used initially…

…LDLR, which account for most cases. Variants in APOB that impair apolipoprotein B binding to the LDL receptor. Gain of function variants in PCSK9, which…

…relationship between triglyceride concentrations and aortic disease is less clearly defined, although triglycerides may contribute to the development and progression of aortic pathology. Severe HTG…

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

…is consequently recommended to complement ICA, particularly for intermediate non left main coronary stenoses. Myocardial ischaemia may occur despite the absence of significant epicardial obstruction…

…revascularisation recommendations are not restricted to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the documented…

…mural thrombi to develop over infarcted myocardium in either ventricle. With contemporary imaging, LV thrombus has been reported in as many as 15% of patients…

…the index MI and how much is related to the intervention. Diagnostic criteria General principles For events occurring within 48 hours of the index procedure…

…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…

…who therefore require assessment for pseudo resistance, secondary hypertension, treatment related contributors, and excess cardiovascular risk. The European definition requires failure to reduce office systolic…

…limited right ventricular dysfunction to severe right sided failure and cardiogenic shock. The haemodynamic disturbance results from impaired right ventricular contraction and reduced forward flow…

…haemorrhage into the plaque. The diagnosis is supported by the general criteria for acute MI together with evidence of acute coronary atherothrombosis. Post mortem demonstr