…or preserved Whether hypotension is present Whether an accessory pathway is suspected, particularly before administration of digoxin The duration of the AF episode, if known…

…parenteral nutrition. The need for several simultaneous, incompatible infusions. Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple…

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

…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…

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

…lidocaine–prilocaine) or infiltration anaesthesia for painful debridement. Wound bed dressing chosen by exudate volume, edge protection (zinc paste, barrier film). Compression materials: two layer…

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

…criteria exist. Figure 1. Flow chart for the investigation of suspected endocarditis. Vegetations Vegetations are ecotate masses made up of the foci of infection. Vegetations…

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

…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…

…mmHg—accompanied by signs of poor vital organ perfusion or frank shock states. In the specific context of perioperative care in patients with pulmonary arterial…

…or very old or frail patients who may not tolerate rapid blood pressure reduction. Initial Combination Therapy General Strategy For most adults with confirmed hypertension…

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

…for tendon and nerve injury will heal badly however neatly the suture is placed. The commonest cause of wound infection is retained contamination, not poor…

…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…

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

…ECG, and normal initial troponin may be observed in a chest pain unit or another non intensive care setting while serial testing is completed. Diagnostic…

…material addresses posterior infarction primarily in the context of suspected acute coronary syndrome and acute myocardial ischaemia. Patients may present with acute chest pain or…

…a small lipid core, the pathophysiology of Acute Coronary Syndromes (ACS) is driven by the sudden destabilization of these lesions, a process known as atherothrombosis…

…chronic or pre existing hypertension, gestational hypertension, and preeclampsia. Collectively, they affect approximately 5–15% of pregnancies worldwide and are major contributors to maternal, fetal…

…of the vena cava can be accomplished using a wedge board (or any hard material) to tilt the body 15 to 30° to the left…

…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…

…laboratory components; the diagnostic criteria themselves are not reproduced in the available source material. Waist circumference is particularly important because intra abdominal, or visceral, adipose…

…ischaemia or viable myocardium provides a less compelling basis for intervention. The source material does not provide a distinct symptom profile, physical examination pattern or…

…at a particular symptom complex. The source material does not describe a characteristic symptom profile at initiation or during routine therapy. Potential clinically important complications…

…and perforation occur. If you find one magnet, actively look for another , in the other nostril, in the ears and in the mouth. Nose 1…

…cotton wisp Ingrown nail with moderate inflammation Splinting with a strip of suture material or a drain Ingrown nail, severe or recurrent Partial nail avulsion…

…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…

…Other definitions of unhealthy drinking include at least two drinks daily in women or three in men, or at least four drinks for women or…

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…arrest, it is essential to reconfirm the rhythm in two leads if possible to distinguish true bradyarrhythmic or asystolic arrest from other tachyarrhythmic events. On…

…The source material specifically frames many pharmacological recommendations for patients with symptomatic NYHA class II–IV HFrEF. Advanced or refractory heart failure should be considered…

…thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI), or medical management. The standard post ACS regimen is DAPT for 12 months…

…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…

…scaffold A durable or resorbable polymer coating An antiproliferative drug The drug is delivered from the stent surface and suppresses cellular proliferation and neointimal growth…

…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…

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

…material does not cover the baseline clinical presentation and symptoms of the arrhythmias for which sotalol is prescribed. Evaluation and Physical Examination The source material…

…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…

…to other coronary branches or vascular beds, propagate through gaps between stent struts, and compromise the treated lumen. Conventional angiography has limited sensitivity for detecting…

…vein suspected of thrombosis or previously thrombophlebitic. Intraosseous access (absolute, for the bone in question): A fracture of the bone to be punctured, or a…

…where the neurovascular bundle lies, and the drainage is stopped for coughing, chest pain, or when the volume limit is reached. Indications Diagnostic aspiration: a…

…before attempting Relative A known urethral stricture Relative Acute prostatitis or urethritis Relative Latex allergy (choose an all silicone catheter) Where urethral injury is suspected…

…thresholds. Clinical Presentation and Symptoms Most AAAs are asymptomatic and are identified either during routine abdominal examination or incidentally on imaging performed for another indication…

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

…the presence of substantial pre existing CKD, particularly when congestive heart failure or other causes of ischaemic AKI coexist. Risk assessment Patient related risk factors…

…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…

…may include manifestations of coronary, cerebral or peripheral arterial disease, although the source material does not specify symptom patterns in detail. Physical manifestations Tendinous xanthomas…

…risks loss of suppression. Clinical presentation and symptoms The source material does not describe specific symptoms or physical manifestations of HTG. Moderate HTG is primarily…

…Iatrogenic lesions commonly follow cardiac surgery, coronary angiography or other invasive procedures, and affected patients may be relatively painless compared with those with spontaneous dissection…

…and other structural features that may not be evident on angiography alone. It is particularly useful when ACS occurs without significant obstructive CAD or when…

…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…

…The source material does not provide a detailed catalogue of specific embolic syndromes. Clinical suspicion should be heightened after: Anterior STEMI. A large or transmural…

…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…

…and infarction Definition and clinical rationale Stable angina, or chronic chest pain attributable to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of…

…from: Inaccurate or inconsistent blood pressure measurement; White coat hypertension; Poor adherence or persistence with prescribed therapy; Inadequate dosing; An inappropriate diuretic for kidney function…

…of right sided ST segment elevation supports the diagnosis, although the source material does not provide sensitivity, specificity, or threshold criteria. Echocardiography Two dimensional echoca

…plaque rupture or erosion Type 2 MI caused by oxygen supply–demand imbalance unrelated to acute atherothrombosis Type 3 Cardiac death with suspected acute ischaemia…