…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…

…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…

…the specific context of perioperative care in patients with pulmonary arterial hypertension (PAH), progression of right heart failure may indicate the need for inodilator therapy…

…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…

Procedurer The result of a repair is determined before the first needle goes in. A wound that has not been irrigated clean, has not been…

…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…

…for several simultaneous, incompatible infusions. Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of…

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

…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…

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

…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…

…and a thin fibrous cap. Disruption of the cap exposes the lipid core and extracellular matrix to circulating blood. Tissue factor within the plaque and…

…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…

…maternal, fetal, and neonatal morbidity and mortality. Their incidence has increased in parallel with older maternal age at first childbirth and the rising prevalence of…

…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…

…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…

…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…

…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…

…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…

…majority of objects can be removed in general practice or in the emergency department with simple equipment. Two principles determine the outcome: the first attempt…

…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…

…or at least four drinks for women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism…

…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…

…arrest. Evaluation and Physical Examination The source material does not provide specific details regarding the physical examination or general evaluation of patients with bradycardia. Diagnostics…

…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…

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

Cardiology Clinical medicine Definition and Pathophysiology Dietary patterns are the overall combinations of foods habitually consumed rather than isolated nutrients considered independently. For cardiometabolic health…

…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…

…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…

…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…

…evidence of myocardial necrosis, or severe ischaemia on stress testing. Such developments may convert an initially selective or delayed approach into an indication for angiography…

…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…

…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…

…approximately 0.2%–0.5% per year beyond the first year, although the available material does not establish a significant increase in late morbidity or…

…enough. Lidocaine 10 mg/mL to anaesthetise the marrow cavity in a conscious patient. Fixation material for the intraosseous needle. Procedure Peripheral venous cannula 1…

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

…impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient. Perioperatively and postoperatively in longer procedures…

…increases risk, particularly among first degree relatives, with siblings appearing to be especially affected. The principal determinant of adverse outcome is aneurysm size. Larger aneurysms…

…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…

…temporal association is present; contrast induced AKI should be reserved for the smaller subgroup in which iodinated contrast is considered causally responsible. This distinction is…

…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…

…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…

…and reduction of LDL C, non HDL C and apolipoprotein B. Causes and secondary contributors A search for secondary contributors is an essential first step…

…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…

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

…to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the documented ischaemic burden. In chronic coronary…

…may include systemic arterial embolic manifestations. The source material does not provide a detailed catalogue of specific embolic syndromes. Clinical suspicion should be heightened after…

…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…

…most persuasive when the initial probability is high enough that the result meaningfully increases the likelihood of disease and can justify further investigation or treatment…

…diuretic for kidney function; Excess dietary sodium and volume overload; Concomitant drugs or conditions that increase blood pressure; or An undiagnosed secondary cause of hypertension…

…the first 24 hours in patients with RVI. The ECG should therefore include right sided precordial leads when RVI is suspected in the setting of…

…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