…damaged nail fold edge Nail avulsion and inspection of the nail bed, with suture of any nail bed laceration Contraindications There are no absolute contraindications…

…40% of atrial size Jet orientation central variable excentric Pulmonary vein flow S dominant reduced S wave systolic flow reversal, Qualitative parameters Mild regurgiation Moderate…

…regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of…

…regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of…

…manifestations of HTG. Moderate HTG is primarily discussed as a cardiovascular risk marker, while severe HTG is clinically important because of its association with acute…

…recommended as the initial study in patients with low to moderate risk of CAD. In patients with a high to very high risk of CAD…

…about suppression of the HPA axis, where a long half life produces more marked suppression. Stress dosing in known adrenal insufficiency A patient with primary…

…Indications Evaluation of chest pain with an intermediate pre test probability of coronary artery disease. Assessment of exercise capacity and symptoms in known heart disease…

…moderate hyperglycaemia over a few days. Principles Insulin component Function Who needs it : : : Basal insulin (intermediate or long acting) Covers fasting glucose production Everyone with…

…Decompensated heart failure — compression of both legs acutely increases preload. Untreated deep vein thrombosis in the acute phase. Septic phlebitis, ongoing soft tissue infection with…

…with mild to moderate heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with…

…If oral anticoagulation is indicated, NOACs should be chosen except in patients with moderate to severe mitral stenosis or mechanical heart valves; for these patients…

…less patients with pre existing cardiovascular disease/cardiac arrest Solu Cortef HYDROCORTISONE SODIUM SUCCINATE HYDROCORTISONE SODIUM SUCCINATE Heart Damage wp less elevation of blood pressure…

…D rugs/alcohol concomitantly Each component is assigned 1 point, with a maximum score of 9. The score takes into account various risk factors that…

…regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of…

…the competing risk of death from non cardiovascular causes, an important consideration in older populations. Risk prediction is particularly relevant in adults with elevated blood…

…the anticipated benefit–risk balance of revascularization. Coronary angiography remains primarily an anatomical examination, whereas contemporary decision making increasingly combines anatomical imaging with functional assessment…

…Chronic hypoperfusion with hibernating myocardium Post ischemic stunning Adverse left ventricular (LV) remodeling Ischemic cardiomyopathy is the leading cause of heart failure with reduced ejection…

…with lower cardiovascular and all cause mortality and with reduced incidence or burden of hypertension, type 2 diabetes, coronary disease, stroke, peripheral arterial disease, heart…

…COPD. Adenosine has caused mild to moderate exacerbation of asthma symptoms. Adenosine should be used with caution in patients with obstructive lung disease or asthma…

…European Society for Cardiology, 2800 adults per 1 million individuals have congenital heart defects, and half of them have moderate or complicated defects; the remaining…

…visualize clearly with trans thoracic echocardiography. Causes of right ventricular hypertrophy Lung disease (with increased pulmonary vascular resistance), congenital heart disease (transposition of the great…

…and intensive care early with life threatening features or an inadequate response. First line treatment is oxygen in hypoxaemia, repeated doses of an inhaled short…

…mild to moderate Secondary prevention, walking exercise ≤ 0.40 Severe ischaemia Urgent vascular surgical assessment Exercise ABI. With a normal or borderline resting ABI but…

…in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes…

…PE) ↓ ↑ ↑ ↓ Vital signs and measures of perfusion Parameter Normal Comment : : : Heart rate 50–100/min MAP 70–105 mmHg Target ≥ 65…

…Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and…

…early diastolic early diastolic holodiastolic Quantification of jet Mild regurgitation Moderate regurgitation Severe regurgitation Jet width / LVOT width < 0.25 0.25 0.64…

…The grading must not be used mechanically. A patient with a plasma potassium of 6.2 mmol/L, new bradycardia and acute kidney injury may…

…8 Vomiting together with clear neurological impairment Respiratory failure or respiratory arrest Clinical signs of raised intracranial pressure or impending herniation Moderately severe symptoms New…

…are distinguished by the history and the speed of the course. An AST/ALT ratio 2 with moderately raised values suggests alcohol related liver disease…

…Since 2022 the z score with a lower limit of normal at z = −1.64 (the fifth percentile) has been recommended in preference to…

…spread of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy: an otoscope with a charged battery and clean disposable specula…

…early diastolic early diastolic holodiastolic Quantification of regurgitant jet Mild regurgitation Moderate regurgitation Severe regurgitation Jet width / LVOT width < 0,25 0,25 0…

…GY. A novel user friendly score (HAS BLED) to assess 1 year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey…

…Prasugrel can be taken with or without food. Administering a 60 mg loading dose on an empty stomach may provide the fastest onset of effect…

…the prevention of atherothrombotic events in adult patients with acute coronary syndrome (ACS) or a prior heart attack and a high risk of developing an…

…PhD University of Gothenburg, The Sahlgrenska University Hospital, Sweden References Jervell A, Lange Nielsen F. Congenital deaf mutism, functional heart disease with prolongation of the…

…claudication, accompanied by moderate pain or paresthesia, while sensory and motor function remain preserved. The duration and progression of symptoms should be documented carefully. Longer…

…sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy. The cardiovascular implications of lower alcohol intake remain…

…mL/min/1.73 m² Abnormal urinalysis or renal imaging Risk of progression rises with proteinuria and depends on cause 2 60 mL/min/1…

…potential causes of shock. Patients with moderate to severe chronic kidney disease have a higher burden of comorbidity and an increased risk of in hospital…

…population screening test. It may also be considered in selected lower risk individuals with a family history of premature coronary artery disease. CAC findings incidentally…

…pharmacologic agent in the heart failure armamentarium. Its use has declined over time due to the advent of more efficacious agents with wider therapeutic to…

…exercise induced arrhythmias Evaluating the blood pressure response Refining risk stratification and prognosis For patients with low or moderate pre test likelihood of obstructive CAD…

…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…

…or moderate intensity statins should have treatment intensified. The 2025 ACS guideline recommendations include: High intensity statin therapy for all patients with ACS. Addition of…

…those with a family history of high Lp(a); individuals with cardiovascular disease that is not explained by major conventional risk factors; patients at moderate…

…available, PET MPI is recommended in individuals with suspected chronic coronary syndrome and a moderate or high pre test likelihood of obstructive coronary artery disease…

…refractory to guideline directed medical therapy, occur at a low level of exertion, or are associated with high event risk. The apparent differences between thresholds…

…of dynamic LV function, valve disease, pulmonary pressure, or haemodynamics Stress imaging is not recommended in patients undergoing urgent non cardiac surgery or those with…

…with the diameter of the LVOT. A jet diameter smaller than 25% of the LVOT diameter suggests moderate aortic regurgitation. A jet diameter 65% of…

…severity of electrolyte disturbances, particularly before laboratory results are available. Notably: Both hyperkalemia and hypokalemia can induce life threatening arrhythmias and cardiac arrest, with hyperkalemia…

…Mild hypothermia Conscious with tremors 32 35°C Moderate hypothermia Impaired consciousness, with or without shivering 28 31°C Severe hypothermia Unconscious, with signs of life <28…

…Patients with left ventricular hypertrophy may instead display normalization of secondary T wave inversions (lead V5, V6, aVL, I). ECG in moderate hyperkalaemia Previously mentioned…

…in cardiac output during moderate exercise is the result of increased stroke volume and increased heart rate. However, when roughly half of the maximal cardiac…

…disease (ischemic heart disease). Evaluation of coronary artery disease. Assessment of therapeutic response. Exercise testing can be used to evaluate the effect of medications or…

…thickness, often indicative of early or mild ischemia. Moderate defects : Associated with wall thinning, suggesting a more advanced level of ischemia or partial scarring. Severe…

…of all individuals with Noonan syndrome have pulmonic stenosis. The stenosis is subvalvular, causing a narrowing of the RVOT (right ventricular outflow tract). Carcinoid heart…

…presence of collateral circulation, etc –ischemia may also develop during resting conditions. Indeed, in patients with ischemic heart disease, the majority of all ischemic episodes…