…straddle injury Relative Recent urethral or prostatic surgery — contact a urologist before attempting Relative A known urethral stricture Relative Acute prostatitis or urethritis Relative Latex…

…recent years ( Figure 2 ). The chain of survival is only as strong as its weakest link, which means that all components of the chain must…

…OAC. Bleeding Risk Assessment: HAS BLED Score Bleeding risk must be quantified using validated tools, with the HAS BLED score being the most widely recommended…

…it in recent years. Most cases (70%) of takotsubo cardiomyopathy occur in situations with extreme stress, such as car accidents, gun violence, threats, or any…

…of clinical conditions characterized by a recent change in symptoms or signs, with or without electrocardiographic changes, and with or without acute elevations in cardiac…

…in most textbooks in the field. However, contemporary data suggest that the current figure is approximately 60%. The discrepancy between traditional figures and recent studies…

…guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment of chronic coronary syndromes (CCS). Ischemic heart disease…

…guidelines. Hence, this chapter will present the most recent evidence and recommendations for the evaluation and treatment of chronic coronary syndromes (CCS). Ischemic heart disease…

…occurs in approximately 1% of patients. It manifests as localized, transient swelling of the subcutaneous or submucosal tissues, most frequently involving the face, lips, tongue…

…has remained stable. New data suggest that the incidence of heart failure among young adults has increased in recent years ( Nabel et al, Savarese et…

…has remained stable. New data suggest that the incidence of heart failure among young adults has increased in recent years ( Nabel et al, Savarese et…

…and Internet connected devices. Additional breakthroughs have been achieved in recent years, with the leadless pacemaker being the most promising improvement. 1 Given the wide…

…Every seven years HPV, with reflex cytology if HPV positive The interval is counted from the most recent sample analysed for HPV. Invitations are sent…

…by far the most common cause of ST segment elevation in any population (up to 90% of males aged 40 years or younger display this…

…baseline HbA1c or the magnitude of HbA1c reduction. 7 Instead, these agents exert multifaceted effects through direct activation of receptors in target tissues. 15 Recent…

…of troponin release must therefore be considered throughout assessment. Coronary disease is most commonly related to atheromatous plaque producing progressive narrowing or obstruction of epicardial…

…Of every 10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle. In other words…

…cardiac arrest is the most lethal manifestation of cardiovascular disease, accounting for 50% of all cardiovascular deaths ( Tsao et al ). A recent meta analysis showed…

…to ask it. Indications Wide complex tachycardia where ventricular tachycardia must be distinguished from supraventricular tachycardia with bundle branch block or aberrancy. Narrow complex tachycardia…

…Most reports have suggested that comorbidities – e.g. cardiovascular disease, pulmonary disease, advanced age, smoking, diabetes, hypertension, cancer, etc – are the most important risk factors…

…regimen remains the default for most patients with ACS, including those with NSTE ACS. It applies whether ACS is managed with PCI or without revascularization…

…27] . Recent guideline updates have introduced critical nuances to HF terminology to reflect the dynamic nature of myocardial remodeling. The designation "Heart Failure with improved…

…structural and ischemic heart disease. Assessment of ischemia on ECG is difficult in the presence of left bundle branch block. This is because left bundle…

…burden. Assessment of the size, mass, geometry, and function of the left ventricle is fundamental for the diagnosis and prognosis of most cardiac diseases, including…

…detail. The clinical definitions and recommendations presented in this chapter are in line with recent guidelines (2020) issued by the American Heart Association (AHA), American…

…and unstable presentations, the critical entity of electrical storm, and the long term management strategies informed by recent sub group analyses, registry data, and ongoing…

…if the patient reverts to sinus rhythm. Th e infusion must be aborted if hypotension or bradycardia occurs. A defibrillator should be immediately available as…

…reduced level of consciousness Gastric lavage Corrosive injury or suspected oesophageal perforation Gastric lavage Petroleum products Gastric lavage Oesophageal varices, coagulopathy, recent oesophageal or gastric…

…department [1,3]. Step 1: confirm the blood pressure and stabilise the patient Immediate assessment 1. Assess airway, breathing, circulation and level of consciousness. 2…

…reduced level of consciousness Coma Marked drowsiness, for example a Glasgow Coma Scale below 8 Vomiting together with clear neurological impairment Respiratory failure or respiratory…

…Recent nasal or pharyngeal surgery Signs that should raise the suspicion of a base of skull fracture: periorbital bruising, retroauricular bruising, haemotympanum, CSF rhinorrhoea or…

…INR before the first dose. A raised baseline value suggests liver disease or vitamin K deficiency and must be investigated before treatment is started. 2…

…strips, tissue adhesive or a dressing alone. Contraindications Primary closure must be avoided or considered carefully in: Bite wounds — particularly cat and human bites, and…

…initial components of assessment. The history should include: previous TIA or stroke; symptoms suggesting current or recent cerebral ischaemia; known CAD, PAD, or other atherosclerotic…

…involves the atria, atrioventricular node, accessory pathway and the ventricles. In most cases, the re entry is induced by a premature atrial beat. Atrioventricular reent

…The most serious transfusion accidents rarely stem from laboratory errors but from the wrong blood being given to the wrong patient — a mislabelled tube, or…

…an irregular pupil, a soft globe — because a perforated eye must never be instrumented, have its pressure measured, or be palpated. Indications A sensation of…

…Clinical assessment History that affects the level of risk Ask briefly and to the point: When did the deterioration begin, suddenly or over several days…

…difficult bag mask ventilation or failed intubation — and already at the planning stage when the MACOCHA score or the LEMON assessment indicates that difficulties are…

Info Brugada's algorithm is the most used algorithm for distinguishing ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with wide QRS complex. The algorithm entails…

…therapy. I C Symptom relief Symptom Management Recommendation Level of evidence Hypoxia Oxygen is indicated if SaO2 < 90% or PaO2 < 60 mmHg. I…

CPR This chapter will introduce the most common and essential terms used in resuscitation science, providing a foundation for understanding subsequent chapters. SCA (Sudden Cardiac…

…whether they are continuous or episodic, how long an attack lasts, and whether anything actually triggers it [1,2]. The single most important practical rule…

…known coronary or cerebrovascular disease. Follow up after vascular surgery or endovascular intervention. Assessment of healing potential in ulcers and before deciding the level of…

…represents the most common form of neurally mediated syncope (NMS), a disorder of autonomic reflexes. It typically occurs after attaining an upright posture or following…

Arrhythmias and arrhythmology ECG Atrial flutter Atrial flutter is the second most common pathological tachyarrhythmia. Only atrial fibrillation is more common. Atrial flutter occurs almost…

Echocardiography Mitral regurgitation Causes of mitral regurgitation The most common cause of mitral regurgitation in high income countries is age related degeneration of the valvular…

Echocardiography Echocardiography in 2D Two dimensional (2D) ultrasound is the most commonly used modality in echocardiography. The two dimensions presented are width (x axis) and…

…further assessment. Clinical presentation and symptoms The clinical presentation is heterogeneous. AF may be well tolerated, particularly when the ventricular response is not excessive, or…

…or a combination of these symptoms. The diagnosis requires elevated levels of cardiac troponins. In addition to elevated troponins, the patient must display either symptoms…

…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…

…pathophysiology Post infarction mechanical complications are structural disruptions of acutely infarcted myocardium occurring most often during the first days after ST elevation myocardial infarction (STEMI…

…which may or may not be present Markedly reduced cardiac output in severe cases Cardiogenic shock in the most advanced presentations The symptoms of RVI…

…Symptoms of ischemic heart disease are generally not related to body position or respiration. Triggering factors Symptoms triggered by exercise/effort (what level of exercise)…

…syndrome) being the most common. Atrial fibrillation with onset during hyperthyroidism (thyrotoxicosis), alcohol overdose, thoracic surgery, acute myocardial infarction, pericarditis/myocarditis or pulmonary embolism is…

…and careful analysis of ECG tracings. Most modern devices are capable of transmitting ECG tracings continuously to cloud based platforms, which enables the clinician to…

…which is synonymous with ischemic heart disease, is the most common form of cardiovascular disease. It has been the number one killer in Western and…

Arrhythmias and arrhythmology ECG Mechanisms of cardiac arrhythmias: from automaticity to re entry This section introduces the most common arrhythmias encountered in clinical practice, beginning…

…clinical examination, blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI). Anatomy of…

…ECG, normal variants & pathological variants Sinus tachycardia is the most common tachyarrhythmia (tachycardia). Sinus tachycardia is the result of an increased rate of depolarization (i…