…for sudden cardiac death: what the new Nature study shows Low risk (blue) versus high risk (red) ECG morphs in lead aVL (adapted from Obermeyer…

…findings. OMI is defined by acute coronary artery occlusion causing transmural ischemia and requiring urgent reperfusion, even in the absence of classic ST elevation. Multiple…

…important precautions. A hypertensive emergency is defined by a markedly raised blood pressure in combination with new or progressive acute target organ damage. Common manifestations…

…but the system around the patient : that the weekly dose is adjusted in small steps, that every new prescription is assessed as a potential interaction…

…new ST elevation in at least two contiguous leads [8, 10]. The specific voltage thresholds vary based on patient age, sex, and lead location, as…

…be selected according to clinical judgement. Low to moderate probability: greater than 5% to 50% in the chronic coronary syndrome pathway. Coronary CT angiography (CCTA…

…Types of heart failure. In HEREF, left ventricular systolic function (ejection fraction) is impaired (defined as ejection fraction <40%). In HFPEF, there are clinical signs…

…Types of heart failure. In HEREF, left ventricular systolic function (ejection fraction) is impaired (defined as ejection fraction <40%). In HFPEF, there are clinical signs…

…be suspected? Anaphylaxis is a clinical diagnosis. Treat as anaphylaxis in any of the following: 1. Acute onset of skin or mucosal symptoms , for example…

…whether the condition is new or clearly worse than baseline. Contact relatives, home care services, the residential care home or the previous care provider. 5…

…the left side. A positive test in the posterior canal is characterised by: A latency of 1–5 seconds before the nystagmus begins. Upbeating and…

…crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing or new organ damage in which immediate, controlled blood pressure…

… choose a new site if in doubt Cellulitis over the insertion site Change the puncture site Preparation and equipment Ultrasound with a curved array probe…

…cap, mask, fenestrated drape. Chlorhexidine in alcohol 5 mg/mL. Local anaesthesia: lidocaine 10 mg/mL, 10–20 mL, a 25 G needle for the…

…ago and are at high risk of a new event. Treatment can be started without interruption as continuation treatment after the initial one year treatment…

…defined as a drug induced or drug exacerbated cardiac arrhythmia, constitutes a major clinical problem. It can manifest as an increase in the frequency of…

…MI). MI denotes cardiomyocyte necrosis occurring in the clinical setting of acute myocardial ischaemia and is diagnosed according to the fourth universal definition of MI…

…complete the ECG course in order to obtain your certificate. New ECG test will be added in February. Continue to log in if you are…

…has unleashed a new paradigm in cardiometabolic medicine. These therapies are revolutionizing public health strategies, transcending their original roles as glucose lowering agents to become…

…leading cause of heart failure with reduced ejection fraction (HFrEF) in developed countries. New ischemic events are major determinants of subsequent LV deterioration and long…

…new regional wall motion abnormality in an ischaemic distribution Identification of a coronary thrombus by angiography or autopsy, where applicable to the relevant infarction category…

…also protect against future proximal disease progression, while stents do not prevent the development of new proximal atherosclerosis. The choice between procedures therefore depends on…

…is characterized by new onset hypertension after 20 weeks, generally accompanied by proteinuria or evidence of maternal organ involvement. Proteinuria is defined as urinary protein…

…ischaemia needs to be defined before revascularization Residual ischaemia must be assessed after initiation of medical treatment LV function requires evaluation in the setting of…

…cardiogenic shock. UA itself is defined by a recent change in the pattern of myocardial ischaemia rather than by a particular symptom intensity alone. The…

…the European Society for Cardiology (ESC) suggest a new classification ( Knuuti et al, 2019/2020 ), in which stable coronary artery disease is part of the…

…of the thrombus in the artery: a proximally located thrombus will cut off blood flow to more branches, and thus more myocardium, as compared with…

…This is not a new experience for either the pathologist or the internist. That there is something lacking in our understanding of this problem is…

…et al. ). As the atherosclerotic plaque increases in size, it bulges into the artery lumen and causes stenosis (reduction of the artery lumen). The reduction…

…from V1 to V5 is absent. It may be broken, as in Figure 1 . Any type of infarction may cause pathological R wave progression. However…

…in the medium. This is illustrated in Figure 3. Figure 3. Wavelength Wavelength is defined as the distance between two points (along the sound wave…

…Current guideline criteria for ischemic ST segment depression: New horizontal or downsloping ST segment depressions ≥0,5 mm in at least two anatomically contiguous leads…

…Moreover, the ST segment may have a concave appearance if the T wave is prominent (such as in hyperkalemia, early repolarization or even early phases…

…the European Society for Cardiology (ESC) suggest a new classification ( Knuuti et al, 2019/2020 ), in which stable coronary artery disease is part of the…

…fibrillation. ECG 3 . Ventricular fibrillation, coarse (large amplitudes). ECG 4 . Ventricular fibrillation. ECG 5 . Ventricular fibrillation, fine (low amplitudes). ECG 6 . Ventricular fibrillation, coarse. ECG…

…recommended [1,5]. STEMI criteria and occlusion patterns on the ECG Classic ST elevation criteria New ST elevation at the J point in at least…

…blood gas in respiratory compromise, low saturation, suspected carbon dioxide retention, reduced consciousness, or when NIV is being considered. 4. Give short acting bronchodilators. 5…

…the brief attacks. Lying down, turning over in bed or looking up triggers a new attack. A patient with vestibular neuritis or stroke, by contrast…

…is considerably better [3,5]. Pathophysiology Alcohol enhances inhibitory signalling via gamma aminobutyric acid, GABA, and inhibits excitatory glutamate signalling, in part via NMDA receptors…

…platelets: in ongoing bleeding with coagulopathy, or as part of balanced transfusion in massive haemorrhage. Transfusion thresholds in the stable, non bleeding patient Patient category…

…J point in two contiguous leads: Leads Threshold : : V2–V3, men ≥ 40 years ≥ 2.0 mm V2–V3, men < 40 years ≥ 2.5 mm…

…atria begin to contract again. An unsynchronised shock that happens to fall in the T wave can precipitate ventricular fibrillation, and cardioversion of fibrillation of…

…potassium into the cells with insulin and glucose. Add high dose salbutamol in marked hyperkalaemia if there is no contraindication. 5. At the same time…

…is a warning sign of impending overcorrection. Grading Hyponatraemia is defined as a plasma sodium below 135 mmol/L. The biochemical grade alone does not…

…three to six months during ongoing compression therapy, and always in the event of new or increasing pain. Preparation and equipment Doppler for the ankle…

…in wide circles and apply the drape. 4. Anaesthetise the skin and the needle track. Wait a minute or so. 5. Advance the needle in…

…with pigment in the cuticle — Hutchinson's sign). An open fracture of the distal phalanx with a subungual haematoma — manage it as an open fracture…

…use 38.5 degrees instead. Follow the local definition where one exists, but a neutropenic patient who is clinically unwell must be managed as an…

…is defined as life threatening organ dysfunction caused by a dysregulated host response to infection. Clinically this usually corresponds to an acute increase in the…

…Go AS, Chang Y, et al. A new risk scheme to predict warfarin associated hemorrhage: the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) study…

…anticoagulants (new oral anticoagulants) include apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Lixiana®), rivaroxaban (Xarelto®). If oral anticoagulation is indicated, NOACs should be chosen except in patients…

…an elevated cardiac troponin concentration and new ST segment depression in new onset AF should not automatically be labelled type 2 myocardial infarction without further…

…of muscle mass, particularly in older adults Patients require individualized progression because new symptoms during exercise may signal an adverse clinical response. Recreational activity should…

…HFrEF) is defined by the combination of symptoms, with or without physical signs, and an LVEF below 40%. Signs may be absent in early disease…

…delayed, partly due to autopsy studies demonstrating an absence of coronary thrombi in a significant proportion of deceased patients. Historically referred to as coronary thrombosis…

…4a MI after PCI In a patient with normal baseline cTn, type 4a MI is defined by: cTn greater than 5 times the 99th percentile…

…around days 3–5, although the reported range extends from 1 to 14 days after infarction. VSR may also occur as late as 2 weeks…

…Consequently, posterior infarction should not be regarded as an isolated electrocardiographic pattern in every case; it may represent the posterior component of a broader infarct…

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

…myocardium or a new regional wall motion abnormality in an ischaemic pattern. Identification of a coronary thrombus by angiography or autopsy, except in type 2…