…or no reflow rates may reach 15%–20%, substantially exceeding those seen with native vessel PCI. Mechanisms The principal mechanism is distal embolization of atheromatous…

Procedurer Opioids have no standard dose. The effect varies tenfold between individuals, and the only way to find the right level is to give a…

…indicates a pathological condition. Explanation: In the absence of symptoms, heart rates ≥30 beats/min are considered normal in highly trained athletes. Sinus rhythm should…

…population measure that performs poorly at the level of the individual: it does not distinguish muscle from fat and takes no account of fat distribution…

…a formalin container for the biopsy. No. 11 scalpel for the skin incision, sterile dressings, pressure dressing. Procedure 1. Place the patient in the lateral…

Procedurer Cryotherapy destroys tissue through intracellular ice crystal formation and through microvascular thrombosis in the treated area. The method is quick, cheap and requires no…

Procedurer The insertion itself is rarely the difficult part — it is the confirmation of the position that determines whether the tube is safe. A misplaced…

…the prescription has no target — the nasal cannula stays in place for days without anyone asking why, or the patient at risk of carbon dioxide…

…5 days. Suspected or known tendon rupture. No response to previous injections at the same site. More than three injections at the same site within…

…likely. If there is AV dissociation, ventricular tachycardia is very likely. If there are no signs of ventricular tachycardia, antidromic AVRT should be strongly considered.

…calcium channel blocker. Clevidipine is highly selective for vascular smooth muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces…

…Section DICT Concern Cardiac side effects Severity of cardiotoxicity Hyaluronic Acid HYALURONIC ACID HYALURONIC ACID NA no no ZYPREXA Relprevv OLANZAPINE PAMOATE Olanzapine pamoate Arrhythmia…

…® Mechanism of action • Induces arteriolar vasodilation. No effect on venous circulation. • May cause reflex sympathetic stimulation (can be counteracted with simultaneous administration of beta…

…1 Hypokinesia Reduced thickening (typically 10–30% thickening from end diastole to end systole) 2 Akinesia Markedly reduced, or no thickening (<10%) 3 Dyskinesia Paradoxical…

…mmol/L (55 mg/dL) to reduce cardiovascular risk. 1. Assess Prior Treatment • No prior treatment, low dose, or low intensity lipid lowering therapy: • Start…

…pressure control. Mechanism of action Nitroglycerin provides nitric oxide (NO) that induces vasodilatation (of both arterioles and veins) via generation of cyclic GMP, which then…

…<2 3 days), and monitor the patient closely to avoid cyanide toxicity. • Dose dependent reduction in coronary and renal perfusion. • Dose dependent elevation of intracranial…

…Usually hospital based, often ICU Usually outpatient Initial treatment Carefully titrated intravenous therapy when indicated Oral treatment and prompt follow up Main risk of management…

…of life, repeated hospital presentations and angiography, and increased short and long term adverse cardiovascular outcomes. Clinical Presentation and Symptoms Symptoms may resemble those of…

…and no obstructive stenosis in a major epicardial coronary artery. Non obstructive disease is generally defined as the absence of a stenosis of 50% or…

…is no longer viewed merely as an electrical anomaly but as a progressive, complex atrial myopathy. For the practicing cardiologist, mastering the nuances of anticoagulation…

…to no flow time, low flow time, patient preferences, patient background, and the decision to initiate CPR is often ambiguous. Since the risk of attempting…

…Acquisition of ECGs in pediatric patients is slightly different from adults, due to obvious anatomical differences. There are, however, no differences regarding the ECG grid…

…prolongs survival. Myocardial stunning starts to normalize within minutes after the hypoxia is relieved. However, full recovery of contractility may take hours to days. It…

…the fastest intrinsic rate of depolarization will be the pacemaker, which means that it usually is atrial myocardium. Asystole occurs if no escape rhythm awakes…

…Example of third degree AV block. Click to zoom. ECG features of third degree AV block On the ECG P waves have no relation to…

…variation and requires a change of treatment. Common precipitants are viral infection, bacterial infection and air pollution, but often no definite trigger can be identified…

…of the measurements are valid , with at least 20 daytime and 7 night time values, and with a measurement interval of no more than 30…

Procedurer The ankle brachial index is the cheapest and most accessible method of objectively demonstrating peripheral arterial disease, and it is needed more often than…

…thresholds: a DOAC is given at an eGFR 30 mL/min. At an eGFR of 15–30 mL/min the documentation is inadequate and closer…

…the most common cause of misclassification. Five minutes' seated rest, back and arm supported, legs uncrossed, no conversation Cuff width ≥ 40% of the upper arm…

…type and screen and the serological crossmatch have a limited period of validity — usually about five days — because new antibodies can form after transfusion or…

…a 20 minute no touch period, for example after poisoning, since this is not compatible with a DCD process. The assessment of medical suitability is…

…report of 2024, the diagnosis of DKA requires three components: diabetes or hyperglycaemia, ketosis and metabolic acidosis. A very high glucose value is no longer…

…Ask the patient to keep the eyes open and look straight ahead — without open eyes there is no diagnosis. Procedure The Dix–Hallpike test 1…

…the R wave The shock is delivered immediately Why Avoids the vulnerable phase of the T wave There is no R wave to synchronise to…

Procedurer What determines the outcome of an emergency intubation is rarely the laryngoscopy itself but what was done before it: how well the patient was…

…or a very strong clinical suspicion. 3. Give intravenous calcium in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells…

…blood pressure is often at least 180/120 mmHg, but no absolute threshold defines the condition. A rapid rise in blood pressure can cause serious…

…Give intravenous glucose if the patient has a reduced level of consciousness, is having seizures or cannot swallow. 5. If there is no intravenous access…

…A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance…

…and note the time. It must not stay on for longer than 20–30 minutes. Procedure Paronychia — incision and drainage 1. A digital block if…

…25–30 mg of oral morphine per day, and 25 micrograms/hour to approximately 40–50 mg of oral morphine per day. Patches have no…

…first. Procedure Choice of insertion site The left lower quadrant is the first choice : the abdominal wall is thinner there than on the right, and…

…echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which the procedure is…

…suspicion of tension pneumothorax in a haemodynamically or respiratorily unstable patient. Contraindications In tension pneumothorax and in empyema there are no absolute contraindications — the procedure…

…Drugs for sedation, analgesia and control of shivering. Procedure 1. Start temperature management early — within the first hour after ROSC, in parallel with coronary angiography…

…overdose. Tumour lysis syndrome appears as an indication in older protocols but is no longer routinely recommended — alkaline urine increases the precipitation of calcium phosphate…

…is initiated. High No treatment High 2 Oral anticoagulation (warfarin or NOAC) is recommended for all male patients with scores of 2 or more. Very…

…minutes Duration of action 1.5 to 5 hours Delivery IV Dose 5–15 mg/hour IV infusion. Higher doses (up to 30 mg/hour…

…Classified as QT prolonging drug in DrugBank. No data on QT prolongation or risk of torsade de pointes in PubMed. GnRH Antagonist Cancer (prostate) Synthetic…

…for whom no practical risk prediction tool currently exists. At the other end, roughly two thirds of ICDs implanted for reduced LVEF never deliver an…

…presence of abnormal clinical risk assessment. Low risk PE is characterized by clinical low risk features, negative cardiac biomarkers, and no imaging evidence of RV…

…or combinations of these mechanisms. Drug selection can therefore be tailored to the suspected mechanism. No antianginal class has demonstrated consistent superiority for symptom relief…

…a non significant increase in cerebral haemorrhage. Bleeding outcomes The principal harm of aspirin in primary prevention is bleeding, which may occur relatively soon after…

…participants who were described as frail generally had no more than mild frailty, limiting the applicability of trial findings to people with substantial functional impairment…

…reported that 27.8% (52 of 187 patients) had myocardial injury, defined as elevated troponin T levels (TnT). In hospital mortality rate was 59.6%…

…PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke…

…acquisition ECG gating A single breath hold No intravenous line No premedication No special preparation Radiation exposure of approximately 1–1.5 mSv with contemporary…

…diagnosing CAD in stable patients with: Low clinical likelihood or no previous diagnosis of CAD Characteristics suggesting that good quality imaging is achievable It is…