…artery disease has been classified into the following three syndromes: Stable angina pectoris : Symptoms appear primarily during exercise or other situations with increased myocardial load…

…artery disease has been classified into the following three syndromes: Stable angina pectoris : Symptoms appear primarily during exercise or other situations with increased myocardial load…

…in a partially or fully occlusive intraluminal thrombus [5] . ACS Classification The clinical spectrum of Acute Coronary Syndromes encompasses Unstable Angina (UA), Non ST Elevation…

…ACS): Non ST Elevation Myocardial Infarction (NSTEMI) and Unstable Angina (UA) The focus of this chapter is the diagnosis and management of patients with Non…

…the IPAP against hypercapnia SpO₂ 88–92% Hypoxaemic failure without hypercapnia CPAP or high flow nasal oxygen 5–10 cmH₂O According to oxygenation requirement SpO₂…

…or non HDL C, cardiovascular risk may be misestimated if cholesterol measures alone are used. Risk in these circumstances appears to track more closely with…

…some lesions with apparently lesser narrowing are physiologically important. Lesion location also matters: stenoses in the left main stem or proximal left anterior descending artery…

…physiological or systemic stressors, with treatment directed at the precipitating condition. Myocardial and non ischaemic mimics Takotsubo syndrome, myocarditis, and cardiomyopathies may present with symptoms…

…occur at a low level of exertion, or are associated with high event risk. The apparent differences between thresholds reflect different guideline frameworks and clinical…

…reperfusion therapy. This approach fails to identify a substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting…

…compared with simvastatin monotherapy Bempedoic acid plus ezetimibe Approximately 38% reduction PCSK9 inhibitor added to statin therapy Approximately 60% reduction Inclisiran, with or without statin…

…myocardial ischaemia despite normal or non obstructive coronary arteries; dyspnoea; fatigue; and recurrent symptoms causing impaired quality of life. Women with suspected angina are more…

…low risk: patients with NSTE ACS may have substantial myocardial ischaemia, dynamic ECG abnormalities, myocardial necrosis, haemodynamic deterioration, heart failure, malignant arrhythmias, or mechanical complications…

…a non contrast, electrocardiographically gated computed tomography (CT) scan. Image acquisition generally requires a single breath hold and does not require intravenous access, premedication, or…

Echocardiography Ultrasound artifacts The following artifacts are common in ultrasound imaging: The ultrasound image displays non existing structures. The ultrasound image does not display existing…

…conditions. MPI uses radiotracers in combination with single photon emission computed tomography (SPECT) or positron emission tomography (PET) to assess myocardial perfusion and blood flow…

…®, Rogitine ® Indications Hypertensive crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity…

…excluding non ST segment elevation acute coronary syndrome (NSTE ACS) in patients with a low to intermediate likelihood of CAD when cardiac troponin and/or…

…of its association with acute pancreatitis. Evaluation and physical examination Evaluation should establish: The triglyceride concentration and whether the sample was fasting or non fasting…

…In older patients delirium is often multifactorial. 7. Start non pharmacological treatment immediately , in parallel with the investigation. 8. Document the diagnosis and communicate it…

…Duration : : : : Pneumonia, non severe (DS CRB65 0–1) phenoxymethylpenicillin 1 g × 3 PO 5–7 days or benzylpenicillin 3 g × 3 IV Pneumonia, in chronic…

…reactivity: Do not administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs …

…established. Limited data are available for children with sickle cell anemia. Method of Administration Route : Oral. Prasugrel can be taken with or without food. Administering…

…if hypotension or bradycardia occurs. A defibrillator should be immediately available as a precaution. Dosage of vernakalant Vernakalant is dosed by body weight, with the…

…to classify 10 year risk as follows: Risk category 10 year risk of fatal or non fatal CVD Low <2% Moderate ≥2% to <10% High …

…ACS) with multivessel coronary artery disease (MVD), revascularization may be directed exclusively at the infarct related artery (IRA), or it may extend to additional non…

…weeks even without weight loss. Cardiovascular Outcomes Associated With Dietary Patterns Cardiovascular disease and mortality The strongest long term evidence supports Mediterranean or DASH style…

…with or without pain, include sudden loss of consciousness, a confusional state, profound weakness, the appearance of an arrhythmia, evidence of peripheral embolism, or an…

…erosion. Thrombosis associated with a calcified nodule. Epicardial or microvascular coronary spasm. Spontaneous coronary artery dissection. Coronary embolism of cardiac or non cardiac origin. Oxygen…

…patients with total and proximal occlusions may present without ST segment elevations (which they should exhibit) due to rich collateral circulation in the ischemic area…

…Only indices that detect microvascular disease as an independent cause of ischemia, including with non obstructive epicardial arteries (ANOCA/INOCA); CFR has independent prognostic value…

…troponin. If clinical suspicion persists despite an initially non diagnostic ECG, the ECG must be repeated, particularly with ongoing or recurrent pain [1,3,4]…

…trials, tenecteplase was non inferior to alteplase with respect to an excellent functional outcome, without an increased risk of symptomatic intracerebral haemorrhage or death [3]…

…when fitting the device. Use the arm with the higher pressure, or the non dominant arm if the values are equal. Check against a manual…

…with at least one of the following: airway compromise respiratory compromise circulatory compromise severe gastrointestinal symptoms, particularly after exposure to a drug, insect venom or…

…Indications Intermittent claudication, rest pain in the foot or leg, or a non healing distal ulcer. Before compression treatment of a leg ulcer — compression in…

…secured with tape. Greater extension makes the artery harder to palpate. Procedure Catheter over needle (direct technique) 1. Palpate the course of the artery with…

…home or on 24 hour recording. Masked hypertension: normal in the office but raised outside it — associated with the same risk as manifest hypertension. Non…

…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…

…direct laryngoscope with Macintosh blades 3 and 4 as back up, always with the light checked. Tubes in three sizes, a stylet or bougie taken…

…aspiration: a non fasted patient, ileus, third trimester pregnancy, marked reflux. A need for high airway pressures, for example severe ARDS, marked obesity or a…

…a millilitre or two intracutaneously and along the needle track, with a fine needle. A manometer with a three way tap when the opening pressure…

…bleeding with haemodynamic instability, for example a systolic blood pressure below 90 mmHg, a narrow pulse pressure, peripheral vasoconstriction, impaired consciousness, a rising lactate or…

…Contraindications Ongoing respiratory depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given…

…for or against active cooling to 32–36 °C. The HYPERION result means that active hypothermia is still used in some units with a non…

…non variceal bleeding [1,2]. Upper gastrointestinal bleeding can present as haematemesis, coffee ground vomiting or melaena. Haematochezia can occur in massive upper bleeding with…

…at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly prolonged QT intervals—the implantation…

…at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly prolonged QT intervals—the implantation…

…VT : VT 30 seconds, or VT <30 seconds terminated by therapy. Non sustained VT (NSVT) : VT with ≥3 beats and spontaneous termination. Classification according to…

…VSD), and patent ductus arteriosus (PDA). Echocardiography provides a non invasive, accessible method to calculate this ratio, guiding clinical decisions about intervention or monitoring. Below…

…S, et al. CHA₂DS₂ VASc or a non sex score (CHA₂DS₂ VA) for stroke risk prediction in atrial fibrillation: a cohort study. Eur Heart J …

…GFR Levels: The MDRD equation tends to underestimate GFR in individuals with near normal or mildly reduced kidney function (eGFR 60 mL/min/1.73…

…with NSTE ACS (NSTEMI or unstable angina) are treated similarly with respect to anti ischemic and anti thrombotic drugs. Management must, however, be individualized with…

…2031 7. The TIMI risk score for unstable angina/non ST elevation MI: A method for prognostication and therapeutic decision making E M Antman, M…

…typically present with near syncope, syncope, or cardiac arrest. Before the onset of sustained VT, patients frequently experience PVCs and runs of non sustained VT…

…infarction with low dose aspirin. Approximately 12% reduction in non fatal ischaemic stroke in trials specifically evaluating this outcome. No demonstrated reduction in cardiovascular or…

…reduction in a subgroup with diabetes was approximately 19.1%. The drug also lowers hsCRP. In a population of individuals unable or unwilling to take…

…classified as cardiac , possibly cardiac , or non cardiac . The term “atypical” is discouraged because it may understate the possibility of ischaemia. A focused history should…

…or ischaemia associated with obstructive epicardial coronary disease. Angina or ischaemia caused by epicardial vasomotor dysfunction or microvascular abnormalities without obstructive epicardial disease. The non…

…usually with aspirin and clopidogrel. Shortening therapy to one to three months is an option when bleeding risk is very high. Prasugrel or ticagrelor may…