…oesophageal spasm and acid reflux. Clinical Presentation and Symptoms Characterising the presenting symptom The symptom should be classified as cardiac , possibly cardiac , or non cardiac…

…decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive ventilation or intubation. Aortic disease An acute aortic dissection is a hypertensive emergency requiring…

…reaction Skin or mucosa only, stable breathing and circulation Observation, a non sedating antihistamine for symptoms Anaphylaxis Objective airway, respiratory or circulatory compromise, or a…

…must consider both cardiac and non cardiac etiologies [1]. Cardiac Causes The primary differential diagnoses include conditions that directly affect the myocardium or major vessels…

…viral or idiopathic but is more frequent when the underlying cause is non idiopathic. Clinical Presentation and Symptoms Dyspnoea is the most frequent symptom and…

…pain and hypertension despite treatment. A related entity is non A non B dissection , which involves the arch without involvement of the ascending aorta or…

…unit or another non intensive care setting while serial testing is completed. Diagnostic Framework The diagnostic pathway combines three principal domains: Clinical presentation and vital…

…Inadequate oxygenation despite maximal oxygen or non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing…

…reference This is a practical quick reference for emergency physicians in suspected acute ischaemic stroke. It covers time windows, indications and contraindications for intravenous thrombolysis…

…several clinical manifestations that indicate particularly high risk and should influence the urgency of management: Recurrent or ongoing chest pain despite medical treatment Acute heart…

…hypertension associated with pheochromocytoma; treatment of dermal necrosis after extravasation of drugs with á adrenergic effects. Phentolamine doses and administration in hypertension (hypertensive crisis/emergency).

…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…

…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…

…subacute or non acute. The history taking must be systematic and accurate because the history itself is often sufficient to make a diagnosis or identify…

…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]…

…angioplasty and bare metal stents (BMS) in response to restenosis caused principally by neointimal hyperplasia. Contemporary DES combine a metallic scaffold, a polymeric or polymer…

…non acute or asymptomatic bradyarrhythmia. In patients presenting with intermittent symptoms of bradycardia, it is fundamental to establish a temporal correlation between the symptoms and…

…least two occasions, and preferably confirmation by home measurement or 24 hour recording — the thresholds for which are lower than for office measurement. Classification of…

…give information and obtain consent if the patient is awake, and scan the vessel with ultrasound before you drape — a thrombosed or non compressible vein…

…both vasopressor and inotropic effects (Figure 1). What follows is a quick reference for their use in the emergency department, the intensive care or coronary…

…bypassing non PCI hospitals. A regional network should link emergency medical services, non PCI hospitals, PCI centres, intensive care facilities, and, where available, cardiothoracic and…

…ECG is recorded, the greater the probability that the rhythm has deteriorated into PEA or asystole, and therefore the worse the prognosis. This does not…

…V6R) and posterolateral infarction (leads V7, V8, V9). Criteria for ischemia/infarction have been established for these leads (please refer to ECG leads or Additional…

…and death Cardiac arrest is the mechanism of death for most diseases and conditions, including non cardiovascular conditions. A cardiac arrest can be expected or…

…severity of symptoms in STEMI patients, compared to those with Non ST Elevation Myocardial Infarction (NSTEMI) or unstable angina (UA), is attributed to the greater…

…30 seconds or requiring termination earlier due to hemodynamic collapse [4] . Sustained VT is a medical emergency that universally warrants acute intervention and long term…

…emergency medical dispatch to catheterization laboratory) in order to provide reperfusion therapy as early as possible. I B Designated PCI centres should provide angiography and…

…Inter arm difference: a sequential systolic difference of 10 mmHg between the arms. Orthostatic hypotension: a fall of ≥20 mmHg in SBP and/or ≥10…

…non invasive and invasive rewarming techniques should be pursued. Heated intravenous fluids (crystalloids). Heated and moistened oxygen. Warm covers. Heat fan. Remove any cold or…

…prevention Primordial prevention seeks to prevent the emergence of risk factors. It includes maintenance of favourable blood pressure, body mass index, cholesterol and glucose levels…

…OMI) versus Non Occlusion Myocardial Infarction (NOMI). This method focuses on the presence or absence of ACO, rather than rigid ECG thresholds, and incorporates advanced…

…and defibrillation energy levels should remain consistent with those used for non pregnant adults. The fetus is not harmed by defibrillation, amiodarone, or adrenaline (epinephrine…

…the appropriate clinical context. Unstable Angina presents with clinical and/or electrocardiographic signs of myocardial ischemia but lacks this biomarker elevation. With the ubiquitous adoption…

…NSTE ACS (Non ST Elevation Acute Coronary Syndromes) . This chapter deals with the pathophysiology, definition, criteria and management of patients with NSTEMI and unstable angina…

…16 and EPAP 6–8 cmH₂O Increase the EPAP against obstruction, the IPAP against hypercapnia SpO₂ 88–92% Hypoxaemic failure without hypercapnia CPAP or high…

…especially associated with metabolic syndrome and mildly elevated triglycerides, even when LDL C is normal or low. Clinical Significance Non HDL C is strongly associated…

…diameter stenosis and haemodynamic significance is weak, particularly for intermediate lesions. Even lesions with a visual diameter reduction of 50–70% may or may not…

…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…

…coronary microvascular dysfunction or vasospasm. A normal or non obstructive coronary anatomy does not necessarily exclude an ischaemic mechanism. Clinical assessment and estimation of pre…

Cardiology Pharmacology & dosing Definition and pharmacological basis Ezetimibe is a non statin lipid lowering agent that inhibits the Niemann–Pick C1 like 1 (NPC1L1) transporter…

…ischemia and infarction Definition and Pathophysiology Angina with non obstructive coronary arteries (ANOCA) describes anginal symptoms in patients whose epicardial coronary arteries are normal or…

…both calcified and non calcified plaque and can assess stenosis. A major limitation is that CAC does not measure total plaque burden or stenosis severity…

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…

…to myocardial oxygen demand, and myogenic responses, where vascular smooth muscle constricts or dilates in response to changes in intraluminal pressure. Coronary blood flow is…

…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…

…Evaluation should establish: The triglyceride concentration and whether the sample was fasting or non fasting. The presence of ASCVD, peripheral arterial disease or aortic disease…

…several non pharmacological measures at the same time, and use drugs only in severe agitation or marked distress. Delirium is an acute neuropsychiatric syndrome and…

…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…

…daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin—except low dose heparin)…

…angina (UA) Non ST elevation myocardial infarction (NSTEMI) ST elevation myocardial infarction (STEMI) This applies to patients undergoing either primary or delayed percutaneous coronary intervention…

…440 ms), or severe bradycardia, sinus node dysfunction or second degree and third degree heart block in the absence of a pacemaker. Use of intravenous…

…SCORE2 and SCORE2 OP estimates can be used to classify 10 year risk as follows: Risk category 10 year risk of fatal or non fatal…

…and the haemodynamic consequences of the culprit lesion. Patients may present with ST segment elevation myocardial infarction (STEMI), non ST elevation ACS (NSTE ACS), or…

…nuts or extra virgin olive oil compared with a low fat dietary pattern. The intervention included broader dietary modification, particularly increased fruit, legume and seafood…

…In contrast, plaque erosion tends to occur in vessels with little or no lipid core, rich proteoglycans, and many smooth muscle cells, leading to a…

…supply and demand. In many cases, the initiating process is plaque disruption with thrombosis; other cases result from spasm, microvascular dysfunction, embolism, dissection, hypotension or…

…other branches of the same coronary artery or another coronary artery, will alleviate the ischemia, improve myocardial function and increase resistance to episodes of more…

…Non hyperemic pressure ratios (instantaneous wave free ratio [iFR], resting full cycle ratio [RFR], and related resting indices) simplified the procedure by removing the need…

…the higher pressure, or the non dominant arm if the values are equal. Check against a manual measurement and document the difference. Programme measurements every…

…a substantially increased risk of myocardial infarction and stroke. Indications Intermittent claudication, rest pain in the foot or leg, or a non healing distal ulcer…