…to standard STEMI criteria. Observational data suggest that up to 30% of patients initially classified as NSTEMI have an unrecognized OMI, with comparable infarct size…

…closely associated with cardiovascular risk than LDL C in many studies, although the relative advantage of apoB over non HDL C or standard lipid testing…

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

…CT angiography The standard investigation in acute stroke to identify large vessel occlusion, dissection or other vascular pathology CT perfusion Used with an unclear time…

…CABG), or percutaneous coronary intervention (PCI), including attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA)…

…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…

…Non specific ST depressions, T wave inversions (negative T waves) do not affect the management of cardiac arrest. Recurrent VT or VF after ROSC in…

…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…

…in ischemic events or stent thrombosis. Stable coronary disease and elective PCI For chronic coronary syndromes treated with elective PCI, the standard DAPT duration is…

…IV Standard dose after stabilisation or piperacillin–tazobactam 4 g × 4 IV plus gentamicin 5–7 mg/kg IV as a single dose Urosepsis with…

…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…

…and can guide resuscitative efforts. If the patient presents with hypotension or has a lactate level exceeding 4 mmol/l, commence an intravenous fluid resuscitation…

…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…

…non traumatic cardiac arrest (i.e. standard CPR, as per guidelines). Contusio cordis Contusio cordis refers to a contusion of the myocardium, greater vessels or…

…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…

…directionality. While the technique requires meticulous attention to imaging standards, its non invasive nature and reproducibility make it indispensable in congenital and critical care cardiology…

…prevention Standard role Aspirin remains the traditional antiplatelet agent for long term secondary prevention in patients with established coronary disease, including those with or without…

…Clinical context and treatment objectives DAPT is used in two principal settings: After ACS , whether managed medically or with revascularization. After elective PCI for CCS …

…systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical cul de sac [19] …

…in PEA and cardiac arrest within 8 minutes. Cardiac arrest as a result of asphyxia or hypoxia is managed according to the standard CPR algorithm…

…devices, may provide less accurate MAP readings compared to invasive arterial catheterization, particularly in patients with irregular heart rhythms or low blood pressure. Additionally, individual…

…A standard cuff measuring approximately 12–13 cm in width and 35 cm in length is suitable for most patients. Larger or smaller cuffs should…

…inflammatory or pleiotropic effects, and colchicine has been studied as an additional therapy alongside standard treatment. Interleukin 1β inhibition Canakinumab reduced inflammatory biomarkers without…

…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…

…regurgitation with heart failure Cardiac tamponade from haemopericardium Myocardial ischaemia from coronary ostial compromise Focal neurological deficits or non haemorrhagic stroke Renal, mesenteric or lower…

…NSTEMI is confirmed by a typical rise and/or fall of high sensitivity cardiac troponin (hs cTn), with at least one value above the 99th…

…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…

…of both CPAP and bilevel ventilation, or alternatively flow generated CPAP with a PEEP valve. Masks in several sizes. An oronasal mask is first choice…

…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…

…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…

…plus ezetimibe. Consider bempedoic acid in selected patients, particularly those with statin intolerance or persistent failure to reach goal. For statin intolerant patients, ezetimibe may…

…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…

…initially selective or delayed approach into an indication for angiography and possible revascularization. Initial evaluation and risk stratification Clinical assessment Assessment begins with the clinical…

…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…

…image artifact. Side lobe artifact A 2D image is formed by allowing the ultrasound beam to sweep back and forth within a defined sector. The…

…exercise or the use of chronotropic and inotropic agents. Radiotracers are employed to evaluate myocardial perfusion by measuring the intensity of their uptake within the…

…®, 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…

…somatic illness, drugs, poisoning, withdrawal, surgery or several concurrent factors. A diagnosis of delirium is therefore the beginning of the investigation, not the end. In…

…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 …

…bleeding risk, including oral anticoagulants, clopidogrel, NSAIDs, or fibrinolytics. For patients with active bleeding requiring reversal of prasugrel's pharmacological effect, platelet transfusion may be

…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 …

…culprit lesion. Patients may present with ST segment elevation myocardial infarction (STEMI), non ST elevation ACS (NSTE ACS), or ACS complicated by cardiogenic shock. In…

…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…

…60 minute occlusion of the left anterior descending coronary artery (LAD) would reduce the infarct size by 60%, as compared with directly occluding the LAD…

…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]…

…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…

…diagnosis or for grading. Antihistamines, corticosteroids, inhaled bronchodilators and nebulised adrenaline never replace intramuscular adrenaline [1,2]. Delayed administration of adrenaline is associated with more…

…No smoking or coffee in the preceding hour. Remove socks and any compression stockings. Avoid measuring the arm pressure on the side with a dialysis…

…example during mechanical ventilation or severe metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom non invasive measurement is…

…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…

…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…

…delay it. Indications Suspected meningitis or encephalitis. Suspected subarachnoid haemorrhage with a normal or non diagnostic CT. Suspected neuroborreliosis, neurosyphilis or another CNS infection. Suspected…

…impaired consciousness, a rising lactate or a worsening acidosis. An assessed need for at least 4 units of red cells within 1 hour. An actual…

…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…