…All 3 examinations are recommended for medical professionals. Evaluation of skin color is not necessary to confirm cardiac arrest. Skin color is pale or cyanotic…

…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…

…10 mL, with a longer needle so that the periosteum can be infiltrated generously — it is the periosteum that hurts, not the skin. Aspiration needle…

Continous medical discussion: the ECG blog ECG The best ECG book is not the one making it simple In the thrilling and ever evolving field…

…instability. Posterior infarction may occur in patients with a clinically unstable acute coronary syndrome, but the examination does not reliably establish or exclude the diagnosis…

…trained and equipped to identify STEMI and administer fibrinolysis if necessary. I C If possible, patients should bypass non PCI centres to a PCI capable…

…occurrence is highly stochastic. This is evident from the fact that the vast majority of all myocardial infarctions and episodes of myocardial ischemia, do not…

…AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical history (with emphasis on causes of AV blocks; please…

…In patients with an estimated glomerular filtration rate below 30 mL/min/1.73 m2, an appropriately up titrated loop diuretic is necessary before resistant…

…the treatment. Commonly, patients with bradycardia have a strong indication for drugs that aggravate or cause bradycardia (e.g. beta blockers in heart failure). In…

…post I would like to discuss hot topics related to coronary artery disease and I will emphasize on issues that are typically raised by patients…

…that a BMI within the conventional "normal" range (up to 25 kg/m²) does not necessarily equate to optimal cardiovascular health. 2 Evidence suggests that…

…CAC is therefore not merely an incidental imaging finding; it can refine the decision to test and may identify patients who require preventive therapy even…

…recorded body temperatures from which patients have been successfully resuscitated are 11.8°C for accidental hypothermia and 4.2°C for medically induced hypothermia (Mroczek et…

…12 months may be considered in patients who: Have tolerated DAPT without significant bleeding. Have high ischaemic risk. Do not have a high risk of…

…the tip is in tissue, not in the joint cavity. 6. Withdraw the needle, apply compression and a dressing. The knee The patient lies supine…

…in appropriately selected patients. In diabetes, carotid plaque prevalence correlates linearly with diabetes and carotid atherosclerosis tends to be more advanced than in people without…

…Professor Yusuf is the most cited researcher in cardiovascular medicine, a real giant. During his lecture professor Yusuf said that he was not too impressed…

…those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no…

Continous medical discussion: the ECG blog Myocardial ischemia and infarction Myocardial ischemia The definition of ischemia may appear trivial but it is actually a very…

…A notch is evident in the ascending part of the ST segment. A male patient (Figure 1) presented at age 36 years with an ECG…

Procedurer Pericardiocentesis is performed on the basis of the haemodynamics, not the volume of fluid. A litre that has accumulated slowly can be asymptomatic, while…

…often for practical than for medical reasons: the cuff is in the wrong place, the electrodes come off, the patient has not kept a diary…

…is not suspected. 6. Call the PCI service immediately in STEMI, a STEMI equivalent or very high risk NSTEMI. 7. Document symptom onset, first medical…

…clinical settings because it is considered a more accurate indicator of metabolic mass than body weight alone. BSA is utilized in various medical applications: Calculation…

…that awakens the patient from sleep. Patients receiving modified antiplatelet therapy require clinical surveillance for both recurrent ischemia and bleeding. The source material does not…

…factors that increase myocardial oxygen demand or worsen ischaemia, including anaemia, uncontrolled hypertension, thyrotoxicosis, tachyarrhythmias, uncontrolled heart failure, and concomitant valvular heart disease. In patients…

…syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or other symptoms that may be…

…respiratory acidosis , that is, a pH below 7.35 and a PaCO₂ above 6.0 kPa despite optimal medical treatment with bronchodilators, steroids and controlled…

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

…patients with low or moderate pre test likelihood of obstructive CAD, CCTA or functional imaging should generally be preferred when available. Exercise ECG is not…

…but not high sensitivity, assays detect troponin in approximately 20–50%. Their greater analytical sensitivity improves diagnostic accuracy and negative predictive value in patients with…

…presentations Left main disease may be clinically silent, and revascularisation recommendations are not restricted to patients with symptoms. Current guidance supports revascularisation for significant left…

…among high risk patients. The strategy may, however, increase peri procedural complications and bleeding. Clinical presentation The available source material does not provide a detailed…

…disease, the principal symptomatic indication for revascularization is angina that remains refractory despite medical therapy when significant stenoses are anatomically or physiologically suitable for treatment…

…Most patients with this working diagnosis subsequently develop myocardial necrosis and cardiac troponin elevation, although not every patient with an initial STEMI pattern has myocardial…

…refers to patients with a historical baseline LVEF ≤40% that has subsequently improved to 40% under guideline directed medical therapy (GDMT). These patients must be…

…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…

…Medical therapies do not alter disease progression. Diuretics may be used for symptom relief. Surgical repair or valve replacement is considered when medical therapy is…

…more than the laboratory value. A normal INR and a normal APTT do not exclude DOAC effect. Duplicate therapy. Check that the patient is not…

…tumour types are not a bar). Untreated generalised infection, or certain transmissible agents according to the current transmission risk assessment. In DCD: patients in whom…

…women than in men and can last for years. ACE Inhibitor Induced Angioedema Angioedema secondary to ACE inhibitor therapy occurs in approximately 1% of patients…

…Reduced Ejection Fraction (HFrEF) There is overwhelming evidence that ACE inhibitors should be used in symptomatic and asymptomatic patients with a reduced ejection fraction (EF…

…therapeutic aim is symptom control rather than modification of long term cardiovascular outcomes. With the important exception of beta blockers in selected patients after acute…

…after initial medical treatment. The presence of ST segment changes or a positive troponin assay identifies patients in whom an invasive strategy is generally preferred…

…Routine PCI of an occluded infarct related artery is not recommended when presentation is more than 48 hours after symptom onset in the absence of…

…medical services should be called. Patients who have been prescribed sublingual nitroglycerin should be instructed in its appropriate use, although specific dosing instructions are not…

…In out of hospital cardiac arrest (OHCA) the initial rhythm is recorded by the EMS (emergency medical service) team upon their arrival at the scene…

…procedure should be conducted post intubation. Avoid lavage if gastrointestinal perforation or obstruction is suspected. If the patient is intubated, administer activated charcoal through a…

…pro arrhythmic effects of digoxin. Potassium levels must always be assessed in patients using digoxin whenever they seek medical attention. Arrhythmias may occur already at…

…in patients with symptomatic or asymptomatic peripheral arterial disease, in whom AAA has been reported with a substantial cumulative incidence. The source material does not…

…In that setting, clinical assessment must determine whether immediate blood pressure lowering treatment is required. Patients with suggestive symptoms, signs or a medical history indicating…

…Physical findings related to cholesterol deposition. Untreated or inadequately treated patients may develop premature CAD. Symptoms therefore depend on the vascular territory involved and may…

…Patients may continue to have lifestyle limiting symptoms despite guideline directed medical therapy (GDMT), prompting consideration of revascularization. The likelihood that symptoms are attributable to…

…is not seen in STEMI and suggests pericarditis instead. Pain is not uniformly present. The proportion of painless or silent STEMIs is greater in patients…

…haemodynamics Stress imaging is not recommended in patients undergoing urgent non cardiac surgery or those with an unstable clinical condition. In patients with suspected or…

Hydralazine Hydralazine is not preferred for hypertensive emergencies due to the high risk of reflex sympathetic stimulation. Drug Hydralazine Brand names Apresoline ®, Bidil ®…

…procedure while awake. Suspected necrotising fasciitis — pain that is disproportionately severe, a rapid course, skin discolouration, systemic upset — is an acute surgical emergency, not an…

Referensvärden A diagnosis of hypertension is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by…

…or with a history of gastrointestinal bleeding Refeeding syndrome There is a risk in starvation, alcoholism, anorexia nervosa, or more than 5 days without nutrition…