…of RV dysfunction. Catastrophic or “supermassive” PE refers to refractory cardiogenic shock or the need for ongoing cardiopulmonary resuscitation. Mechanical circulatory support, including extracorporeal membrane…

…neuronal injury increases. Treatment must therefore start at 5 minutes and be escalated without unnecessary pauses [1]. The aims are, simultaneously, to: 1. terminate clinical…

…including depression and anxiety Social support and practical barriers to participation Occupational and sporting goals Current pharmacological treatment Early assessment of left ventricular ejection fraction…

…on the oesophagus or upper gastrointestinal tract, ileus and ongoing upper gastrointestinal bleeding. Marked agitation or inability to cooperate. Copious secretions without an effective cough…

…a reason to reject a DOAC , not as the standard option. Contraindications Ongoing clinically significant bleeding. Pregnancy in the first trimester and close to delivery…

…collateral circulation. A first or anterior infarction. Single vessel disease without collateral support. Chronic kidney disease, particularly in relation to VSR. Large infarction, especially for…

…and potential future refinements underscore its enduring relevance in cardiology. By combining anatomical and clinical data, it continues to support heart teams in delivering persona

…the test must therefore never be performed without atropine, ECG monitoring and access to airway support. Indications Clinically suspected myasthenia gravis in a patient with…

…clinical knowledge support documents have tightened the threshold to 24 hours for patients with risk factors; cardioversion between 24 and 48 hours without ongoing anticoagulation…

…in treatment failure or in ongoing massive potassium release. In cardiac arrest with suspected hyperkalaemia, advanced life support is followed while the hyperkalaemia is treated…

…began within 12 hours; timely PPCI cannot be achieved within 120 minutes of diagnosis; and there are no contraindications to fibrinolytic therapy. Treatment should begin…

…onset: primary PCI remains indicated when there are ongoing ischaemic symptoms, haemodynamic instability or life threatening arrhythmias. Twelve to 48 hours after onset: routine primary…

…information about each step, take place with the patient's ongoing consent, and be able to be stopped at any moment. A trauma informed approach…

…Give blood according to the circulatory response and the transfusion principles below 6 Stop anticoagulants in serious ongoing bleeding. Reverse selectively according to the drug…

…Ongoing myocardial ischaemia with chest pain and ECG changes. Acute pulmonary oedema. Impaired consciousness. Synchronised cardioversion under sedation, at an energy level according to the…

…acute HMOD, although other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence of ongoing acute organ injury is decisive. The pathophysiology…

…For example, exercising patients with ongoing myocardial ischemia may provoke life threatening ventricular arrhythmias. Patients with previous acute coronary syndromes (ACS) Exercise stress testing is…

…within 10 minutes of the diagnosis, if symptom duration is under 12 hours and there is no contraindication After successful fibrinolysis Transfer directly to a…

…are routinely missed. The third thing to know by heart is that an arterial line must never be confused with a venous access. Indications Continuous…

…the time to haemorrhage control that determines the outcome. Indications Symptomatic anaemia, or a haemoglobin below the applicable transfusion threshold (see below). Ongoing bleeding with…

…a few minutes. 4. Make a small skin incision with the scalpel. 5. Aspiration: advance the needle with the stylet in place perpendicular to the…

…Thrombosis or known stenosis in the target vessel. Coagulopathy or ongoing anticoagulation: choose a compressible vessel (the internal jugular or femoral vein), not the subclavian…

…Indirect criteria after circulatory arrest, following a five minute no touch period The circulation at retrieval Maintained up to retrieval Ceased; warm ischaemic time is…

…and a vasoconstrictor vertically into the nose. Wait 10–15 minutes. 3. Apply the silver nitrate stick to the vessel with light pressure , rolling it…

…stress echocardiography) has greater diagnostic accuracy. Contraindications Absolute: Acute coronary syndrome within 48 hours, or ongoing unstable angina. Uncontrolled symptomatic arrhythmia. Symptomatic severe aortic stenosis…

…crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing or new organ damage in which immediate, controlled blood pressure…

…suspected intracranial space occupying lesion with mass effect and midline shift. Ongoing anticoagulant treatment or marked coagulopathy. A platelet count below 50 × 10⁹/L is…

…resistance at the posterior pharyngeal wall after about 10–15 cm is expected. 5. Ask the patient to flex the head forward and swallow repeatedly …

…to need 5–15 mg of morphine in total. If more than that is required without effect, reconsider the pain mechanism instead of continuing to…

…drops, olive oil, carbamide peroxide) are instilled 15–30 minutes before the procedure, or over a few days at home for a hard plug. Have…

…Uncorrected coagulopathy or thrombocytopenia Relative Ongoing anticoagulant treatment — plan the aspiration for the trough level or pause the drug according to local practice Relative Skin…

…physical exertion 30 minutes A large meal 2 hours Withholding applies only to diagnostic spirometry with a reversibility test. At follow up during ongoing treatment…

…Haemodynamic and electrical status Haemodynamic instability, cardiogenic shock, acute heart failure related to ongoing ischaemia, life threatening arrhythmias, and cardiac arrest after presentation are markers…

…Hence, an ECG must be performed and interpreted within 10 minutes of arrival to the care facility (typically the emergency room [ER]). It is recommended…

…Absolute contraindications Acute myocardial infarction (MI) within 48 hours Ongoing unstable angina Uncontrolled cardiac arrhythmia with hemodynamic compromise Active endocarditis Symptomatic severe aortic stenosis Decompensated…

…cardiac arrest. Pulmonary embolism is causally related to deep vein thrombosis (DVT). Approximately 70% of individuals with symptomatic pulmonary embolism have an ongoing DVT, and…

…in patients with structural heart disease, VT necessitates a nuanced, multidisciplinary approach to diagnosis and management. Over the past decade, the landscape of VT management…

…Under 110 per minute At least 110 per minute Bradycardia or arrhythmia PEF Over 50 percent of personal best or predicted 33 to 50 percent…

…orthostatic hypotension Dix Hallpike, supine roll test, orthostatic blood pressure Episodic spontaneous vestibular syndrome Attacks lasting minutes to hours, sometimes days, without an obligatory trigger…

…Severe pain Titrate the pressure up gradually Rheumatoid arthritis with vasculitis Individual assessment Repeat the ABI every three to six months during ongoing compression therapy…

…response to initial treatment and the expected continued bleeding matters more than an exact estimate of blood loss [1]. Strong indications for activation Ongoing bleeding…

…35 per cent Paracetamol PO or IV 1 g × 4 The basic analgesic; always give it in parallel unless contraindicated NSAID PO According to the…

…wrong treatment : Aortic dissection with haemopericardium — drainage can increase the bleeding and worsen the prognosis. The patient must go to cardiothoracic surgery. In profound shock…

…has in practice no absolute contraindications. With active cooling to hypothermia , caution applies in: Ongoing uncontrolled bleeding or marked coagulopathy. Severe sepsis and septic shock…

…following criteria present: haemodynamic instability or cardiogenic shock recurrent or ongoing chest pain refractory to medical treatment life threatening arrhythmias or cardiac arrest mechanical complications…

…electrocardiographic abnormalities and with or without an acute rise in cardiac troponin. The spectrum ranges from symptom free presentation to persistent chest discomfort, cardiac arrest…

…Furthermore, ongoing ischemia, hypomagnesemia, and moderate to severe renal impairment increase the likelihood of digitalis intoxication even at therapeutic doses. Diagnostics Electrocardiography and Electrophysiology Electrocardiographic…

…permit mural thrombi to develop over infarcted myocardium in either ventricle. With contemporary imaging, LV thrombus has been reported in as many as 15% of…

ECG Introduction to ECG interpretation Video lecture: The ECG curve: P wave, PR Interval, Q wave, R wave, S wave, QRS complex, ST segment, T…

…and ongoing management of patients on sotalol. Because the drug is excreted unchanged primarily by the kidneys, creatinine clearance must be assessed prior to initiation…

…supply cannot increase adequately. Ischaemia begins in the subendocardium, which contributes substantially to systolic wall thickening; consequently, inducible regional systolic wall thickening abnormalities may develop…

ECG Introduction to ECG interpretation The normal T wave Assessment of the T wave represents a difficult but fundamental part of ECG interpretation. The normal…

…UA is defined by one or more of the following patterns: Angina at rest, usually prolonged for more than 20 minutes. New onset severe angina…

…some blood flow is maintained (for example, high quality cardiopulmonary resuscitation or partial ROSC), the midbrain may receive enough oxygen to preserve some pupillary reflex…

…ongoing ischemia : LBBB causes severe disturbance of ventricular repolarization, which usually prevents other ST T changes (such as those arising from ischemia) to come to…

…near the ventricular cavity, and it may to some extent receive oxygen from the blood in the ventricular cavity. The right bundle branch then runs…

…A net positive QRS complex should be followed by a net positive T wave (refer to the previous discussion on concordance/discordance and Figure 1 )…