…as in Figure 1 . Any type of infarction may cause pathological R wave progression. However, the specificity for pathological R wave progression is considerably lower…

…and other sedating drugs. Thromboembolic risk, for example immobilisation, cancer and previous venous thromboembolism. A documented decision on the ceiling of care. Signs of a…

…and are at high risk of a new event. Treatment can be started without interruption as continuation treatment after the initial one year treatment with…

…and MYBPC3. Approximately 40–60% of tested patients have a single variant identified as the cause of disease, although the yield varies by cohort. A…

…It is calculated as: Non HDL C = total cholesterol − HDL C Apolipoprotein B (apoB) reflects the concentration of circulating atherogenic particles because each apoB…

…ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source…

…unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach…

…to place under the shoulders as an alternative to a hanging head. Frenzel goggles or video Frenzel if available — small beats of nystagmus can otherwise…

…and other NSAIDs: Increased risk of gastrointestinal bleeding when combined with acetylsalicylic acid. Uric acid excretion agents (e.g., probenecid): Salicylates counteract the effect of…

…administered as soon as possible in the absence of contraindications, using a loading dose followed by maintenance treatment. The source material does not specify the…

…C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression. As the burden of retained…

…affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary…

…operative assessment, or evaluation of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of severe asymptomatic stenosis is low, screening has…

…Relevant predispositions, such as connective tissue disease. No single pain descriptor is diagnostic. The severity of pain also has limited discriminatory value. Features suggesting myocardial…

…among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However, association is not the same as causation . A cause is…

…In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography…

…or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the…

…other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator or institutional experience Assessment of coronary complexity The…

…is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of…

…is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective…

…be able to determine the direction of the re entry loop. Figure 1. Typical atrial flutter. The atrial rate (i.e the rate measured between…

…This is because the strong and oppositely directed forces tend to cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy…

…The balance between pro thrombogenic and pro thrombolytic factors varies from one minute to another, which may cause variations in the size of the thrombus…

…using two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves. The cardinal difference between continuous…

…tomographic images of the left ventricle. In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron, they annihilate each other…

…ischemia, it merely reduces the probability of ischemia as the underlying cause. Concave ST segment elevations are very common in the population (discussed below). Study…

…unreliable, such that they may cease and thus cause cardiac arrest. Junctional escape rhythm is more reliable (the risk of cardiac arrest is considerably lower)…

…between the lowest rib and the iliac crest, at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other…

…50 Dose reduction as in the table above for rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible…

…marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of site The posterior superior…

…of infection. Indications Infusion of vesicant solutions: vasopressors, concentrated potassium, cytotoxic drugs, parenteral nutrition. The need for several simultaneous, incompatible infusions. Haemodialysis, plasmapheresis or other…

…front , and this is why the margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis…

…obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked…

…kg IV as a single dose Urosepsis with shock and suspected ESBL meropenem 1 g × 3 IV Do not treat asymptomatic bacteriuria. The exceptions are…

…Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to 120 mmHg…

…palpitations hunger anxiety pallor paraesthesiae Neuroglycopenic symptoms An inadequate supply of glucose to the brain can cause: difficulty concentrating irritability or abnormal behaviour slurred speech…

…rise can cause osmotic demyelination syndrome [1,2]. Hyponatraemia is primarily a disorder of water balance. The plasma sodium reflects the ratio between the body…

…liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome, haemolysis The R value = (ALT / upper limit of normal)…

…infectious diseases physician early in a high risk course, in instability, with resistance problems, or with suspected fungal infection 10 Document the times of triag

…inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which the…

…of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection over the…

…cuts cause burning pain. 2. Position the pads, preferably anteroposteriorly : one anteriorly over the praecordium to the left of the sternum, the other on the…

…overdose. Tumour lysis syndrome appears as an indication in older protocols but is no longer routinely recommended — alkaline urine increases the precipitation of calcium phosphate…

…help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of aortic root dilation. Key Formulas BSA Calculation (Mosteller formula): [ …

…Proietti M, Lane DA, Lip GYH. Evaluation of the HAS BLED, ATRIA, and ORBIT bleeding risk scores in atrial fibrillation patients on warfarin. Am J…

…studies have questioned the significance of female sex as an independent risk factor for stroke in AF patients. Evidence suggests that the increased stroke risk…

…regardless of the type of oral anticoagulant used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such as…

…3 Interpretation of HEMORR₂HAGES score. Comparison with ATRIA and HAS BLED Scores Several studies have compared the predictive performance of HEMORR₂HAGES with other bleeding risk…

…involve the sensitization of sensory nerve endings due to the accumulation of bradykinin. ACE is responsible for metabolizing bradykinin and other tachykinins, such as substance…

…the fourth universal definition of MI. Type 1 MI is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of…

…The clinical consequences are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of acute PE…

…as at least eight drinks weekly in females or at least 15 drinks weekly in males, or binge drinking in either sex. Other definitions of…

…and control the adhesion and migration of inflammatory cells. Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial…

…beyond the arrhythmia itself. It may cause symptoms and impaired quality of life, contribute to heart failure, and increase the risk of stroke and other…

…trial participants who were described as frail generally had no more than mild frailty, limiting the applicability of trial findings to people with substantial functional…

…levels of circulating pro inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic plaque rupture is increased during infections). As noted…

…They should not be applied as the principal risk tool in people with: Documented atherosclerotic cardiovascular disease (ASCVD) Diabetes mellitus in circumstances where diabetes specific…

…The cardiovascular burden of CKD extends beyond CAD to peripheral arterial disease, cerebrovascular disease, valvular heart disease, heart failure, atrial fibrillation, and other arrhythmias or…

…colchicine requires attention to the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes. Mechanisms of action Colchicine Colchicine…

…The rationale for complete revascularization is that untreated, flow limiting disease may continue to cause ischaemia, recurrent symptoms, myocardial infarction, or other major adverse cardiovascular…