…condition. It is associated with a two to four fold increase in lifetime cardiovascular disease (CVD) risk and approximately doubles cardiovascular risk on average. Its…

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

…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…

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

…Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory…

…revascularization is that untreated, flow limiting disease may continue to cause ischaemia, recurrent symptoms, myocardial infarction, or other major adverse cardiovascular events. Complete revascularization is…

…more recent analyses question whether this reflects true biological protection. Potentially favourable associations with myocardial infarction may coexist with adverse effects on stroke, heart failure…

…characterized by reduced physiological reserve and increased vulnerability to adverse outcomes. It is dynamic and may improve or worsen with illness, treatment, or other interventions…

…and treatment goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator…

…The principal benefits relevant to clinical cardiology include: Clinical setting or outcome Reported benefit of cessation Cardiovascular disease overall Substantial reduction in cardiovascular events and…

…kg Body weight 50 kg: Adult dosage. Adverse effects Adverse effects typically persist <10 seconds due to the short half life of adenosine. Anxiety Chestpain…

…to lack a pupillary reflex upon their initial presentation. An absent pupillary reflex upon presentation was associated with a threefold increased risk of an adverse…

…Consequently, the decision to prescribe colchicine requires attention to the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes…

…3. Give atropine 0.5 mg intravenously (alternatively glycopyrronium 0.2 mg) to reduce the risk of a cholinergic vagal reaction with bradycardia. Wait 5…

…and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The association is mediated by…

…Vascular complications 0.43 Contrast agent reaction 0.37 Haemodynamic complications 0.26 Cardiac chamber perforation 0.03 Other complications 0.28 Total major complications…

…Virtual histology IVUS has also been used to identify thin cap fibroatheroma, a plaque phenotype associated with subsequent major adverse cardiovascular events in observational studies…

…MPI is used principally to: Diagnose and quantify stress induced myocardial ischaemia. Detect and characterize myocardial scar. Estimate the risk of major adverse cardiovascular events…

…with ECG may reveal atrial fibrillation. Unfortunately, atrial fibrillation is too often discovered first at hospital admission due to its complications (stroke, thromboembolism, heart failure…

…other imaging methods, namely exercise capacity (and VO2 max , see below). In addition to exercise capacity, stress testing also provides information on electrocardiographic (ECG) reaction…

…examination should be available or performed urgently to evaluate ventricular and valvular function. Levosimendan drug is generally well tolerated. Severe adverse effects are less common…

…interval: 0.88–1.24 The magnitude of cardiovascular risk reduction was considered similar to that achieved with statins for a comparable absolute degree of…

…of the QRS complexes vary from one beat to another (in the same lead). This is due to the swinging back and forth of the…

…myocardial fibrosis Reversible ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic stunning Adverse left ventricular (LV) remodeling Ischemic cardiomyopathy is the leading cause of…

…of the R waves. This is believed to be due to delayed (and thus electrically unopposed) depolarization in the ischemic area. Fragmented QRS complex The…

…Akutsjukvård Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the…

…administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for…

…dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting the relevant variant to each child. However, other inheritance patterns, de…

…combined dyslipidaemia, non HDL C is particularly relevant because it captures triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk…

…and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks of vertigo, seconds to a minute or so…

…binding to plasma albumin, but the therapeutic effect remains unchanged. Sulfonylureas: Salicylates may potentiate the hypoglycemic effect of sulfonylureas, possibly due to reduced binding to…

…with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and aggregation contribute importantly to arterial thrombus formation…

…deposition and retention of LDL C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression…

…compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic…

…PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke…

…and may extend to the arms, shoulders, neck, jaw, upper back, abdomen, or epigastrium. Dyspnoea, nausea, vomiting, diaphoresis, fatigue, faintness, and other symptoms may occur…

…That study spread like a virus through social media and it is likely that it may have resulted in increased mortality due to stopping statins…

…acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI…

…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…

…to the arterial obstruction: Buttock, hip or thigh symptoms suggest aortoiliac disease. Calf symptoms are typical of femoropopliteal disease. More distal disease may cause foot…

…This is due to the fact that atrial flutter is caused by a macro re entry circuit (a large re entry circuit) and re entry…

…ECG has low sensitivity with respect to detecting biventricular hypertrophy. This is because the strong and oppositely directed forces tend to cancel each other out…

…medical attention due to chest discomfort or other symptoms that may be caused by myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left…

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

…they annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect these gamma rays to construct images with high spatial and…

…Concave ST segment elevations, on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted in both…

…have constant PP interval and ride straight through the strip, without any relation to QRS complexes. P waves may occur on the ST T segment…

…and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90, women 0.85 = abdominal…

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

…Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather…

…incompatible infusions. Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure…

…margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor…

…main clinical rule Two questions determine the initial management: 1. Does the patient have severe neurological symptoms that may be due to the hyponatraemia? 2…

…A normal GGT shifts the suspicion to bone, pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction…

…a blood gas, coagulation tests and other investigations according to the clinical picture 5 Take cultures or molecular tests from the suspected focus, but avoid…

…pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which the procedure is the wrong treatment …