…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…

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

…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…

…and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory cell entry into the intima, and…

…or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular dysfunction and/or MVD…

…Progressive dilation can subsequently impair left ventricular ejection fraction. Enlargement of the left ventricle predisposes to atrial and ventricular arrhythmias. In advanced alcohol related cardiomyopathy…

…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…

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

…for smoking and anticipated barriers to cessation. Exposure to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation…

…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…

…In contrast, dilated, light unresponsive pupils are indicative of cerebral anoxia or brain death and constitute an adverse prognostic sign. Notably, the presence of dilated…

…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…

…time to diplopia on upward gaze, or the number of seconds the patient can hold the head lifted off the couch. Filming before and during…

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

…mortality is generally below 0.1% in contemporary series. Reported risks vary according to the population and definitions used. Complication Reported risk (%) Mortality 0.11…

…and necrotic components. Virtual histology IVUS has also been used to identify thin cap fibroatheroma, a plaque phenotype associated with subsequent major adverse cardiovascular events…

…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…

…is too often discovered first at hospital admission due to its complications (stroke, thromboembolism, heart failure, dyspnea). Most individuals, however, do experience symptoms and th

…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…

…of cardiovascular risk reduction was considered similar to that achieved with statins for a comparable absolute degree of LDL C lowering. Diabetes and glycaemic outcomes…

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

…extensive MI with necrosis and scar formation Diffuse myocardial fibrosis Reversible ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic stunning Adverse left ventricular (LV…

…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…

…6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV…

…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…

…risk of transmitting the relevant variant to each child. However, other inheritance patterns, de novo variants, incomplete penetrance and variable phenotypic expression complicate risk prediction…

…in addition to LDL and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years without diabetes and with LDL…

…blood flow to maintain cellular function. Myocardial ischemia occurs when there is insufficient oxygen available. Insufficient oxygen supply results in diminished ATP production and subsequently…

…2 to 24 hours After failed fibrinolysis Immediate rescue PCI The 120 minute limit is a ceiling for the choice between primary PCI and fibrinolysis…

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

…min). Patients with mild to moderate heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function)…

…term interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular…

…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…

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

…may have resulted in increased mortality due to stopping statins. There are three main questions discussed in media, blogs and on social plattforms: Is high…

…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…

…sufficient Severe elevation Acute HMOD Present Absent clinically Symptoms Often present and related to the affected organ May be absent or nonspecific Treatment setting Usually…

…perfusion is insufficient to meet the basal nutritional requirements of tissue. Typical symptoms include: Ischaemic rest pain. Coldness or numbness of the foot and toes…

…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…

…and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to…

…velocitites to be measured. Continuous wave Doppler is therefore not limited by pulse repetition frequency (PRF). Figure 1. The principles of continuous wave Doppler and…

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

…on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted in both North American and European…

…waves have no relation to the QRS complexes. The QRS complexes may be normal or wide. P waves have constant PP interval and ride straight…

…index 15–19 kg/m² 17–22 kg/m² Ideal and dosing weight Drug dosing often requires a weight other than the actual body weight…

…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…

…5. Aspiration: advance the needle with the stylet in place perpendicular to the bone surface, angled slightly anteriorly and medially. Rotate under steady pressure until…

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

…on an irregular surface. Petroleum jelly around the lesion to protect the surrounding skin. Eye protection and gloves for the operator. Explain before treatment that…

…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…

…s exchangeable sodium and potassium and the total body water. In hypotonic hyponatraemia the amount of water is too great in relation to the amount…

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

…glucose and lactate. Add a blood gas, coagulation tests and other investigations according to the clinical picture 5 Take cultures or molecular tests from the…

…liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and to the left