…until pressure necrosis and perforation occur. If you find one magnet, actively look for another , in the other nostril, in the ears and in the…

…brachial index (TBI). The digital arteries rarely calcify, which makes toe pressure the method of choice in diabetes and renal failure. A normal TBI is ≥

…sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI. QTc prolongation The QT…

…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…

…cases, TTP has been reported with ticagrelor treatment. TTP is characterized by thrombocytopenia and microangiopathic hemolytic anemia associated with neurological findings, renal failure, or fever…

…However, other inheritance patterns, de novo variants, incomplete penetrance and variable phenotypic expression complicate risk prediction. Familial clustering may also reflect shared environmental or behavioural…

…Non HDL C and apoB are secondary targets or risk refining measures, particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance…

…In acute coronary syndromes, however, symptoms and ECG changes are manifest at rest because of the severe reduction of coronary flow caused by acute atherothrombosis…

…serious arrhythmia or acute heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast not…

…drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre…

…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)…

…and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and…

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

…vasoconstriction and platelet aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other…

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

…Other life threatening cardiopulmonary conditions account for approximately 5% of presentations in some populations. Despite this relatively low prevalence, missed myocardial infarction remains consequential, and…

…Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction…

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

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

…presentation and symptoms The clinical presentation of multivessel CAD varies from stable angina or exertional limitation to acute coronary syndrome (ACS), ventricular arrhythmia, heart failure…

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

…other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption but to achieve complete abstinence from tobacco and ultimately…

…with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2:1 block will be difficult…

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

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

…and the other for analyzing reflected sound waves. The cardinal difference between continuous wave Doppler and pulsed wave Doppler is that ultrasound is emitted 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…

…atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular…

…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…

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

…myeloproliferative neoplasm. Work up and staging of lymphoma and myeloma. Suspected bone marrow metastasis. Assessment of treatment response and measurement of residual disease (MRD). Fever…

…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…

…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…

…block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise during…

…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…

…coronary syndrome, acute left ventricular failure with pulmonary oedema, acute aortic syndrome, acute kidney injury, microangiopathic haemolysis, and severe pre eclampsia or eclampsia. The blood…

…Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes…

…breathing and circulation. 2. Assess the neurological symptoms and at the same time exclude other acute causes, for example hypoglycaemia, poisoning, stroke, meningitis and a…

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

…haematological malignancy, stem cell transplantation, immunosuppressive drugs, radiotherapy, bone marrow failure and certain targeted cancer treatments. Fever is not obligatory Hypothermia, new confusion, tachypnoea, hypotension…

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

Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…

…spike is followed by a wide QRS complex and a pulse that can be felt. The other predictable error is forgetting that pacing hurts a…

…forward. Heart failure, pulmonary oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant…

[calc_aorta] Sinus of Valsalva (SOV) and Aortic Root Assessment The sinus of Valsalva diameter (SOVd) is a critical measurement in evaluating aortic root morphology…

…score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist for patients with AF, including HAS BLED, HEMORR2HAGES, and ORBIT scores. Each…

…AF patients. Evidence suggests that the increased stroke risk in women is more closely associated with other comorbidities and age rather than sex alone. Consequently…

…used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES, ATRIA, ORBIT, and GARFIELD AF scores…

…with ATRIA and HAS BLED Scores Several studies have compared the predictive performance of HEMORR₂HAGES with other bleeding risk assessment tools, notably ATRIA and HAS…

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

…and heart failure are among the conditions associated with myocardial injury. Relationship to chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations…

…Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease, active cancer, and other conditions…

…biological protection. Potentially favourable associations with myocardial infarction may coexist with adverse effects on stroke, heart failure, cardiovascular mortality and atrial fibrillation. Consequently, alcohol should…

…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…

…the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and is also a common tachyarrhythmia requiring treatment in decompensated heart failure (DHF)…

…treatment, or other interventions. Frailty commonly overlaps with multimorbidity and is frequent in patients with cardiovascular disease, including heart failure and ischaemic heart disease. Ageing…

…disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections. However, in some individuals the infection may be severe and deadly. Importantly…

…chronic coronary syndromes, coronary revascularization, stroke, transient ischaemic attack, and peripheral arterial disease. Heart failure is also considered established clinical CVD in the risk based…

…cerebrovascular disease, valvular heart disease, heart failure, atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking…