…Other microorganisms, generally, cause subacute endocarditis. Endocarditis can affect native (own) valves and valve prostheses. As always, foreign materials pose a high risk of infection…

…antibiotics are given only in certain more severe cases. CNS and other Diagnosis Agent Dose Duration : : : : Bacterial meningitis, initial therapy (after corticosteroid) cefotaxime plus ampicillin…

…things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines the need…

…Only clinical signs of herniation halt the puncture, and antibiotics and a corticosteroid are then given immediately after blood cultures. For questions other than acute…

…and the condition is classified as cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other frequent…

…Causes Tamponade shares the causes of pericardial effusion. Important clinical associations include: Idiopathic or viral pericarditis Malignant pericardial disease Tuberculosis Purulent or bacterial pericarditis Trauma…

…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 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…

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

…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…

…disease, hay fever, or nasal polyps (increased risk of hypersensitivity reactions, such as asthma attacks, angioedema, or urticaria with NSAIDs). Alcohol consumption may increase the…

…after PCI; reduce recurrent atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term…

…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…

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

…components of assessment. The history should include: previous TIA or stroke; symptoms suggesting current or recent cerebral ischaemia; known CAD, PAD, or other atherosclerotic disease…

…The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome (ACS). Other cardiopulmonary causes…

…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…

…particularly in complex multivessel or left main disease. Clinical presentation and symptoms The clinical presentation of multivessel CAD varies from stable angina or exertional limitation…

…over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma…

…threatening complications. Among patients with established peripheral artery disease, those who stop smoking have approximately twice the five year survival of those who continue. After…

…As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals. Atrial flutter causes characteristic ECG changes, as discussed below…

…cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In case the ECG or other examinations suggest…

…have ST T changes caused by other pathological conditions (such as bundle branch blocks). Comparing the ECG recordings may reveal if the ST T segments…

…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…

…in reduced cardiac output and risk of hypoperfusion. Distinguishing AV block 2 and AV block 3 In case the distinction between second degree AV block…

…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…

…hours of the last dose. Andexanet alfa where available Low molecular weight heparin Protamine has only a partial effect Unfractionated heparin Protamine Antiplatelet agents Platelet…

…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…

…Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is needed for management. Cryoglobulinaemia, cold agglutinin disease…

…and other marked obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise during an ongoing crisis. Distinguish the…

…determine which agent is best. The choice is therefore governed chiefly by the target organ damage, the pharmacology of the drug, comorbidity, and the ability…

…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…

…the same time exclude other acute causes, for example hypoglycaemia, poisoning, stroke, meningitis and a postictal state. 3. Check a repeat plasma sodium if the…

…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

…not the volume of fluid. A litre that has accumulated slowly can be asymptomatic, while 150 mL collected over an hour causes tamponade. The indication…

…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…

…Syncope is particularly important as a marker of potentially severe disease. The presence of haemodynamic instability places the patient in the high risk category and…

…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…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…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…

…19 causes ventricular dysfunction. Guo et al also demonstrate that troponin T and NT pro BNP may be used as prognostic markers during the disease…