…are mostly due to acute myocardial ischemia or myocardial infarction, and in these cases, the likelihood of ROSC is higher as compared to other etiologies…

…to exclude or verify the following potentially life threatening causes of chest pain: Ischemic heart disease : stable angina pectoris, unstable angina pectoris, acute myocardial infarction…

…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…

…inflammatory drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be prescribed routinely to individuals without established…

…increase the risk of stroke and other thromboembolic events. Subclinical cerebral injury may contribute to vascular dementia, and thromboembolism may affect organs other than the…

…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…

…cerebral vascular disease or peripheral vascular disease. A family history of premature myocardial infarction, vascular disease or marked hypercholesterolaemia. Physical findings related to cholesterol deposition…

…management: 1. Does the patient have severe neurological symptoms that may be due to the hyponatraemia? 2. Is the hyponatraemia acute or chronic? Severe symptoms…

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

…intravenous drugs. Such treatment has not been shown to improve the prognosis and can cause hypotension, acute kidney injury, myocardial ischaemia or cerebral hypoperfusion. Pain…

…start of CPR to ROSC or end of resuscitation attempts. Efficient CPR generates approximately 25% of normal cardiac output, which postpones or mitigates cerebral injuries…

…and current antihypertensive treatment. Missed doses or abrupt withdrawal of a beta blocker, clonidine or another sympatholytic drug. Cocaine, amfetamine, other sympathomimetics, herbal remedies and…

…if feasible, be transferred to such centers. Post cardiac arrest syndrome (PCAS) Post cardiac arrest syndrome (PCAS) emerges after ROSC or initiation of ECMO. The…

…compromise of branch vessels. Type A disease may cause cardiac tamponade, severe acute aortic regurgitation, coronary malperfusion, myocardial ischaemia, heart failure, shock and cerebral or…

…or unchanged in ischemia. R wave amplitude Acute transmural ischemia may transiently increase the amplitude of the R waves. This is believed to be due…

…or ischaemic ECG changes Concomitant cardiac disease Oxygen targets Patient Initial target saturation : : Known COPD or another clear risk of hypercapnic respiratory failure 88 to…

…syndrome (ACS) or a prior heart attack and a high risk of developing an atherothrombotic event. Contraindications Hypersensitivity to the active substance or any excipient…

…from: Incomplete penetrance of a variant inherited from a parent. A de novo variant. Less commonly, autosomal recessive inheritance. X linked or other non autosomal…

…189 mg/dL, 10 year risk of a first hard ASCVD event—fatal or nonfatal myocardial infarction or stroke—should be estimated. The risk categories…

…the cell will die. Death of myocardial cells is referred to as myocardial infarction. Myocardial ischemia in clinical practice: coronary artery disease In clinical practice…

…lead ECG within 10 minutes. 3. Attach defibrillator pads if the patient is unstable or at marked risk of arrhythmia. 4. Take a full blood…

…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…

…administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other contraindications…

…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…

…LDL C in many studies, although the relative advantage of apoB over non HDL C or standard lipid testing remains unsettled. In a large population…

…Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated…

…with homozygous FH typically die from acute myocardial infarction at 20 to 30 years of age. People with familial hypercholesterolemia have no other metabolic aberration…

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

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

…by stenosis or occlusion of the aorta or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause. Other…

…to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other…

…atrial flutter is not capable of persisting for longer periods of time. This is due to the fact that atrial flutter is caused by a…

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

…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…

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

…Radiotracers are designed to identify ischemic areas of the myocardium by highlighting regions with reduced blood flow. Radiotracers for SPECT Technetium 99m (Sestamibi or Tetrofosmin)…

…repolarization or even early phases of ischemia). To conclude, concave ST segment elevation is atypical of ischemia, but they do not rule out ischemia. Other…

…features of third degree AV block On the ECG P waves have no relation to the QRS complexes. The QRS complexes may be normal or…

…in oedema and ascites, and in people under 18 years of age, where iso BMI or percentile charts should be used. Waist circumference Measure the…

…The other DOACs are possible according to FASS, but the documentation is insufficient; check more frequently. Warfarin is often preferable <15 or dialysis DOACs are…

…smears immediately at the bedside from the first aspirate, which should be small — a few tenths of a millilitre, at most about 0.5 mL…

…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…

…buds for small lesions (these give a more superficial and less controllable depth of freeze). A size 15 scalpel or a pumice stone to pare…

…Contraindications Known hypersensitivity to edrophonium. Mechanical obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without…

…7 days or doxycycline 200 mg × 1 on day 1, then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime…

…need investigation on the basis of an isolated, asymptomatic low sensor reading alone. Symptoms Autonomic symptoms Early warning symptoms are due to sympathetic activation: sweating…

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

…abdominal pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile…

…after myocardial infarction, and traumatic haemopericardium — these require surgery; pericardiocentesis is at best a bridge to it. A small (under 10 mm), loculated or purely…

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

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

…oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic alkalosis or an…

…or additional risk factors 55 mm (ascending aorta, aortic arch) All individuals 60 mm (descending aorta) All individuals Risk factors : previous dissection, family history of…

…this score aids clinicians in estimating the risk of bleeding complications due to anticoagulants. Components of the ATRIA Score The ATRIA score assigns points based…

…CHA₂DS₂ VASc score. As of 2025, it is recommended to use the CHA₂DS₂ VA score for stroke risk assessment in atrial fibrillation patients. By excluding…

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

…to guide clinicians in balancing estimating the risks of bleeding. Components of the HEMORR₂HAGES Score The acronym HEMORR₂HAGES represents the following parameters: H epatic or…

…transient swelling of the subcutaneous or submucosal tissues, most frequently involving the face, lips, tongue, and upper airway. Due to the risk of airway compromise…

…Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis…

…when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of acute PE comprises four clinically useful groups: High…