…are frequently misunderstood. The transition from the ST segment to the T wave should be smooth. The normal T wave is somewhat asymmetric, with a…

…sarcoidosis Other cardiac procedures Chemotherapeutic agents Catheter ablation Critical illness Defibrillator shocks Strenuous exercise Cardiac contusion The diagnosis should therefore distinguish isolated myocardial injury from…

…the renal injury probably represents acute tubular necrosis arising from the combined effects of contrast exposure and other ischaemic or nephrotoxic stresses. The kidney is…

…in the evening and at night, but diurnal variation is not a diagnostic requirement. Hallucinations, usually visual, disturbed sleep rhythm, anxiety, fear and delusions are…

…R wave progression Normal R wave progression implies that the R wave amplitude increases gradually from V1 to V5 and then diminishes again in V6…

…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…

Info Table 1 provides a summary of the indications, contraindications, dosage, administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary…

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

…density lipoprotein cholesterol (LDL C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role…

…ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source…

…assess the circulation and the bleeding risk, and exclude dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time…

…in the acute vestibular syndrome — continuous vertigo with spontaneous nystagmus, nausea and difficulty walking that has lasted hours to days — to distinguish vestibular neuritis from…

…NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or duodenal ulcers. Liver cirrhosis. Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy…

…from MI or percutaneous coronary intervention (PCI), ischaemic risk, bleeding risk, need for anticoagulation, and whether coronary stents are present. Clinical objectives of therapy The…

…from the causal role of low density lipoprotein cholesterol (LDL C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD). Atherosclerosis develops through the…

…its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention…

…operative assessment, or evaluation of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of severe asymptomatic stenosis is low, screening has…

…and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around…

…cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However, association is not the same as causation . A…

…the evidence for shortened regimens derives from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other…

…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…

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

…isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial disease, and management should therefore address the entire arterial…

…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…

…spread rapidly through the atria from this re entry circuit. Examples of atrial flutter. Click to zoom. ECG in atrial flutter The ECG shows regular…

…This is because the strong and oppositely directed forces tend to cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy…

…if the opportunity is given. An ECG without ischemic ST T changes when recording during chest pain is not consistent with myocardial ischemia. In other…

…Doppler (CW Doppler), ultrasound waves are continuously emitted from the transducer and the reflections of these waves are analyzed continuously (Figure 1). This is possible…

…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…

…1 mm in all other leads. • Men & women V4R and V3R: ≥0,5 mm, except from men <30 years in whom the criteria is ≥1…

…the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular (AV) dissociation. Importantly, for the…

…22 above 70 years, and reduced food intake together form the basis of most screening instruments and should prompt a nutritional assessment. See also unintentional…

…min, the other DOACs at eGFR <15 mL/min) at least 96 hours should have elapsed since the last dose before an invasive procedure. Exact…

…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…

…parenteral nutrition. The need for several simultaneous, incompatible infusions. Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple…

…the surroundings with petroleum jelly and, where necessary, a shielding cone. 5. Hold the spray nozzle 1–2 cm from the skin , perpendicular to the…

…obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked…

Infektionssjukdomar Farmakologi & dosering Lathundar The doses below are taken from the recommendations of Strama Stockholm for the empirical antibiotic treatment of adults in hospital and…

…1,2]. Malignant hypertension is not entirely synonymous with a hypertensive emergency. The term denotes severe hypertension with advanced hypertensive retinopathy, usually retinal haemorrhages, exudates…

…administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below…

…acute the condition is. A patient with a chronic plasma sodium of 112 mmol/L may be relatively unaffected, while a rapid fall from 140…

…Both raised Drug induced liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome, haemolysis The R value = (ALT …

…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…

…needles. An 18 G puncture needle, 7–9 cm (a spinal needle or the needle from a pericardiocentesis set), 10 mL and 20 mL syringes…

…or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in the adjacent joint. Known hypersensitivity to the…

…a pulse that can be felt. The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous)…

…The benefit of alkalinisation over fluids alone is disputed and practice differs between units. Poisoning with other weak acids where the poison control centre recommends…

[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…

…B, Lane DA, Lip GYH. Comparison of bleeding risk scores in patients with atrial fibrillation: insights from the AFFIRM trial. J Intern Med . 2018;283…

…point) The total score ranges from 0 to 9, with higher scores indicating an increased risk of stroke (Table 1). Interpretation of the CHA₂DS₂ VA…

…performs similarly or superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES, ATRIA, ORBIT, and GARFIELD AF scores. Moreover, the HAS BLED score has…

…Yan Y, Milligan PE, et al. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation. Am Heart J . 2006;151…

…Similarly, angioedema occurring in the setting of ACE inhibitor therapy is bradykinin mediated rather than mast cell mediated, distinguishing it from classic allergic reactions. Clinical…

…longer episodes, a lower threshold for provocation, or symptoms that awaken the patient from sleep. Initial symptoms of NSTEMI and UA may be similar. NSTEMI…

…and other conditions incorporated into validated clinical risk tools Acute RV failure is a rapidly progressive syndrome characterized by systemic congestion resulting from impaired RV…

…duration , sex , and genetically influenced effects on the cardiovascular system. Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with…

…and control the adhesion and migration of inflammatory cells. Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial…

…activation subsides, making it difficult to determine whether AF initiated the deterioration or resulted from it. AF has important consequences beyond the arrhythmia itself. It…

…used in younger adults, whereas a markedly frail 65 year old may require the more cautious approach generally applied to older patients. Frailty is characterized…

…2019 (COVID 19) has caused a global public health crisis. It is believed that the virus was transmitted from bats to humans in Wuhan, China…