…fracture of the leads. External causes are less common and include electrolyte disorders, metabolic disorders, hypoxemia, antiarrhythmic drugs, or electromagnetic disturbance caused by other machines…

…at least one of the following: Symptoms of myocardial ischaemia. New ischaemic ECG changes. New pathological Q waves. Imaging evidence of new loss of viable…

…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…

…producing adrenal carcinoma Less commonly, ectopic aldosterone production Familial forms include familial hyperaldosteronism type 1, formerly termed glucocorticoid remediable aldosteronism, and other familial forms associated…

…acetylsalicylic acid at the first sign of skin rash, mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit…

…with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational diabetes Small for gestational age delivery Placental…

…Less frequently, it may also present in individuals without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline…

…Assessing the haemodynamic significance of lesions whose angiographic severity is uncertain. Supporting decisions regarding revascularization and, in selected patients, identifying microvascular or vasomotor coronary disorders…

…of painless or silent STEMIs is greater in patients with diabetes mellitus and increases with age. STEMI may present as sudden onset breathlessness. Other less…

…tomography (OCT) can reveal lesions that are not apparent on conventional angiography. Coronary vasomotor disorders may involve epicardial spasm or abnormalities of the coronary microcirculation…

…wave. Because of the long duration of the plateau phase most contractile cells are in this phase at the same time (more or less). Moreover…

…favorable prognosis, as compared with other forms of ventricular tachycardia. Mechanisms of ventricular tachycardia Ventricular tachycardia (VT) may emerge due to increased/abnormal automaticity, re…

…S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization…

…of Brugada syndrome are fairly specific to the disorder, provided that the clinical characteristics are in line with the disorder. There are however other disorders…

…a manifestation of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial…

…alter the local vascular environment. The extracellular matrix is an active component of lesion development rather than merely a structural scaffold. Smooth muscle cells and…

…association with other procedural complications, including distal embolization, coronary dissection, perforation, and abrupt closure. The clinical consequences depend heavily on the amount of viable myocardium…

…an inherited disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic…

…conduction. 2. Calcium Hypercalcemia Causes of hypercalcaemia Primary hyperparathyroidism and malignancies cause 90% of all cases of hypercalcemia. Less common causes are immobilization, sarcoidosis, thyrotoxicosis…

…physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient…

…rise can cause osmotic demyelination syndrome [1,2]. Hyponatraemia is primarily a disorder of water balance. The plasma sodium reflects the ratio between the body…

…Skipping a step is a common reason why mixed acid base disorders are missed. The blood gas describes the physiology at the moment of sampling…

…cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other frequent symptoms are pulsus paradoxus, pericardial friction…

…HMOD) Probable or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic, rare lipid, or BP disorders Pregnancy Established ASCVD includes previous acute…

…impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis is associated with a greater likelihood of cure. When to investigate…

…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…

…artery disease) as the underlying cause. Other common causes are cardiomyopathy (hypertrophic or dilated), arrhythmogenic right ventricular cardiomyopathy, Brugada syndrome, early repolarization. Electrolyte disorders, acidosis…

…after reperfusion in an occluded coronary artery. It also occurs as side effect of drugs, hypoxia, myocarditis and electrolyte disorders. Because the rate (60–100…

…and herpes zoster pain are other considerations when assessing chest pain [2]. Autoimmune/Malignancy: A history suggesting an autoimmune disorder or known malignancy may suggest…

…on QT prolongation or risk of torsade de pointes in PubMed. Drug with neuroleptic and anti histamine properties. Sleep disorder Aceprometazine is often used in…

…Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other circumstances that may affect…

…4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not…

…follow. Consider people with the genetic disorder familial hypercholesterolemia (FH), which is caused by genetic mutations affecting the elimination of LDL cholesterol from the blood…

…ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes…

…Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood…

…and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for the prevention of…

…C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease…

…and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine…

…if the total expected time is 120 minutes or less If PCI cannot be performed within 120 minutes Fibrinolysis within 10 minutes of the diagnosis…

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

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

…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…

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

…affecting at least two vascular beds. Carotid disease therefore commonly coexists with coronary artery disease (CAD), peripheral artery disease (PAD), and other manifestations of systemic…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…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…

…left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures…

…beats per minute. Note that with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2…

…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…

…myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of upper abdominal pain. An…

…1). This is possible by using two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves…

…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…

…Concave ST segment elevations, on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted in both…

…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…

…at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist…

…Drug Standard dose Reduced dose and criterion : : : Apixaban 5 mg twice daily 2.5 mg twice daily if at least two of: age ≥80 years…

…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…

…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…

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

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