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

…QRS duration is <120 ms. Panel B in Figure 5 below shows another example of early repolarization. Readers interested in ST segment elevation differential diagnoses…

…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…

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

…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…

…Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease…

…against clinical effect. 2. Parenteral thiamine early , preferably before or at the same time as carbohydrate administration. 3. Rapid identification of seizures, delirium tremens, infection…

…measure: early and generous fluid administration. The benefit of alkalinisation over fluids alone is disputed and practice differs between units. Poisoning with other weak acids…

…bradycardia in the early hours following infarction may be associated with hemodynamic compromise. More broadly, bradyarrhythmic arrest and asystole represent severe manifestations of impulse generation…

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

…is particularly vulnerable, and delayed intensification of lipid lowering therapy may leave patients exposed to avoidable risk. Contemporary guidance therefore supports an early, intensive approach…

…in patients with diabetes. The haemodynamic consequences depend on lesion location, severity, length, the presence of multilevel disease and collateral circulation. Flow limitation may be…

…sleep apnoea Hypertension with atrial fibrillation in the absence of an underlying structural cardiac explanation Early onset hypertension or cerebrovascular accident at a young age…

…or other trauma. Drowning Cardiac arrest due to drowning Electrocution Cardiac arrest due to electrical current through the heart. Asphyxia Asphyxia as a result of…

…not distinguish different types of dilated cardiomyopathy. Other causes of ventricular dilation ( e.g ischemic cardiomyopathy) must be excluded before establishing a diagnosis of DCM…

…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…

…and the same assumption can be made for the other valves. The area is calculated by measuring the diameter of the valve ( area = π …

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

…and intensive care early with life threatening features or an inadequate response. First line treatment is oxygen in hypoxaemia, repeated doses of an inhaled short…

…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…

…minute. Peptic ulcer remains the commonest cause of upper gastrointestinal bleeding, but the differential diagnosis includes oesophagitis, gastritis, a Mallory Weiss tear, a Dieulafoy lesion…

…Atherosclerotic lesions commonly arise at sites of disturbed flow, including branch points in the epicardial coronary arteries. Early lesions may undergo positive or compensatory remodelling…

…infarction rates. Clinical presentation and symptoms The clinical presentation is determined primarily by the ACS syndrome and the haemodynamic consequences of the culprit lesion. Patients…

…sudden cardiac death. It may also be associated with early death after cardiac transplantation. Myocardial bridging is not itself an atherosclerotic lesion, but it may…

…depression is a common and early electrocardiographic sign of acute pericarditis, reflecting pericardial involvement overlying the atria [4, 5]. Other Differential Diagnoses ST segment elevations…

…from early coronary angiography and revascularization, while avoiding unnecessary procedural complications and bleeding in those at lower risk or in whom the hazards of revascularization…

…with intermediate lesions that do not produce physiologically significant flow limitation. The mechanisms are incompletely defined. Proposed contributors include hypercontractility or hypersensitivity of coronary vascular…

…should be established as early as possible. Airway management should not interrupt compressions for more than 5 seconds. The effect of cricoid pressure and gastric…

…some patients present with severe LMCA stenosis exacerbated by other conditions, and these must also be recognized. Prompt identification of LMCA involvement is therefore critical…

…early exercise tests should not be maximal, which means that the clinician must set a lower goal regarding workload (e.g. reaching 70% of maximal…

…ACC). The chain of survival EARLY RECOGNITION OF CARDIAC ARREST If no medical professional is nearby, bystanders must respond immediately by summoning help (calling the…

…other underlying cause immediately. 9. Request ultrasound of the kidneys and urinary tract when a postrenal cause cannot confidently be excluded. 10. Contact nephrology early…

…acute stroke to identify large vessel occlusion, dissection or other vascular pathology CT perfusion Used with an unclear time of onset, a late time window…

…pattern type 1: ST elevation ≥ 2 mm of coved type with a negative T wave in V1–V2. Early repolarisation: J point elevation ≥ 1 mm…

…remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease, and other very high…

…particularly in iatrogenic aortic injury. Iatrogenic lesions commonly follow cardiac surgery, coronary angiography or other invasive procedures, and affected patients may be relatively painless compared…

…and asymmetric T waves. These must be differentiated from hyperacute T waves seen in the very early phase of myocardial ischemia. Hyperacute T waves are…

…the ECG changes in early repolarization are easy to separate from those in Brugada syndrome and the risk of ventricular arrhythmias and sudden cardiac death…

…of the umbilicus. The fetus should ideally be delivered within 5 minutes following the maternal cardiac arrest. Within the context of pregnancy, hypovolemia and other…

…thickness, often indicative of early or mild ischemia. Moderate defects : Associated with wall thinning, suggesting a more advanced level of ischemia or partial scarring. Severe…

…criteria to management Although the early repolarization pattern has been recognized for almost 50 years, it is still one of the most frequently confused ECG…

…procedure reserved for very serious poisonings in which the patient reaches hospital early. The benefit of both methods falls steeply with the time since ingestion…

…may therefore underestimate the ketosis early on and remain positive after the clinically relevant ketosis has resolved. Capillary measurement of beta hydroxybutyrate has high diagnostic…

…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…

…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…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…and cardiovascular rationale Smoking cessation is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible, other inhaled nicotine products…

…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…