…0.4 0.8 2.1 Table 1. Survival in out of hospital cardiac arrest due to external causes ( Kitamura et al). References DeBehnke DJ…

…as a result of external causes, for example foreign body, hanging or strangulation. Drug overdose Intentional or accidental overdose of medications, drugs or other substances …

…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…

…instantaneous identification of the initial rhythm ( Thorén et al ). The initial rhythm has immense significance for survival in cardiac arrest, regardless of all other circumstances…

…lumen and visualization of the external elastic membrane (EEM). IVUS is consequently useful for determining vessel size, plaque burden, and the dimensions of lesions that…

…team (CAT) and intensive care units and other units caring for resuscitated patients. Figure 1. The chain of survival in out of hospital cardiac arrest…

…Proliferation and accumulation of tissue within the stent progressively reduce the lumen. The stent scaffold prevents the external constriction that characterizes restenosis after balloon angioplasty…

…if there is suspicion of cervical spine injury, in which scenario head tilt chin lift should only be used if other methods fail to open…

…External resources Guidelines from ASE (American Society of Echocardiography) Guidelines from ESC (European Society for Cardiology) Preparations for the examination Patients referred for echocardiography should…

…Use of synchronized electric shock (i.e. a shock synchronized to the QRS complex). Typically used to treat atrial fibrillation, ventricular tachycardia, and other tachyarrhythmias…

…It may be broken, as in Figure 1 . Any type of infarction may cause pathological R wave progression. However, the specificity for pathological R wave…

…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…

…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…

…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…

…Gufoni manoeuvre for treatment. Contraindications Absolute: Unstable cervical spine injury, recent cervical spine surgery, atlantoaxial instability, severe rheumatoid arthritis of the neck. Symptomatic carotid stenosis…

…the efficacy of diuretics and antihypertensives. Risk of acute kidney injury increases when combined with ACE inhibitors. Corticosteroids and other NSAIDs: Increased risk of gastrointestinal…

…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…

…reduce cardiovascular or all cause mortality. Reported relative effects include: Approximately 11% reduction in cardiovascular events in a meta analysis of primary prevention trials involving…

…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…

…ischaemia caused by an acute coronary process. Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other…

…three main questions discussed in media, blogs and on social plattforms: Is high cholesterol a true cause of coronary artery disease? Does diet affect cholesterol…

…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…

…the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic…

…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…

…or days. In the vast majority of cases, the re entry circuit in atrial flutter is located in the right atrium and it typically loops…

…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…

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

…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…

…the opposite angle of observation. The injury currents are not strong enough to be detected on leads with opposite angle of observation. Other vectors may…

…unreliable, such that they may cease and thus cause cardiac arrest. Junctional escape rhythm is more reliable (the risk of cardiac arrest is considerably lower)…

…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…

…the bleeding risk of the procedure and by renal function. In markedly reduced renal function (dabigatran at eGFR <30 mL/min, the other DOACs at…

…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…

…margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is…

…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…

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

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

…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…

…1. Assess airway, breathing and circulation. 2. Assess the neurological symptoms and at the same time exclude other acute causes, for example hypoglycaemia, poisoning, stroke…

…liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome, haemolysis The R value = (ALT / upper limit of normal…

…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…

…tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which…

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

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

…Heart failure, pulmonary oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic…

…SOVd} = 1.92 + 0.74 \times \text{BSA} ) Definition of aortic aneurysm Sinus of Valsalva 45 mm. Any other segment 40 mm in diameter…

…6% High risk 5 or more 5.8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist…

…chadsva] The CHA₂DS₂ VA score has superseded the CHA₂DS₂ VASc score. As of 2025, it is recommended to use the CHA₂DS₂ VA score for stroke…

…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…

…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…

…when alternative etiologies are excluded by diagnostic testing or failed therapeutic trials. If alternative causes of cough are suspected, specific diagnostic pathways may be pursued…

…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…