…coronary syndromes. Cigarette smoking is a prominent association, whereas other conventional coronary risk factors may be absent. The condition is more prevalent in Japan and…

…despite optimal neurohormonal blockade and adequate volume control. It is also utilized for ventricular rate control in atrial fibrillation, particularly when other therapeutic options cannot…

…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…

…Seizures later than this, focal seizures or status epilepticus should raise strong suspicion of another or an additional cause [1]. Delirium tremens most often begins…

…sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI. QTc prolongation The QT…

…sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive…

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

…However, other inheritance patterns, de novo variants, incomplete penetrance and variable phenotypic expression complicate risk prediction. Familial clustering may also reflect shared environmental or behavioural…

…and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years without diabetes and with LDL C between 70 and…

…In acute coronary syndromes, however, symptoms and ECG changes are manifest at rest because of the severe reduction of coronary flow caused by acute atherothrombosis…

…STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based on symptoms, the ECG and…

…in three minutes, without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment…

…Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing bleeding risk. Monitor coagulation…

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

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

…with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic cardiovascular…

…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…

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

…Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction…

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

…disseminated intravascular coagulation, and abrupt deterioration in renal function. By contrast, hypertensive urgency describes severe hypertension without clinical evidence of acute, ongoing target organ damage…

…treatment. Revascularization improves angina related health status, but it should not be undertaken when symptoms are present without anatomical or physiological criteria supporting revascularization. In…

…also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention. Clinical assessment should include functional status and walking capacity…

…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…

…with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2:1 block will be difficult…

…has low sensitivity with respect to detecting biventricular hypertrophy. This is because the strong and oppositely directed forces tend to cancel each other out. However…

ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

…and the other for analyzing reflected sound waves. The cardinal difference between continuous wave Doppler and pulsed wave Doppler is that ultrasound is emitted and…

…annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect these gamma rays to construct images with high spatial and temporal…

…on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted in both North American and European…

…be normal or wide. P waves have constant PP interval and ride straight through the strip, without any relation to QRS complexes. P waves may…

…lowest rib and the iliac crest, at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement…

…as in the table above for rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible according to FASS…

…Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather…

…the use of ultrasound throughout the puncture, and maintaining maximal barrier precautions without shortcuts. The most common serious error is dilating a vessel that turns…

…front , and this is why the margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…without acute target organ damage should not normally be lowered rapidly with intravenous drugs. Such treatment has not been shown to improve the prognosis and…

…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…

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

…with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance. Synthetic function and prognosis…

…pregnant women, patients after allogeneic stem cell transplantation and patients treated with CAR T cells or other advanced immunotherapies may require separate local protocols. Definition…

…Diastolic collapse of the right atrium and right ventricle The cardinal echocardiographic finding A dilated inferior vena cava without respiratory variation Strongly suggests a raised…

…mg/mL) is water soluble and short acting, not a depot preparation, and gives a shorter duration of effect. Lidocaine 10 mg/mL without adrenaline …

…spike is followed by a wide QRS complex and a pulse that can be felt. The other predictable error is forgetting that pacing hurts a…

…treatment looks simple — bicarbonate and a look at the urine dipstick — but it fails routinely for one single reason: without normal potassium the urine cannot…

[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…

…score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist for patients with AF, including HAS BLED, HEMORR2HAGES, and ORBIT scores. Each…

…AF patients. Evidence suggests that the increased stroke risk in women is more closely associated with other comorbidities and age rather than sex alone. Consequently…

…used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES, ATRIA, ORBIT, and GARFIELD AF scores…

…with ATRIA and HAS BLED Scores Several studies have compared the predictive performance of HEMORR₂HAGES with other bleeding risk assessment tools, notably ATRIA and HAS…

…the sensitization of sensory nerve endings due to the accumulation of bradykinin. ACE is responsible for metabolizing bradykinin and other tachykinins, such as substance P…

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

…Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease, active cancer, and other conditions…

…myocardial infarction may coexist with adverse effects on stroke, heart failure, cardiovascular mortality and atrial fibrillation. Consequently, alcohol should not be initiated as a cardiovascular…

…and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory cell entry into the intima, and…

…organs other than the brain. Patients with AF in the setting of ACS have more comorbidities and a higher risk of complications than patients without…

…and functional deterioration may have greater consequences in frail patients. Clinical Assessment Frailty and Functional Status Treatment decisions should not be based on age alone…

…disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections. However, in some individuals the infection may be severe and deadly. Importantly…

…according to age and the presence of concomitant risk factors. In contrast, patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification…