…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…

…begin before the blood alcohol concentration has reached zero, and several syndromes can overlap [1,4]. Time after a clear reduction or the last intake…

…for pathological R wave progression is considerably lower than pathological Q waves and guidelines do not state any ECG criteria specific to R wave progression…

…other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive ventilation is not…

…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…

…failed fibrinolysis Immediate rescue PCI The 120 minute limit is a ceiling for the choice between primary PCI and fibrinolysis, not an acceptable routine target…

…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…

…maintenance treatment. The source material does not specify the loading dose. Efficacy and harms In secondary prevention trials involving patients with previous vascular disease, aspirin…

…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…

…drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be prescribed routinely to individuals without established ASCVD…

…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…

…blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However, association is not the…

…outcomes may not reliably exclude clinically important differences in ischemic events or stent thrombosis. Stable coronary disease and elective PCI For chronic coronary syndromes treated…

…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…

…with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption…

…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…

…display ST segment elevations that are not caused by ischemia and a significant proportion have ST T changes caused by other pathological conditions (such as…

…ultrasound is emitted and analyzed continuously in the former. This allows much higher velocitites to be measured. Continuous wave Doppler is therefore not limited by…

…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…

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

…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…

…not exclude DOAC effect. Duplicate therapy. Check that the patient is not simultaneously on a DOAC, low molecular weight heparin and an antiplatelet agent without…

…the periosteum that hurts, not the skin. Aspiration needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small…

…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…

…it will disappear, and the documentation is all that remains. 3. Pare down any hyperkeratosis with a scalpel; nitrogen does not penetrate thick keratin. 4…

…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…

…is normalised [3]. A healthy person without diabetes therefore does not normally need investigation on the basis of an isolated, asymptomatic low sensor reading alone…

…stroke, meningitis and a postictal state. 3. Check a repeat plasma sodium if the result is unexpected or does not fit the clinical picture. 4…

…not function. The tests that reflect the synthetic function of the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become…

…malignancy, stem cell transplantation, immunosuppressive drugs, radiotherapy, bone marrow failure and certain targeted cancer treatments. Fever is not obligatory Hypothermia, new confusion, tachypnoea, hypotension, rigors…

…it does not exclude Diastolic collapse of the right atrium and right ventricle The cardinal echocardiographic finding A dilated inferior vena cava without respiratory variation…

…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 …

…with airway expertise. Procedure 1. Dry the skin and shave where necessary. Do not clip the hair — small cuts cause burning pain. 2. Position the…

…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…

…heart failure, cardiovascular mortality and atrial fibrillation. Consequently, alcohol should not be initiated as a cardiovascular preventive strategy. A drink equivalent contains approximately 12–14…

…cells and macrophages; a thin fibrous cap; positive remodelling; neovascularization; intraplaque haemorrhage; adventitial inflammation; spotty calcification. Nevertheless, the presence of these features does not imply…

…infarction without further assessment. Clinical presentation and symptoms The clinical presentation is heterogeneous. AF may be well tolerated, particularly when the ventricular response is not…

…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…