…for example, beta blockers, alpha 2 agonists and antipsychotics, which mainly affect individual symptoms. Initial management ABCDE and immediate tests Assess the withdrawal and other…

…Other definitions of unhealthy drinking include at least two drinks daily in women or three in men, or at least four drinks for women or…

…risk within several years, although risk may remain higher than that of never smokers for a prolonged period. In heavy smokers, cardiovascular risk falls within…

…accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral…

…progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental pathophysiological substrate for acute coronary syndromes (ACS), including…

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

…environmental factors and genetic background. Thrombotic susceptibility is likewise affected by inflammation and other systemic influences. The severity of myocardial injury is determined not only…

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

…Current inhaled treatment and adherence. Opioids, benzodiazepines and other sedating drugs. Thromboembolic risk, for example immobilisation, cancer and previous venous thromboembolism. A documented decision on…

…Information about concurrent ticagrelor treatment is required for interpreting platelet function tests for HIT. Other cosiderations Based on a relationship observed in the PLATO study…

…or other non autosomal dominant mechanisms. Complex or multifactorial genetic architecture. The inheritance pattern affects the appropriate scope and duration of family surveillance. For example…

…triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years without diabetes…

…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…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre…

…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…

…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…

…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…

…only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and…

…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…

…release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin, so biomarker interpretation…

…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…

…thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI), or medical management. The standard post ACS regimen is DAPT for 12 months…

…acute HMOD, although other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence of ongoing acute organ injury is decisive. The pathophysiology…

…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…

…of the aorta or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism…

…most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals…

…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…

…when recording during chest pain is not consistent with myocardial ischemia. In other words, chest pain caused by ischemia will always result in ischemic ST…

…two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves. The cardinal difference between continuous wave…

…to regions with lower concentration, for reasons other than perfusion differences, making image interpretation more ambiguous. Table 1. Radiotracers used for SPECT imaging Thallium 201

…Current guideline criteria for ischemic ST segment elevation: New ST segment elevations in at least two anatomically contiguous leads: • Men age ≥40 years: ≥2 mm…

…the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular (AV) dissociation. Importantly, for the ventricles to have any electrical…

…circumference < 31 cm is a screening marker for sarcopenia Body composition Measurement Women Men : : : Body fat, normal 21–33 % (age dependent) 8–22 % Body…

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

…side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of…

…parenteral nutrition. The need for several simultaneous, incompatible infusions. Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple…

…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…

…sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real…

…Lathundar The doses below are taken from the recommendations of Strama Stockholm for the empirical antibiotic treatment of adults in hospital and in residential care…

…organ damage. Isolated malignant retinopathy without other acute organ damage can often be treated more cautiously with oral drugs under careful observation [3,4]. A…

…any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient's need for…

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

…MELD Na is used for transplant prioritisation; both are available among the calculators. Fibrosis markers Index Calculation Interpretation : : : FIB 4 (age × AST) / (platelets × √ALT) <…

…international guidelines on neutropenic fever [2]. The direct evidence for exactly one hour in neutropenic fever is limited, but delayed antibiotics are associated with a…

…pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which the procedure is the wrong treatment …

…a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint…

…a pulse that can be felt. The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous)…

…differs between units. Poisoning with other weak acids where the poison control centre recommends it, for example certain phenoxy acid herbicides (2,4 D, MCPA)…

…Any other segment 40 mm in diameter. Thresholds for surgery Threshold for surgery Relevant patient category 27.5 mm/m 2 Turner syndrome 40 mm…

…8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist for patients with AF, including HAS BLED…

…factor for stroke in AF patients. Evidence suggests that the increased stroke risk in women is more closely associated with other comorbidities and age rather…

…stands for: H ypertension A bnormal renal/liver function S troke B leeding history or predisposition L abile INR (International Normalized Ratio) E lderly (age…

…1 point) E thanol abuse (1 point) M alignancy (1 point) O lder age ( 75 years) (1 point) R educed platelet count or function (1…

…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…

…Manifestations include angina, other chest discomfort, dyspnoea, or no symptoms. Although chronic coronary disease may remain stable for prolonged periods, it can progress or destabilize…

…and death. The clinical consequences are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of…

…Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory…

…critically ill patient, AF may be pre existing, newly detected for the first time, or newly developed during management of an acute illness. The clinical…

…account for chronological age, biological age, frailty, multimorbidity, cognitive status, functional capacity, orthostatic symptoms, and treatment burden. Although older adults are often defined chronologically, age…