…the context of pregnancy, hypovolemia and other etiologies of hypotension remain the predominant causes of cardiac arrest. Should cardiac arrest occur postpartum, hemorrhage must be…

…points in the epicardial coronary arteries. Early lesions may undergo positive or compensatory remodelling, in which the vessel enlarges outward before a major reduction in…

…Exclude intracerebral haemorrhage and assess early ischaemic changes CT angiography The standard investigation in acute stroke to identify large vessel occlusion, dissection or other vascular…

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

…on call early. In cirrhosis or suspected variceal bleeding, also contact a gastroenterologist with hepatology expertise 9 Activate the local major haemorrhage protocol in uncontrolled…

…risk factor [2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities, does not significantly increase stroke risk. Conversely…

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

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

…the type of oral anticoagulant used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES, ATRIA…

…of HEMORR₂HAGES with other bleeding risk assessment tools, notably ATRIA and HAS BLED: HAS BLED Score: In a study evaluating bleeding risk prediction in AF…

…by increased serious gastrointestinal bleeding and a non significant increase in cerebral haemorrhage. Bleeding outcomes The principal harm of aspirin in primary prevention is bleeding…

Akutsjukvård Psykiatri Lathundar Delirium in older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work…

…smooth surface and a nucleus that often exhibits cavities, which consist of hemorrhages in the tumor. Polypoid myxoma usually causes haemodynamic complications due to obstruction…

…is defined by a markedly raised blood pressure in combination with new or progressive acute target organ damage. Common manifestations are hypertensive encephalopathy, intracerebral haemorrhage…

…the right place. In suspected bacterial meningitis it is the time to antibiotics that saves the patient — the puncture must never delay it. Indications Suspected…

…intoxication, or other sympathomimetic exposure, including methamphetamine. Abrupt withdrawal of antihypertensive medication, particularly clonidine, can also precipitate a hypertensive crisis. Pregnancy Hypertensive emergencies in pre

…disease Cardiomyopathy Stroke or subarachnoid haemorrhage Takotsubo syndrome Pulmonary embolism Recent coronary revascularization Infiltrative disease, such as amyloidosis or sarcoidosis Other cardiac procedures Chemotherapeutic agents…

…Ménière's disease, TIA and arrhythmia, among others. Acute severe balance disturbance without nystagmus: HINTS does not apply. Assess gait and truncal stability and investigate…

…imbalance between myocardial oxygen supply and demand. In many cases, the initiating process is plaque disruption with thrombosis; other cases result from spasm, microvascular dysfunction…

…Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation be entirely inhibited (as seen in acute airway…

…and they tend to accompany each other. Therefore, the term perimyocarditis is often used in clinical practice (this article will use all three terms interchangeably…

…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…

…dyspnoea in a patient with COPD. Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered [1]. Do the following early…

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

…particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance or metabolic syndrome Elevated triglycerides Low or apparently well controlled LDL C…

…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…

…NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical…

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

…NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or duodenal ulcers. Liver cirrhosis. Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy…

…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…

…contained in all apoB containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride…

…or other atherosclerotic disease; diabetes and other cardiovascular risk factors; smoking, hypertension, hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral…

…although some series report 10–20%. Other life threatening cardiopulmonary conditions account for approximately 5% of presentations in some populations. Despite this relatively low prevalence…

…1960s. In 1948 the NHLBI initiated the Framingham Heart Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were…

…with STEMI or other very high risk features. Noninferiority studies designed mainly around bleeding outcomes may not reliably exclude clinically important differences in ischemic events…

…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…

…where possible, other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption but to achieve complete abstinence from tobacco…

…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…

…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…

…ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or other…

Echocardiography Continuous Wave Doppler In continuous wave Doppler (CW Doppler), ultrasound waves are continuously emitted from the transducer and the reflections of these waves are…

…In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted in…

…ST segment may have a concave appearance if the T wave is prominent (such as in hyperkalemia, early repolarization or even early phases of ischemia)…

…3. In third degree AV block, no atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other…

…and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90, women 0.85 = abdominal…

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

…compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

…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…

…That makes the test useful only if you have selected an objectively measurable finding in advance — usually ptosis or fatigable gaze palsy — that can be…

…hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick reference for dosing in impaired renal function. Respiratory tract…

…a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms…

…not to normalise the plasma sodium. Chronic or minimally symptomatic hyponatraemia must be corrected in a controlled fashion, since too rapid a rise can cause…

…pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of…

…pathway when needed 9 Contact the haematologist or oncologist. Contact an infectious diseases physician early in a high risk course, in instability, with resistance problems…

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

…Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in the adjacent joint…

…The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous) pacing in bradycardia with haemodynamic compromise…

…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…