…3. Give oxygen in hypoxaemia. 4. Start an inhaled short acting β2 agonist immediately. 5. Add ipratropium in a severe or life threatening attack. 6…

…Definition and pharmacological basis Ezetimibe is a non statin lipid lowering agent that inhibits the Niemann–Pick C1 like 1 (NPC1L1) transporter in the intestine…

…than by a distinct advantage of one drug over the other. Mathew et al. Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock…

…activation of the piezoelectric crystals. The crystals are activated from one side to the other, as illustrated in Figure 2. The sequence of activation goes…

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…

…abdominal pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile…

…line, on level with V4. V6: placed on level with V4 and V5, in the mid axillary line. V4R: placed on the right medioclavicular line…

…To calculate flow across a valve, the Doppler line is placed in the valve orifice. The ultrasound machine displays the recorded flows as the spectral…

…risk of CAD. In patients with a high to very high risk of CAD, invasive coronary angiography is the first line option. Coronary computerized tomography…

…Its primary clinical utility in contemporary practice is late line therapy for patients who remain profoundly symptomatic despite optimal neurohormonal blockade and adequate volume control…

…below). This chapter presents recommendations for conducting a standard transthoracic echocardiographic (TTE) examination and it is in line with guidelines issued by ASE, EACVI and…

…arrest and in the uncontrolled emergency — but it should be changed or removed once the situation has stabilised. Preparation and equipment A central line set…

…treatment is required if there is concomitant acute life threatening organ damage. Isolated malignant retinopathy without other acute organ damage can often be treated more…

…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…

…resorption. Other conditions in which high flow oxygen is given irrespective of the saturation according to international guidelines are decompression sickness and sickle cell crisis…

…disorder, provided that the clinical characteristics are in line with the disorder. There are however other disorders that may bring about similar ECG changes, and…

…likely that the coming guidelines by the American Heart Association (AHA) and American College of Cardiology (ACC) will be in line with the European guidelines…

…on the other hand, is caused by a complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive…

…likely that the coming guidelines by the American Heart Association (AHA) and American College of Cardiology (ACC) will be in line with the European guidelines…

…into the mediastinum. The anterior superior iliac spine is a second line alternative in marked obesity or when the supine position is necessary. After previous…

…the blood pressure in several ways. Monoamine oxidase inhibitors can cause a hypertensive crisis through interactions, while venlafaxine and higher doses of bupropion, among others…

…be measured in the sitting position . 2. Identify the level. Palpate both iliac crests and draw an imaginary line between them. The line crosses the…

…for other reasons. Extubate as soon as it is safe to do so after the endoscopy. Fluid and monitoring Use a balanced crystalloid in the…

…with or without other LDL C lowering drugs, when additional LDL C reduction is required, including in patients with atherosclerotic cardiovascular disease (ASCVD) or heterozygous…

…wave, it is still referred to as a QRS complex . In other words, if ventricular depolarization only generates a Q wave and an R wave…

…WPW syndrome) and other conditions involving an accessory pathway. Paroxysmal atrial fibrillation in patients with severe symptoms, provided that first line therapies have failed and…

…220 msec. The PR segment is the flat line between the end of the P wave and the start of the QRS complex. The PR…

CPR Time is the most critical factor for survival in cardiac arrest. Life saving interventions must be initiated momentarily to maximize the probability of survival…

…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…

…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…

…itself. It may cause symptoms and impaired quality of life, contribute to heart failure, and increase the risk of stroke and other thromboembolic events. Subclinical…

…you find one magnet, actively look for another , in the other nostril, in the ears and in the mouth. Nose 1. Ask the patient to…

…illness, treatment, or other interventions. Frailty commonly overlaps with multimorbidity and is frequent in patients with cardiovascular disease, including heart failure and ischaemic heart disease…

…in a nationwide cohort. J Thromb Haemost . 2011;9(8):1460 1467. doi:10.1111/j.1538 7836.2011.04378.x. 5. Apostolakis S, Lane…

…or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients with left ventricular dysfunction and/or MVD…

…if other methods fail to open the airway. Figure 1. Methods to open the airway. No large study has compared oropharyngeal and nasopharyngeal airways in…

…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…

Echocardiography Ultrasound artifacts The following artifacts are common in ultrasound imaging: The ultrasound image displays non existing structures. The ultrasound image does not display existing…

…may provoke life threatening ventricular arrhythmias. Patients with previous acute coronary syndromes (ACS) Exercise stress testing is routinely performed after acute myocardial infarction in order…

…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…

…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…

…Emergency medicine Procedurer Definition and Pathophysiology Cardiac tamponade is a life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular…

…in some cases up to 6 hours or more. Discuss this with the poison control centre. Gastric lavage is considered only after a life threatening…

…10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle. In other words, the heart…

…current ($I {Na}$) and are identified in 20% to 30% of probands [7] . Historically, expanded genetic panels implicated over 20 other genes (e.g.…

…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…

CPR This chapter will introduce the most common and essential terms used in resuscitation science, providing a foundation for understanding subsequent chapters. SCA (Sudden Cardiac…

…mentioned below are discussed in detail in other chapters, to which links are provided throughout the text. Heart rate During the first week of life…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…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…

…over extensor tendons, are characteristic clinical manifestations of untreated FH and may develop when the disorder is not recognized early in life. Corneal arcus and…

…ECG interpretation will frequently be a matter of life and death. ECG interpretation is a sophisticated art, even in the current era of artificial intelligence …

…scores in patients with atrial fibrillation undergoing anticoagulation: the AMADEUS study. J Am Coll Cardiol . 2012;60(9):861 867. 3. Pisters R, Lane DA…

…as the syndrome associated with ischemic heart disease is broader than chest pain itself, encompassing symptoms like tightness, pressure, and discomfort in the chest, arms…

…The table below shows a systematic history taking in patients presenting with chest pain (chest discomfort) or other symptoms suggestive of the five conditions listed…

…of the left ventricle . Patients with DCM typically develop heart failure early in life and a family history of heart failure, ventricular arrhythmias or sudden…

…in the United States alone, yet no reliable model currently exists for the long term prediction of sudden cardiac arrest. The constraint does not lie…

…suction, a bag and mask, and access to equipment and competence for advanced life support in the room. Two people: one who injects and monitors…

…blood flow to vital organs such as the brain and kidneys. Maintaining MAP within an optimal range is crucial in managing conditions like sepsis, trauma…

…in the groin or on the neck Bleeding, vascular injury, pseudoaneurysm Surgeon, ultrasound first Other situations that argue for the operating theatre rather than the…