…typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and…

…mild. 6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start…

Info Table 1 provides a summary of the indications, contraindications, dosage, administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary…

…and thromboembolic disorders. Most recognised heritable cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting the…

…density lipoprotein and chylomicron remnants. It is calculated as: Non HDL C = total cholesterol − HDL C Apolipoprotein B (apoB) reflects the concentration of circulating…

ECG Myocardial ischemia and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes…

…within 120 minutes Fibrinolysis within 10 minutes of the diagnosis, if symptom duration is under 12 hours and there is no contraindication After successful fibrinolysis…

…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…

…and other NSAIDs: Increased risk of gastrointestinal bleeding when combined with acetylsalicylic acid. Uric acid excretion agents (e.g., probenecid): Salicylates counteract the effect of…

…atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term antiplatelet therapy after STEMI…

…disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory…

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

…and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke. The…

…Other cardiopulmonary causes , including myopericardial disease, pulmonary embolism, aortic emergencies, and pneumothorax. Non cardiopulmonary causes , including gastrointestinal, musculoskeletal, and anxiety related disorders. The immediate objective…

…FH). Heterozygous FH results in high LDL cholesterol levels (but nothing else) and increases the risk of acute myocardial infarction by more than 50 times…

…In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography…

…necrosis of small arteries in the kidneys, retina, and brain. Its clinical retinal signature includes flame haemorrhages, cotton wool spots, and papilloedema. Associated complications may…

…other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator or institutional experience Assessment of coronary complexity The…

…over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma…

…infarction and limb threatening complications. Among patients with established peripheral artery disease, those who stop smoking have approximately twice the five year survival of those…

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

…This is because the strong and oppositely directed forces tend to cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy…

…myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of upper abdominal pain. An…

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

…tomographic images of the left ventricle. In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron, they annihilate each other…

…angle of observation. Other vectors may interfere with the injury currents, and inhibit them from being detected by leads with opposite angles of observation. The…

…unreliable, such that they may cease and thus cause cardiac arrest. Junctional escape rhythm is more reliable (the risk of cardiac arrest is considerably lower)…

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

…by the bleeding risk of the procedure and by renal function. In markedly reduced renal function (dabigatran at eGFR <30 mL/min, the other DOACs…

…the puncture went. Indications Unexplained cytopenia in one or more cell lines. Suspected acute leukaemia, myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging of…

…time Highest risk of pneumothorax, the vessel cannot be compressed after arterial puncture, technically more difficult with ultrasound Femoral vein Fastest, and does not interfere…

…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…

…obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked…

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

…Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to 120 mmHg…

…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…

…osmolality and urine sodium before treatment. 5. With severe symptoms: give hypertonic saline immediately. Do not wait for a complete work up of the cause…

…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…

…be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and organ…

…mitral and tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions…

…of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection over the…

…anteriorly over the praecordium to the left of the sternum, the other on the back between the left scapula and the spine. The anterolateral position…

…sodium and volume load becomes pure harm. Dialysis is then the way forward. Heart failure, pulmonary oedema and other conditions with a high risk of…

[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…

…Lane DA, Lip GYH. Evaluation of the HAS BLED, ATRIA, and ORBIT bleeding risk scores in atrial fibrillation patients on warfarin. Am J Med . 2016…

…GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182,678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur…

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

…3 Interpretation of HEMORR₂HAGES score. Comparison with ATRIA and HAS BLED Scores Several studies have compared the predictive performance of HEMORR₂HAGES with other bleeding risk…

…bradykinin and other tachykinins, such as substance P. When ACE is inhibited, the resulting accumulation of these peptides irritates afferent neural pathways in the respiratory…

…lower threshold for provocation, or symptoms that awaken the patient from sleep. Initial symptoms of NSTEMI and UA may be similar. NSTEMI is diagnosed when…

…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…

…Progressive dilation can subsequently impair left ventricular ejection fraction. Enlargement of the left ventricle predisposes to atrial and ventricular arrhythmias. In advanced alcohol related cardiomyopathy…

…present during the second and third decades of life, while clinical manifestations commonly emerge much later. Despite this prolonged course, its major complications—including myocardial…

…affect organs other than the brain. Patients with AF in the setting of ACS have more comorbidities and a higher risk of complications than patients…

…Consequently, isolated systolic hypertension and widening pulse pressure are common in later life. These changes contribute to the complexity of defining an appropriate treatment target…

…outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections…

…adults with elevated blood pressure (BP), in whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast…

…The cardiovascular burden of CKD extends beyond CAD to peripheral arterial disease, cerebrovascular disease, valvular heart disease, heart failure, atrial fibrillation, and other arrhythmias or…

…colchicine requires attention to the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes. Mechanisms of action Colchicine Colchicine…

…the principal precipitating mechanisms include ischaemia related heart failure, acute severe mitral regurgitation, and other mechanical complications. Shock occurs more often when the coronary artery…