…Haemodynamic instability or cardiogenic shock Life threatening arrhythmias or cardiac arrest after presentation Mechanical complications of myocardial infarction Recurrent dynamic ECG changes suggestive of ischaemia…

…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…

…its major complications—including myocardial infarction, unstable angina and stroke—may occur abruptly and without preceding warning. Initiation and progression of the fatty streak The…

…association with other procedural complications, including distal embolization, coronary dissection, perforation, and abrupt closure. The clinical consequences depend heavily on the amount of viable myocardium…

…acute severe mitral regurgitation, and other mechanical complications. Shock occurs more often when the coronary artery is completely occluded and is particularly associated with MVD…

…if there is suspicion of cervical spine injury, in which scenario head tilt chin lift should only be used if other methods fail to open…

…of several possibilities: Extension of the original infarction or reinfarction Acute native vessel thrombosis Stent thrombosis Mechanical complications of myocardial infarction Pericarditis Dynamic recurrence of…

…does not determine the anticoagulation indication. Previous stroke or TIA. The presence of mitral stenosis, a mechanical heart valve or hypertrophic cardiomyopathy. Heart failure, hypertension…

…Use of synchronized electric shock (i.e. a shock synchronized to the QRS complex). Typically used to treat atrial fibrillation, ventricular tachycardia, and other tachyarrhythmias…

…agents Platelet transfusion has weak evidence; discuss with the on call coagulation service Always in parallel: mechanical control of bleeding, tranexamic acid where it is…

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

…pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of acute PE comprises four clinically useful groups: High risk…

…endotracheal intubation, mechanical chest compressions, targeted temperature management, etc.) and are much less effective in terms of the number needed to treat (NNT). The Number…

…except in a mechanical valve prosthesis and in moderate to severe mitral stenosis, where warfarin applies. Apixaban is often preferred, among other reasons because it…

…mechanical tricuspid prosthesis the lead must not be passed through the valve. The order of management in acute bradycardia Atropine is given in doses of…

…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…

…g skeleton, calcifications, mechanical heart valves) and reflect virtually all sound waves, leaving too few waves to explore the area behind the reflector. This results…

…that ensures that no other sound waves affect the transducer. The crystals are supported by a backing layer that suppresses the vibrations of the crystals…

…The occurrence of neoatherosclerosis helps explain why ISR and other stent related events may arise well after the initial intervention. Mechanical mechanisms Mechanical abnormalities may…

…resuscitated cardiac arrest, cardiac transplantation or mechanical circulatory support, nonfatal myocardial infarction, transient ischemic attack or stroke, and initiation of renal replacement therapy. The study…

…form of a sound wave. If the sound waves encounter a new medium, some sound waves will be reflected while others will transfer the mechanical…

…at any age. Exercise, or any other activity causing adrenergic stimulation, increase the risk of syncope, ventricular arrhythmias and sudden cardiac arrest. ARVC can cause…

…ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes…

…Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood…

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…

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

…C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease…

…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…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…are provoked by a change of position — turning over in bed, lying down, standing up, tilting the head backwards. A symptom free interval between attacks…

…cardiovascular complications (after acute myocardial infarction, unstable coronary artery disease, or stable angina pectoris): 75–80 mg tablet once daily. Prophylaxis against recurrence of cerebrovascular…

…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…

…C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression. As the burden of retained…

…aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The…

…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…

…The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome (ACS). Other cardiopulmonary causes…

…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…

…from selected populations, frequently with low or intermediate ischemic risk and under representation of patients with STEMI or other very high risk features. Noninferiority studies…

…of vascular autoregulation during a rapid or severe rise in BP. This may produce acute injury in the brain, retina, heart, aorta, kidneys, or other…

…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…

…as limb complications. Atherosclerotic lesions generally affect large and medium sized arteries. Pathological features include plaque formation with calcium deposition, medial thinning, destruction of muscular…

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

…beats per minute. Note that with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2…

…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…

…80% of men display ST segment elevations that are not caused by ischemia and a significant proportion have ST T changes caused by other pathological…

…1). This is possible by using two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves…

…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…

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

…most often not equal (which makes the PR interval appear as varying). Management of third degree AV block Please refer to Management of AV Blocks.

…at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist…

…marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of site The posterior superior…

…different position or a different vessel. Choice of site Vessel Advantages Disadvantages : : : Internal jugular vein (right) Best ultrasound conditions, a straight course to the superior…

…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…

…applies where you work. They assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick…

…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…

…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…

…rise can cause osmotic demyelination syndrome [1,2]. Hyponatraemia is primarily a disorder of water balance. The plasma sodium reflects the ratio between the body…

…A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance…

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

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