…attacks without a clear trigger: consider vestibular migraine, Ménière's disease, TIA and arrhythmia, among others. Acute severe balance disturbance without nystagmus: HINTS does not…

…is usually normal when the patient is not experiencing ischaemia. A minority of patients have clinical evidence of systemic vasospasm, particularly migraine or Raynaud phenomenon…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…complex fibroatheroma. Smooth muscle cells (SMCs) migrate from the tunica media into the intima, driven by platelet derived growth factor (PDGF) and other cytokines. Within…

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

…other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive ventilation is not…

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

…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…

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

…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…

…Suggests : : Nystagmus that is purely vertical, downbeating or direction changing Central cause Nystagmus without latency that does not fatigue Central cause New headache, neck pain…

…not administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other…

…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…

…drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be prescribed routinely to individuals without established ASCVD…

…evaluation of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of severe asymptomatic stenosis is low, screening has not been shown…

…faintness, and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured…

…cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However, association is not the same as causation . A…

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

…describes severe hypertension without clinical evidence of acute, ongoing target organ damage. Although BP reduction is required, these patients generally do not need hospital admission…

…treatment. Revascularization improves angina related health status, but it should not be undertaken when symptoms are present without anatomical or physiological criteria supporting revascularization. In…

…also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention. Clinical assessment should include functional status and walking capacity…

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

…be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals. Atrial flutter causes characteristic…

…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…

…is given. An ECG without ischemic ST T changes when recording during chest pain is not consistent with myocardial ischemia. In other words, chest pain…

…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…

…radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect…

…but they do not rule out ischemia. Other features of ischemic ST segment elevations In STE ACS (STEMI) the level of the J point is…

…atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular…

…expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90…

…other DOACs are possible according to FASS, but the documentation is insufficient; check more frequently. Warfarin is often preferable <15 or dialysis DOACs are not…

Procedurer Aspirate and biopsy answer different questions and do not replace one another: the aspirate shows cellular morphology and provides material for flow cytometry and…

…Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central…

…leaves no specimen . That makes the choice of lesion the critical point: never freeze anything whose diagnosis you have not established. Indications Lesion Freeze time…

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

…without other acute organ damage can often be treated more cautiously with oral drugs under careful observation [3,4]. A markedly raised blood pressure without…

…is normalised [3]. A healthy person without diabetes therefore does not normally need investigation on the basis of an isolated, asymptomatic low sensor reading alone…

…The aim is to relieve the cerebral oedema quickly, not to normalise the plasma sodium. Chronic or minimally symptomatic hyponatraemia must be corrected in a…

Referensvärden "Liver function tests" mainly measure damage , not function. The tests that reflect the synthetic function of the liver are the prothrombin time (INR) , the…

…pregnant women, patients after allogeneic stem cell transplantation and patients treated with CAR T cells or other advanced immunotherapies may require separate local protocols. Definition…

…it does not exclude Diastolic collapse of the right atrium and right ventricle The cardinal echocardiographic finding A dilated inferior vena cava without respiratory variation…

…water soluble and short acting, not a depot preparation, and gives a shorter duration of effect. Lidocaine 10 mg/mL without adrenaline , 2–5 mL…

…pacing — pads applied but the device not switched on — in second degree AV block Mobitz type 2, newly discovered complete heart block without current symptoms…

…simple — bicarbonate and a look at the urine dipstick — but it fails routinely for one single reason: without normal potassium the urine cannot be alkalinised…

…Definition of aortic aneurysm Sinus of Valsalva 45 mm. Any other segment 40 mm in diameter. Thresholds for surgery Threshold for surgery Relevant patient category…

…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…

…AF patients. Evidence suggests that the increased stroke risk in women is more closely associated with other comorbidities and age rather than sex alone. Consequently…

…higher indicates high risk of major bleeding Note that a high HAS BLED score should not be used as a reason to withhold anticoagulation therapy…

…HEMORR₂HAGES score. Comparison with ATRIA and HAS BLED Scores Several studies have compared the predictive performance of HEMORR₂HAGES with other bleeding risk assessment tools, notably…

…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…

…whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or…

…congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease, active cancer, and other conditions incorporated into validated clinical risk tools Acute…

…atrial fibrillation. Consequently, alcohol should not be initiated as a cardiovascular preventive strategy. A drink equivalent contains approximately 12–14 g of ethanol. Representative quantities…

…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…

…organs other than the brain. Patients with AF in the setting of ACS have more comorbidities and a higher risk of complications than patients without…

…have greater consequences in frail patients. Clinical Assessment Frailty and Functional Status Treatment decisions should not be based on age alone. Assessment should include: Degree…

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

…In contrast, patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification for that treatment decision. Population to which SCORE2 and SCORE2…