…P wave PR interval QRS complex ST segment T wave U wave QT (QTc) interval Pediatric and neonatal electrocardiograms differ markedly – in terms of rhythm…

…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…

…cells, macrophages, neurons and other tissues. This distribution helps explain why PA produces cardiovascular injury beyond its effects on blood pressure and potassium balance. The…

…87 95% confidence interval: 0.79–0.96 P = .004 Other summaries of the trial describe a 14% reduction in the same composite outcome…

Cardiology Key points Levosimendan alleviates heart failure symptoms, increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of…

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

…sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive…

…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…

…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…

…2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based on symptoms, the ECG…

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

…Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing bleeding risk. Monitor coagulation…

…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…

…with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic cardiovascular…

…stenosis have no focal neurological symptoms. Asymptomatic disease may be discovered during targeted duplex ultrasound (DUS), pre operative assessment, or evaluation of other atherosclerotic disease…

…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…

…Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction…

…syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI), or medical…

…impair autoregulation and cause ischemia Acute rapid reduction may cause harm without prognostic benefit Clinical Presentation and Symptoms Symptoms depend on the organ system involved…

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

…symptoms. Many have impaired walking or a slow gait without describing classic claudication. In older adults, approximately 40% are asymptomatic, 50% report atypical leg symptoms…

…with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption…

…most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals…

…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…

…1 A ). Concave ST segment elevations, on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted…

…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…

…rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible according to FASS, but the documentation is insufficient; check…

…Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather…

…the use of ultrasound throughout the puncture, and maintaining maximal barrier precautions without shortcuts. The most common serious error is dilating a vessel that turns…

…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…

…AV block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise…

…the separate quick reference for dosing in impaired renal function. Respiratory tract Diagnosis Agent Dose Duration : : : : Pneumonia, non severe (DS CRB65 0–1) phenoxymethylpenicillin 1…

…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…

…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…

…1. Assess airway, breathing and circulation. 2. Assess the neurological symptoms and at the same time exclude other acute causes, for example hypoglycaemia, poisoning, stroke…

…Drug induced liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome, haemolysis The R value = (ALT / upper limit…

…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…

…respiratory variation in mitral and tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other…

…rehabilitation possible, not an alternative to it. See the separate guide to joint aspiration and injection. Indications Condition Injection site Comment : : : Subacromial bursitis, rotator cuff…

…on — in second degree AV block Mobitz type 2, newly discovered complete heart block without current symptoms, alternating bundle branch block in acute anterior infarction…

…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…

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

…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…

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

…troponin attributable to myocardial ischaemia. UA presents with compatible ischaemic symptoms but without cardiac specific troponin elevation above the 99th percentile. The clinical presentation should…

…tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease, active cancer, and other…

…drinking in either sex. Other definitions of unhealthy drinking include at least two drinks daily in women or three in men, or at least four…

…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…

…in new onset AF should not automatically be labelled type 2 myocardial infarction without further assessment. Clinical presentation and symptoms The clinical presentation is heterogeneous…

…frailty, multimorbidity, cognitive status, functional capacity, orthostatic symptoms, and treatment burden. Although older adults are often defined chronologically, age thresholds are intrinsically arbitrary. A fit…

…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…