…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…

…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…

…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…

…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…

…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…

…mortality than non variceal bleeding [1,2]. Upper gastrointestinal bleeding can present as haematemesis, coffee ground vomiting or melaena. Haematochezia can occur in massive upper…

…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…

…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…

…with reported reductions of up to 50–55% in guideline summaries. It also lowers non HDL C by up to approximately 50% and apolipoprotein B…

…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…

…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…

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…

…Less commonly, autosomal recessive inheritance. X linked or other non autosomal dominant mechanisms. Complex or multifactorial genetic architecture. The inheritance pattern affects the appropriate scope…

…systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical cul de sac [19] …

…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…

…The absence of thallium uptake indicates non viable myocardium, while redistribution into initially hypoperfused regions suggests viability. What is myocardial redistribution? In myocardial perfusion imaging…

…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…

…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…

…not routinely undergo immediate angiography. A selective or delayed approach is recommended in this setting unless other findings justify urgent intervention. Risk scores Several risk…

…and other tachyarrhythmias with discernible QRS complexes. Shockable rhythm : Tachyarrhythmias that can be treated with defibrillation (ventricular fibrillation) or cardioversion (ventricular tachycardia). Non shockable rhythm…

…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…

…condition) In addition to these five conditions, there are numerous other causes of chest pain, but the other causes are either subacute or non acute…

…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…

…bleeding complications. The CHA₂DS₂ VA score is a clinical tool designed to assess stroke risk in patients with non valvular atrial fibrillation (AF). It is…

…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…

…or cardiac arrest–particularly during physical activity–in a young adult with T wave inversions in V1–V4, or other ECG changes (see below) should…

…on the other hand, attempts to restore sinus rhythm by use of antiarrhythmic drugs. Randomized controlled trials have not demonstrated any clear difference in mortality…

…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…

…not recommended in patients undergoing urgent non cardiac surgery or those with an unstable clinical condition. In patients with suspected or established non ST segment…

…hypertension. Developing and non Western countries rarely display the blood pressure trajectories and high prevalence of hypertension that is ubiquitous in high income Western countries…

…a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non HDL C provides a broader estimate of atherogenic cholesterol than LDL…

…the clinical importance of non fatal gastrointestinal and intracranial haemorrhage is substantial, particularly because the absolute cardiovascular benefit is small in many primary prevention populations…

…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…

…infarction Definition and clinical concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of…

…the possible causes, apply several non pharmacological measures at the same time, and use drugs only in severe agitation or marked distress. Delirium is an…

…NSTEMI, Non STEMI) and STE ACS (STEMI) is slightly simplified. In reality, the course in acute myocardial infarction (AMI) is modified by several factors. The…

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

…ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or other…

…Consequently, the decision to prescribe colchicine requires attention to the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes…

…interpretation in the context of the clinical presentation and other findings. A reduced CFR may occur with angiographically insignificant epicardial disease because of abnormalities in…

…Non HDL C and apoB are secondary targets or risk refining measures, particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance…

…NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical…

…et al. Epidemiology and outcome of adult out of hospital cardiac arrest of non cardiac origin in Osaka: a population based study. BMJ Open 2014…

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

…asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other contraindications: Hemophilia. Thrombocytopenia. Active gastric or duodenal ulcers…

…of secondary hypertension cases. Coarctation of the aorta and renovascular disease are important non endocrine causes, particularly in patients with resistant hypertension. Dietary sodium and…

…elevations in cardiac troponin concentrations. Based on the presenting electrocardiogram (ECG) and the presence of troponin elevation, ACS are classified into unstable angina (UA), non…

…used for non pregnant adults. The fetus is not harmed by defibrillation, amiodarone, or adrenaline (epinephrine). In the event of a cardiac arrest in a…

…may remain elevated thereafter. The overall health benefit is greater still when reductions in non cardiovascular morbidity and mortality are included. Clinical presentation and assessment…

…generally younger than those with atherosclerotic non ST elevation acute coronary syndromes. Cigarette smoking is a prominent association, whereas other conventional coronary risk factors may…

…2]. In a meta analysis of three phase 3 trials, tenecteplase was non inferior to alteplase with respect to an excellent functional outcome, without an…

…is used in adults aged ≥70 years. SCORE2 OP accounts for the competing risk of death from non cardiovascular causes, an important consideration in older…

…the most favourable patterns generally contain more minimally processed, fibre rich and bioactive foods, including fruits, non starchy vegetables, beans, whole grains, nuts and seeds…

…MI and non ischaemic myocardial injury may coexist, and certain disease entities can span both categories; for example, acute heart failure may occur in the…

…tendon. Measure in the same way as on the arm. 4. Posterior tibial artery — behind the medial malleolus. Measure. 5. Repeat on the other leg…

…coenzyme A reductase in the cholesterol synthesis pathway. Inhibition of ACL reduces hepatic cholesterol synthesis and produces reductions in LDL C, non high density lipoprotein…

…particularly in the broader assessment of peripheral arterial and aortic disease; planned surgery, especially carotid endarterectomy (CEA), coronary artery bypass grafting (CABG), or major non…

…intoxication, or other sympathomimetic exposure, including methamphetamine. Abrupt withdrawal of antihypertensive medication, particularly clonidine, can also precipitate a hypertensive crisis. Pregnancy Hypertensive emergencies in pre

…account for attenuation and other technical factors. Relative perfusion assessment has an important limitation: it requires a normally perfused reference territory. In diffuse coronary disease…

…and/or fall in cTn values. An elevated cTn alone does not establish MI, because myocardial injury may occur without myocardial ischaemia. Non ischaemic myocardial…