…Symptoms depend on the organ system involved. Possible manifestations include headache, visual disturbance, chest pain, dyspnoea, dizziness, and neurological deficits. Neurological involvement Hypertensive encephalopathy may…

…infarction—patients may develop hypotension and signs of end organ hypoperfusion. In severe cases, bradycardia may progress to bradyarrhythmic arrest or pulseless electrical activity (PEA)…

…Abnormal urinalysis or renal imaging Mild progression risk, increased by proteinuria 3a 45–60 mL/min/1.73 m² Cardiovascular disease or other organ damage…

…serial examinations. If pathology is discovered during the standard examination, other examinations (which are not included in the standard examination), may be warranted. For most…

…fibrillation, particularly when other therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across multiple organ systems…

…disease or scleroderma renal crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing or new organ damage in which…

…end organ perfusion caused by cardiac insufficiency. Sustained hypoperfusion reduces oxygen and nutrient delivery and, when severe or prolonged, produces multiorgan dysfunction and death. In…

…important precautions. A hypertensive emergency is defined by a markedly raised blood pressure in combination with new or progressive acute target organ damage. Common manifestations…

…to elevated blood pressure Other cardiovascular risk factors and relevant comorbidities Evidence of hypertension mediated organ damage Existing cardiac, cerebrovascular, or renal disease The possibility…

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

…CKD) Hypertension mediated organ damage (HMOD) Probable or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic, rare lipid, or BP disorders Pregnancy…

…the heart pumps and the resistance encountered in the systemic circulation. Therefore, alterations in heart rate, stroke volume, or vascular tone can significantly impact MAP…

…and kidney disease All patients with diabetes should be assessed for: ASCVD Severe target organ damage (TOD) HF AF CKD Other clinically relevant cardiovascular disease…

…excellent, with the vast majority of patients recovering completely after restoration of sinus rhythm (or any other rhythm with normal ventricular rate and activation). Recovery…

…and other thromboembolic events. Subclinical cerebral injury may contribute to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with AF in…

…into the mediastinum. The anterior superior iliac spine is a second line alternative in marked obesity or when the supine position is necessary. After previous…

…particularly cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac amyloidosis, BNP or NT proBNP may be markedly elevated even when overt congestion is not…

…and enter the systemic circulation which causes thromboembolic occlusions of arteries in the brain, limbs or other organs. However, the increased risk in mortality is…

…accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI. QTc prolongation The QT (QTc) interval may be prolonged, shortened or…

…consciousness, or when NIV is being considered. 4. Give short acting bronchodilators. 5. Give a systemic corticosteroid if the exacerbation is more than mild. 6…

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

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

…targets or risk refining measures, particularly in patients with: Diabetes or other cardiometabolic risk factors Obesity Insulin resistance or metabolic syndrome Elevated triglycerides Low or…

…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…

…serious arrhythmia or acute heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast not…

…test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks of vertigo, seconds to a minute or so…

…daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin—except low dose heparin)…

…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…

…discordant with LDL C or non HDL C, cardiovascular risk may be misestimated if cholesterol measures alone are used. Risk in these circumstances appears to…

…No demonstrated reduction in cardiovascular or all cause mortality. Absolute benefit is modest. Across the updated systematic review, absolute reductions in major ASCVD events ranged…

…or other atherosclerotic disease; diabetes and other cardiovascular risk factors; smoking, hypertension, hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral…

…in the chest and may extend to the arms, shoulders, neck, jaw, upper back, abdomen, or epigastrium. Dyspnoea, nausea, vomiting, diaphoresis, fatigue, faintness, and other…

…either one defect gene copy (heterozygous FH) or two defect gene copies (homozygous FH). Heterozygous FH results in high LDL cholesterol levels (but nothing else…

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

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

…a manifestation of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial…

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

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

…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…

…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…

Echocardiography Continuous Wave Doppler In continuous wave Doppler (CW Doppler), ultrasound waves are continuously emitted from the transducer and the reflections of these waves are…

…In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted in…

…ST segment may have a concave appearance if the T wave is prominent (such as in hyperkalemia, early repolarization or even early phases of ischemia)…

…3. In third degree AV block, no atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other…

…height in cm × weight in kg / 3600) m². Normal adult 1.6–2.0 m². Nutritional screening Unintentional weight loss 5 % over three months or…

…concomitant verapamil or increased bleeding risk Warfarin Individual, target INR 2.0 3.0 A mechanical valve may require a higher target Doses in venous…

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

…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…

…test useful only if you have selected an objectively measurable finding in advance — usually ptosis or fatigable gaze palsy — that can be assessed before and…

…has been achieved, 7 days in bacteraemia or cefotaxime plus metronidazole 1 g × 3 IV plus 1.5 g for the first dose, then 1…

…a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms…

…not to normalise the plasma sodium. Chronic or minimally symptomatic hyponatraemia must be corrected in a controlled fashion, since too rapid a rise can cause…

…pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of…

…and where no liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and…

…Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in the adjacent joint…

…all — pacing has no documented benefit there. Transcutaneous pacing: burns or wounds in the area where the pads would go. Transvenous pacing: the relative contraindications…

…time reduces the passage of salicylate into the central nervous system. Contact your national or regional poison control centre for advice on the treatment threshold…

…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…

…4 2.6% High risk 5 or more 5.8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment…

…S, et al. CHA₂DS₂ VASc or a non sex score (CHA₂DS₂ VA) for stroke risk prediction in atrial fibrillation: a cohort study. Eur Heart J …