…associated with an increased risk of sudden cardiac death and ventricular arrhythmias. Figure 2. Fragmented QRS complex. These QRS configurations are also indicate of previous…

…Previous exacerbations and hospital admissions. Current inhaled treatment and adherence. Opioids, benzodiazepines and other sedating drugs. Thromboembolic risk, for example immobilisation, cancer and previous venous…

…very rare cases, TTP has been reported with ticagrelor treatment. TTP is characterized by thrombocytopenia and microangiopathic hemolytic anemia associated with neurological findings, renal failure…

…phenotype later and require delayed or individualized assessment. Disease specific genetic architecture HCM is predominantly associated with variants affecting sarcomeric proteins, particularly MYH7 and MYBPC3…

…LDL C. HDL cholesterol (HDL C) is inversely associated with cardiovascular risk in observational studies, but it is not a validated treatment target. Raising HDL…

…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…

…the more myocardium can be salvaged. Call the PCI service in parallel with drug treatment and transport planning [1,5]. Symptom duration Under 12 hours…

…rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks…

…reported with acetylsalicylic acid. Discontinue acetylsalicylic acid at the first sign of skin rash, mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other…

…by maintenance treatment. The source material does not specify the loading dose. Efficacy and harms In secondary prevention trials involving patients with previous vascular disease…

…HDL C is strongly associated with cardiovascular risk for both initial and on treatment assessment. In most studies, its association with cardiovascular risk is at…

…Factors associated with increased gastrointestinal bleeding include: Older age, with risk increasing particularly after 70 years Male sex Previous upper gastrointestinal disease Hepatic or renal…

…to transient ischaemic attack (TIA) or stroke. The risk associated with asymptomatic disease depends substantially on stenosis severity and plaque characteristics. In the general population…

…pattern. Duration and recurrence. Provoking and relieving factors. Associated symptoms. Similarity to previous documented angina or myocardial infarction. Atherosclerotic and thromboembolic risk factors. Relevant predispositions…

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

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiological rationale Dual antiplatelet therapy (DAPT) denotes treatment with aspirin plus a P2Y12 receptor inhibitor. In the…

…organ damage. Although BP reduction is required, these patients generally do not need hospital admission or intravenous treatment. Some patients with acute pain, anxiety, or…

…stenoses. Higher scores indicate more diffuse or technically complex disease and are associated with a greater relative advantage for CABG over PCI in multivessel disease…

…coronary, cerebrovascular or other peripheral arterial disease, and management should therefore address the entire arterial circulation. PAD is associated with increased cardiovascular morbidity and mortality…

…Smoking cessation is the complete discontinuation of tobacco smoking, with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine…

…persons with significant heart disease, predominantly ischemic heart disease. However, most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular…

…ECG has low sensitivity with respect to detecting biventricular hypertrophy. This is because the strong and oppositely directed forces tend to cancel each other out…

…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…

…administration. Radiotracers with higher levels of redistribution can move from areas of higher concentration to regions with lower concentration, for reasons other than perfusion differences…

…with straight (horizontal, upsloping, or downsloping) or convex ST segment strongly suggest acute transmural ischemia ( Figure 1 A ). Concave ST segment elevations, on the other…

…block: ECG criteria, clinical characteristics and management This chapter discusses third degree AV block, which is synonymous with AV dissociation, complete AV block, AV block…

…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…

…Three questions come up again and again on call: which dose, how long to interrupt treatment before a procedure, and how to reverse in bleeding…

…marrow metastasis. Assessment of treatment response and measurement of residual disease (MRD). Fever of unknown origin or suspected granulomatous disease with marrow involvement. Work up…

…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…

…half of ocular myasthenia, thereafter MuSK and LRP4 antibodies) and on neurophysiology (repetitive nerve stimulation with a decrement ≥ 10 % at 3 Hz, sensitivity about 75…

…below are taken from the recommendations of Strama Stockholm for the empirical antibiotic treatment of adults in hospital and in residential care homes (SÄBO) 2025…

…acute aortic syndrome, marked neurological organ damage, or treatment with sodium nitroprusside. In most hypertensive emergencies the following is aimed for: 1. Lower the mean…

…the glucose should therefore be checked with a capillary or venous measurement [5]. Treatment The awake patient who can swallow safely Give 15 to 20…

… 2. Is the hyponatraemia acute or chronic? Severe symptoms require immediate treatment with hypertonic sodium chloride, whether the hyponatraemia is acute or chronic. The aim…

…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…

…Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and organ dysfunction must therefore be managed as…

…overt tamponade with shock there are no absolute contraindications other than the conditions in which the procedure is the wrong treatment : Aortic dissection with haemopericardium…

…conservative treatment — modification of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other…

…The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous) pacing in bradycardia with haemodynamic compromise…

…is disputed and practice differs between units. Poisoning with other weak acids where the poison control centre recommends it, for example certain phenoxy acid herbicides…

…valve with coarctation or additional risk factors 55 mm (ascending aorta, aortic arch) All individuals 60 mm (descending aorta) All individuals Risk factors : previous dissection…

…insufficient kidney function, and treatment with antiplatelet agents. Research indicates that the ORBIT score may offer better discrimination and calibration for major bleeding events compared…

…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…

…widely recognized and validated tool used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF) who are taking anticoagulants…

…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 management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial infarction (MI) care. Despite their proven morbidity…

…arrhythmias, and heart failure are among the conditions associated with myocardial injury. Relationship to chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical…

…the extent of circulatory compromise. Features associated with an unfavourable short term prognosis include: Tachycardia Low systolic blood pressure Respiratory insufficiency, manifested by tachypnoea and…

…effects on the cardiovascular system. Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias…

…activity may be widespread rather than confined to a single lesion. Plaque composition is heterogeneous. Lipid rich, macrophage rich plaques are commonly associated with ru

…Immediate cardioversion is reserved primarily for instability. Evaluation and physical examination Initial assessment should establish whether AF is associated with acute haemodynamic compromise, pulmonary oedema…

…dynamic and may improve or worsen with illness, treatment, or other interventions. Frailty commonly overlaps with multimorbidity and is frequent in patients with cardiovascular disease…

…effective treatments, although several randomized controlled trials are underway. Figure 1. As of March 25 (2020), there have been more than 530,000 individuals with…

…or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic, rare lipid, or BP disorders Pregnancy Established ASCVD includes previous acute coronary syndrome…

…may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is particularly associated with elevated central venous pressure, which is transmitted to…

…alongside standard treatment. Interleukin 1β inhibition Canakinumab reduced inflammatory biomarkers without affecting lipids or other major coronary risk factors. In patients with previous myocardial…

…and other mechanical complications. Shock occurs more often when the coronary artery is completely occluded and is particularly associated with MVD. Patients with ACS and…