…are placed proximally on the upper arm. Placement of chest (precordial) electrodes are not changed but additional leads may be attached in children under the…

…has no place in the modern treatment of poisoning. Charcoal also does not bind every poison. With the following substances charcoal is ineffective and management…

…arterial disease, and other very high risk settings described in the source material. The statin should be prescribed at the highest tolerated dose. When LDL…

…wide QRS complex and a pulse that can be felt. The other predictable error is forgetting that pacing hurts a great deal in a conscious…

…from all sides and on which the patient's head can hang over the end. A pillow to place under the shoulders as an alternative…

Cardiology Definition and pathophysiology Low density lipoprotein cholesterol (LDL C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing…

…how the patient is positioned, which needle is chosen, and that the tubes go to the right place. In suspected bacterial meningitis it is the…

…washes nitrogen out of the pleural air and speeds resorption. Other conditions in which high flow oxygen is given irrespective of the saturation according to…

…Mix the corticosteroid and the lidocaine in the same syringe. The anaesthetic confirms that the injection has gone to the right place — immediate pain relief…

…In case of suspicion of pericardial disease, it is important to conduct a careful investigation as several conditions may affect hemodynamics and the underlying cause…

…tissue — the acidic environment inactivates the anaesthetic. Place a field block in healthy skin around the abscess instead of injecting into it, and expect the…

…mmHg/s) and note the pressure at which the signal returns. Repeat on the other arm. 2. Ankle pressure. Place the cuff just above the…

…the clinical importance of improved adherence remains dependent on sustained follow up and administration. Clinical indications and place in therapy Inclisiran has been approved in…

…and wait a few minutes. 4. Make a small skin incision with the scalpel. 5. Aspiration: advance the needle with the stylet in place perpendicular…

…appear as moving masses. Mural vegetations are attached to the endocardium and, accordingly, less mobile. Echocardiography is the first place method for detecting vegetation in…

…to the other, as illustrated in Figure 2. The sequence of activation goes from right to left and then from left to right, and this…

…a) and flow velocity (v): Q = a • v This principle can be used to estimate blood flow across the valves. As illustrated in Figure…

…at the aortic valve plane in the parasternal short axis view. SV tricuspid = Area RVOT • VTI RVOT Continuity equation and valvular regurgitation The continuity…

…model provides the best agreement with anatomic data, as compared with other segmentation models. Figure 1. Standardized myocardial segmentation and nomenclature for echocardiography. The left…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…the lead in the other chamber, resulting in inappropriate inhibition of the pacemaker in the latter chamber. This type of oversensing is referred to as…

…using the Cabrera format. As evident in Figure 3, if leads I, II and III would have been displayed next to each other, the T…

…when the leg is placed in a dependent position. With advanced disease, rest pain may become persistent. Tissue loss, ulcers and gangrene may develop. In…

…contract as much as the cells in the basal parts. Since the apex is fixed and there are longitudinal muscle fibers stretching from the apex…

…particularly important as a marker of potentially severe disease. The presence of haemodynamic instability places the patient in the high risk category and requires urgent…

…are modified by the direction of movement of the sound source. Figure 1 presents three trumpets; one placed on a table, and two are mounted…

…node is the heart’s pacemaker under normal circumstances and the rhythm is referred to as sinus rhythm . An arrhythmia is defined as an abnormal…

…as its inner diameter, is strongly related to heart failure, ventricular tachyarrhythmias, and overall mortality. Ventricular dimensions are measured using an electronic caliper, with the…

…types of myocardial cells may be engaged in initiation and maintenance of this arrhythmia. As mentioned above VT causes hemodynamic compromise. The rapid ventricular rate…

…has compared oropharyngeal and nasopharyngeal airways in cardiac arrest. Endotracheal (tracheal) intubation is considered the most reliable airway provided that it is placed by experienced…

…activation starts in the right ventricle and spreads slowly to the left ventricle. As mentioned above, this is similar to the situation in left bundle…

…illustrates the vectors in the horizontal plane. Study Figure 7 carefully, as it illustrates how the P wave and QRS complex are generated by the…

…complex The definition of fragmented QRS complexes ( Figure 2 ) are as follows: QRS complex with more than 1 R wave and/or notch in the…

…ventilation. Home oxygen and the patient's usual saturation. Previous exacerbations and hospital admissions. Current inhaled treatment and adherence. Opioids, benzodiazepines and other sedating drugs…

…interpreting platelet function tests for HIT. Other cosiderations Based on a relationship observed in the PLATO study between the maintenance dose of ASA and the

Cardiology Genetic and miscellaneous conditions Definition and scope Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who…

…ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source…

…Overview Acute coronary syndrome comprises STEMI, NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG…

…80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin…

… reduce ischaemic stroke and cardiovascular mortality; prevent stent thrombosis after PCI; reduce recurrent atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention…

…LDL C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression. As the burden of…

…effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to…

…and plaque characteristics. In the general population, the prevalence of asymptomatic carotid stenosis of at least 70% is low, reported as 0–3.1%. In…

…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…

…studies and randomized controlled clinical trials. This knowledge has been translated into remarkable advances in the management of coronary artery disease, as demonstrated in the…

…In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography…

…The objective is to reduce aortic wall shear stress and rapidly lower systolic pressure. Renal and microvascular complications Renal involvement may manifest as deterioration in…

…CABG over PCI in multivessel disease. A British Cardiovascular Intervention Society myocardial jeopardy score is an alternative method for estimating the extent and severity of…

…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…

…25 mm/s, which is standard in the US and many other countries, a 2:1 block will be difficult to discern because the flutter…

…strong and oppositely directed forces tend to cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In…

…experienced chest pain at home may be asymptomatic during the assessment in the ER, only to develop severe chest pain and magnificent ST elevations a…

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…

…blood flow and measured tracer activity over a wide range (Murthy et al.). As evident in Figure 1, 15 O water is the only tracer…

…on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted in both North American and European…

…electrically dissociated from each other. This condition is referred to as atrioventricular (AV) dissociation. Importantly, for the ventricles to have any electrical (and thus pumping)…

…index 15–19 kg/m² 17–22 kg/m² Ideal and dosing weight Drug dosing often requires a weight other than the actual body weight…

…50 Dose reduction as in the table above for rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible…

…everything in the technique is designed to make sure that never happens, and to make sure the catheter does not become the patient's next…

…inside the visible ice front , and this is why the margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented…