…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…

…stabilise first The induction of vomiting has no place in the modern treatment of poisoning. Charcoal also does not bind every poison. With the following…

…in some clinical settings, while the broader lipid lowering recommendation refers to a recurrent event without requiring that it be of the same type as…

…of ECGs in pediatric patients is slightly different from adults, due to obvious anatomical differences. There are, however, no differences regarding the ECG grid. As…

…lead is in place — but only if it is working, and the commonest source of error is believing that it is. Twitching of the chest…

…pillow to place under the shoulders as an alternative to a hanging head. Frenzel goggles or video Frenzel if available — small beats of nystagmus can…

…a therapeutic objective. LDL C as the primary treatment target Current lipid management frameworks place LDL C at the centre of treatment. Lifestyle intervention is…

…Only clinical signs of herniation halt the puncture, and antibiotics and a corticosteroid are then given immediately after blood cultures. For questions other than acute…

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

…If the amount of fluid in the pericardial cavity exceeds 50 mL, there is an effusion, which is considered pathological. The effusion, as a rule…

…works poorly in inflamed tissue — the acidic environment inactivates the anaesthetic. Place a field block in healthy skin around the abscess instead of injecting into…

…and as a risk marker in diabetes and known atherosclerotic disease. An ABI ≤ 0.90 is diagnostic of peripheral arterial disease and at the same…

…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…

…marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of site The posterior superior…

…as to embolization in the systemic circulation. The complications can be fatal. Approximately 500 Swedes are affected annually by endocarditis and the median age of…

…sequential activation of the piezoelectric crystals. The crystals are activated from one side to the other, as illustrated in Figure 2. The sequence of activation…

…capable of recording these flow variations with high precision. To calculate flow across a valve, the Doppler line is placed in the valve orifice. The…

…with the sample volume placed in the center of the mitral annulus. SV mitral = area mitral • VTI mitral To calculate the flow over the…

…apical segments, constituting 30% of myocardial mass. The 17 segment model provides the best agreement with anatomic data, as compared with other segmentation models. Figure…

…in the thorax. This positions the basal portion of the left lateral wall posteriorly in thorax (Figure 1). This area is most frequently designated as…

…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…

…The coordinate system presenting the limb leads in the frontal plane. This format of displaying the ECG leads is referred to as the Cabrera format…

…numbness of the foot and toes. Pain that is worse at night or when the limb is horizontal. Improvement when the leg is placed in…

…sample volume in the mitral valve plane. Color Tissue Doppler Color tissue Doppler analyzes myocardial velocities within a color sector. Myocardium moving towards the transducer…

…or in combination. Syncope is particularly important as a marker of potentially severe disease. The presence of haemodynamic instability places the patient in the high…

…then the frequency of the reflected sound waves will differ from the emitted sound waves. The change in frequency is referred to as the Doppler…

…On the other hand, sinus bradycardia developing during physical exercise is considered abnormal, because heart rate must increase during exercise. Mechanisms of cardiac arrhythmias The…

…is the solid, compact wall. Thus, with regards to measuring ventricular dimensions, trabeculae and papillary muscles are considered part of the left ventricular cavity. Other…

…i.e reduced) in virtually all cases. Ventricular tachycardia causes immense strain on the ventricular myocardium, simultaneously as the cause of the arrhythmia already affects…

…as early as possible. In out of hospital cardiac arrest (OHCA) ACLS is performed by paramedics, nurses or physicians, depending on the design of the…

…in left bundle branch block (LBBB), which explains why paced QRS complexes are similar to the QRS morphology during LBBB. Stimulation in other regions of…

…genesis of these waves and although it has been discussed previously a brief rehearsal is warranted. Figure 7 illustrates the vectors in the horizontal plane…

…progression implies that the gradual increase from V1 to V5 is absent. It may be broken, as in Figure 1 . Any type of infarction may…

…antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent…

…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

…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…

…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…

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

…Prophylaxis against recurrence of cerebrovascular disease: 75–80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant…

…aspirin is also preferred in patients with intracoronary stents. In acute ACS, aspirin should be administered as soon as possible in the absence of contraindications…

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

…by increased serious gastrointestinal bleeding and a non significant increase in cerebral haemorrhage. Bleeding outcomes The principal harm of aspirin in primary prevention is bleeding…

…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…

…Relevant predispositions, such as connective tissue disease. No single pain descriptor is diagnostic. The severity of pain also has limited discriminatory value. Features suggesting myocardial…

…into remarkable advances in the management of coronary artery disease, as demonstrated in the figure below (from Nabel et al, NEJM, 2014). In this post…

…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…

…or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the…

…particularly in complex multivessel or left main disease. Clinical presentation and symptoms The clinical presentation of multivessel CAD varies from stable angina or exertional limitation…

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

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

…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…

…if the opportunity is given. An ECG without ischemic ST T changes when recording during chest pain is not consistent with myocardial ischemia. In 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…

…tomographic images of the left ventricle. In PET (Positron Emission Tomography), radiotracers emit positrons. When a positron collides with an electron, they annihilate each other…

…in both North American and European guidelines. However, a concave ST segment does not rule out ischemia, it merely reduces the probability of ischemia as…

…to as atrioventricular (AV) dissociation. Importantly, for the ventricles to have any electrical (and thus pumping) activity at all, an escape rhythm must arise in…

…BMI < 20 in people under 70 years or < 22 above 70 years, and reduced food intake together form the basis of most screening…

…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…

…of infection. Indications Infusion of vesicant solutions: vasopressors, concentrated potassium, cytotoxic drugs, parenteral nutrition. The need for several simultaneous, incompatible infusions. Haemodialysis, plasmapheresis or other…

…why the margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which…