…with neutropenia related to cancer treatment. Children, pregnant women, patients after allogeneic stem cell transplantation and patients treated with CAR T cells or other advanced…

…of foamy macrophages. The occurrence of neoatherosclerosis helps explain why ISR and other stent related events may arise well after the initial intervention. Mechanical mechanisms…

…Akutsjukvård Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the…

…Furthermore, sudden cardiac arrests account for 50% of all years of life lost due to cardiovascular disease ( Myerburg et al ). Sudden unexpected cardiac arrest is…

…plumbing problem characterized by the gradual accumulation of inert cholesterol debris, modern vascular biology has redefined atherosclerosis as a dynamic, immune mediated fibroproliferative response to…

…depends almost entirely on the capacity to identify, prospectively, those individuals genuinely at risk of arrest. This predictive problem has proven persistently resistant to resolution…

…arrest The purpose of discovering and measuring risk factors is to obtain estimates of risk, tailor management according to the risk and monitor risk prospectively…

…order to suggest ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic…

…reported in patients taking ticagrelor. This is related to ticagrelor inhibiting the P2Y12 receptor on healthy donor platelets in the test. Information about concurrent ticagrelor…

…dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting the relevant variant to each child. However, other inheritance patterns, de…

…combined dyslipidaemia, non HDL C is particularly relevant because it captures triglyceride rich lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk…

…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…

…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…

…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…

…administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non steroidal anti inflammatory drugs (NSAIDs). Other contraindications…

…with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and aggregation contribute importantly to arterial thrombus formation…

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

…compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic…

…PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke…

…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…

…In this post I would like to discuss hot topics related to coronary artery disease and I will emphasize on issues that are typically raised…

…ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI), or medical management…

…sufficient Severe elevation Acute HMOD Present Absent clinically Symptoms Often present and related to the affected organ May be absent or nonspecific Treatment setting Usually…

…and treatment goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator…

…Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial disease, and management should therefore address the entire arterial circulation. PAD is associated with increased…

…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…

…which is standard in the US and many other countries, a 2:1 block will be difficult to discern because the flutter wave may fuse…

…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…

…findings dictate the management of acute coronary syndromes. Hence, an ECG must be performed and interpreted within 10 minutes of arrival to the care facility…

…pulsed wave Doppler. The disadvantage of continuous wave Doppler is that it is not possible to determine where, along the Doppler line, the velocities are…

…only tracer with myocardial uptake linearly related to coronary blood flow. 15 O Water is an ideal tracer, with a short half life (2 minutes)…

…Concave ST segment elevations, on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted in both…

…It may be very difficult to establish a diagnosis of third degree AV block if the atrial and ventricular rate is equal and the P…

…and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90, women 0.85 = abdominal…

…rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible according to FASS, but the documentation is insufficient; check…

…side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of…

…compressed after arterial puncture, technically more difficult with ultrasound Femoral vein Fastest, and does not interfere with ongoing CPR or airway management, no risk of…

…in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is needed for management. Cryoglobulinaemia…

…suction, a bag and mask, and access to equipment and competence for advanced life support in the room. Two people: one who injects and monitors…

…and the period before a urological procedure. A positive urine dipstick in an older patient is difficult to interpret. Skin and soft tissue Diagnosis Agent…

…treatment is required if there is concomitant acute life threatening organ damage. Isolated malignant retinopathy without other acute organ damage can often be treated more…

…or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor…

…The main clinical rule Two questions determine the initial management: 1. Does the patient have severe neurological symptoms that may be due to the hyponatraemia…

…A normal GGT shifts the suspicion to bone, pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction…

…pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which the procedure is the wrong treatment …

…or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in the adjacent joint. Known hypersensitivity to the…

…preferably anteroposteriorly : one anteriorly over the praecordium to the left of the sternum, the other on the back between the left scapula and the spine…

…chooses to excrete hydrogen ions instead of potassium, and the urine stays acidic however much bicarbonate is given. Potassium replacement is not the management of…

…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…

…use. Some studies suggest HAS BLED has comparable or slightly superior predictive capability for major bleeding compared to ATRIA. ORBIT: Includes factors like older age…

…is more closely associated with other comorbidities and age rather than sex alone. Consequently, the CHA₂DS₂ VA score was developed to provide a more accurate…

…superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES, ATRIA, ORBIT, and GARFIELD AF scores. Moreover, the HAS BLED score has been found to…

…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…

…by specific adverse effects. Most of these adverse events are related to the suppression of the renin angiotensin aldosterone system (RAAS), such as decreases in…

…according to the fourth universal definition of MI. Type 1 MI is generally related to an atherothrombotic event, whereas Types 2–5 MI have other…

…blood flow increases RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress to systemic congestion, reduced cardiac output…

…impair left ventricular ejection fraction. Enlargement of the left ventricle predisposes to atrial and ventricular arrhythmias. In advanced alcohol related cardiomyopathy, dilation may involve all…

…cell recruitment, extracellular matrix remodelling, and thrombosis interact to produce focal arterial lesions. Although epicardial coronary arteries are a major site of disease, atherosclerosis is…

…quality of life, contribute to heart failure, and increase the risk of stroke and other thromboembolic events. Subclinical cerebral injury may contribute to vascular dementia…

…more than mild frailty, limiting the applicability of trial findings to people with substantial functional impairment, multimorbidity, or limited life expectancy. Available randomized evidence has…