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

…is thought to involve the sensitization of sensory nerve endings due to the accumulation of bradykinin. ACE is responsible for metabolizing bradykinin and other tachykinins…

…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…

…other imaging methods, namely exercise capacity (and VO2 max , see below). In addition to exercise capacity, stress testing also provides information on electrocardiographic (ECG) reaction…

…supply results in diminished ATP production and subsequently disruption of cellular metabolism. In case of ischemia, cardiac myocytes protect themselves by switching to anaerobic metabolism…

…mortality is generally below 0.1% in contemporary series. Reported risks vary according to the population and definitions used. Complication Reported risk (%) Mortality 0.11…

…likely due to drug side effects, it is necessary to weigh the risk of terminating the medication as compared with implanting a permanent pacemaker and…

…for another , in the other nostril, in the ears and in the mouth. Nose 1. Ask the patient to blow the nose gently. Clear mucus…

…necessary to normalize blood pressure. Management of hypertension requires careful consideration of other cardiovascular risk factors and coexisting conditions. Therapy must be tailored to each…

…and on neurophysiology (repetitive nerve stimulation with a decrement ≥ 10 % at 3 Hz, sensitivity about 75 %; single fibre EMG about 95 %). Contraindications Known hypersensitivity to…

…to result from the cumulative influence of multiple modest dietary changes. Mediterranean type diets provide polyphenols from extra virgin olive oil, fruits, vegetables, nuts and…

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

…biweekly injections. Inclisiran is used as an adjunct to dietary measures and maximally tolerated statin therapy, with or without other LDL C lowering drugs, when…

…a population of individuals unable or unwilling to take statins, bempedoic acid 180 mg daily produced approximately 21% reductions in both LDL C and hsCRP…

…fatal ischaemic stroke, and vascular death from 8.2% to 6.7% per year. The relative reductions were approximately 31% for non fatal MI, 22%…

…The clinical importance of residual disease is also influenced by anatomic complexity and comorbidity, which themselves may contribute to progression of native coronary artery disease…

…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…

…acute pancreatitis, alkalosis due to hyperventilation, rhabdomyolysis (particularly the initial phase), sepsis, malignancies with osteoblastic metastases, diminished calcium absorption and/or enhanced calcium excretion, chronic…

…of CAD. As LV dysfunction and HF become more prominent, angina may diminish or disappear. Others have no recognized history of angina or MI, making…

…of the R waves. This is believed to be due to delayed (and thus electrically unopposed) depolarization in the ischemic area. Fragmented QRS complex 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…

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

…risk of transmitting the relevant variant to each child. However, other inheritance patterns, de novo variants, incomplete penetrance and variable phenotypic expression complicate risk prediction…

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

…delay and a symptom duration of less than 12 hours, immediate fibrinolysis is recommended in the absence of contraindications, followed by direct transfer to a…

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

…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…

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

…That study spread like a virus through social media and it is likely that it may have resulted in increased mortality due to stopping statins…

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

…and cerebral involvement. Catecholamine excess and drug related presentations Severe hypertension may result from phaeochromocytoma, monoamine oxidase inhibitor crisis, cocaine intoxication, or other sympathomimetic exposure…

…infarction and stroke Likelihood of repeat revascularization Symptom burden and treatment goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to prolonged…

…sedentary behaviour and loss of independence. Identification of PAD also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention…

…This is due to the fact that atrial flutter is caused by a macro re entry circuit (a large re entry circuit) and re entry…

…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…

…and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to…

…The principles of continuous wave Doppler and pulsed wave Doppler. The disadvantage of continuous wave Doppler is that it is not possible to determine where…

…annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect these gamma rays to construct images with high spatial and temporal…

…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…

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

…5. Aspiration: advance the needle with the stylet in place perpendicular to the bone surface, angled slightly anteriorly and medially. Rotate under steady pressure until…

…and maintaining maximal barrier precautions without shortcuts. The most common serious error is dilating a vessel that turns out to be an artery — everything in…

…lesions (these give a more superficial and less controllable depth of freeze). A size 15 scalpel or a pumice stone to pare down hyperkeratotic lesions…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…organ damage should not normally be lowered rapidly with intravenous drugs. Such treatment has not been shown to improve the prognosis and can cause hypotension…

…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…

…main clinical rule Two questions determine the initial management: 1. Does the patient have severe neurological symptoms that may be due to the hyponatraemia? 2…

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

…glucose and lactate. Add a blood gas, coagulation tests and other investigations according to the clinical picture 5 Take cultures or molecular tests from the…

…liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and to the left

…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…

…praecordium to the left of the sternum, the other on the back between the left scapula and the spine. The anterolateral position also works and…

…urine to alkalinise, and the sodium and volume load becomes pure harm. Dialysis is then the way forward. Heart failure, pulmonary oedema and other conditions…

[calc_aorta] Sinus of Valsalva (SOV) and Aortic Root Assessment The sinus of Valsalva diameter (SOVd) is a critical measurement in evaluating aortic root morphology…

…Developed from the ATRIA study cohort, this score aids clinicians in estimating the risk of bleeding complications due to anticoagulants. Components of the ATRIA Score…

…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…

…for major bleeding compared to HAS BLED. The C indices were 0.60 for HAS BLED, 0.55 for HEMORR₂HAGES, and 0.50 for ATRIA…