…self adhesive multifunction pads. A separate three lead ECG cable connected to the patient — the device senses the rhythm through the cable, not through the…

…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…

…contraindications to coronary angiography in the general sense; the decision depends on balancing the expected diagnostic or therapeutic benefit against the patient’s specific procedural…

…or vasomotor coronary disorders. The investigation should be undertaken when its diagnostic or therapeutic consequences are likely to outweigh procedural risks. This balance forms part…

…3 mm, long stent length Large thrombotic burdens increase procedural risk because thrombus can fragment, embolize to other coronary branches or vascular beds, propagate through…

…personnel must be well trained in resuscitation. Subject preparations The procedure must be explained carefully to the patient, who must also be informed that his…

…a patient with known myasthenia responds to further cholinesterase inhibition. The test has a sensitivity of around 60 % and is not specific: motor neurone disease…

…such as amyloidosis or sarcoidosis Other cardiac procedures Chemotherapeutic agents Catheter ablation Critical illness Defibrillator shocks Strenuous exercise Cardiac contusion The diagnosis should therefore distinguish…

…have specific contraindications: Adenosine, Dipyridamole, Regadenoson : Should be avoided in patients with active bronchospasm, severe hypotension, or high degree AV block. Caffeine and other methylxanthines…

…instead in patient selection. Because implantation entails appreciable cost and procedural risk, the risk benefit balance depends almost entirely on the capacity to identify, prospectively…

…other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals. Atrial flutter causes characteristic ECG changes, as discussed below. Atrial flutter tends to…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…for pathological R wave progression is considerably lower than pathological Q waves and guidelines do not state any ECG criteria specific to R wave progression…

…are more prevalent in women. Chronic kidney disease and several other comorbidities also contribute to the disproportionate cardiovascular burden in women. Depression and anxiety are…

Cardiology Endocrinology & metabolism Definition and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every…

…aVR and often V1, and does not correspond to a specific coronary anatomic distribution [4, 5]. In contrast to acute myocardial infarction, pericarditis lacks prominent…

…their use is limited by specific adverse effects. Most of these adverse events are related to the suppression of the renin angiotensin aldosterone system (RAAS…

…Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated…

…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…

…reserve (FFR) is an invasive, lesion specific physiological index used to estimate the functional significance of an epicardial coronary stenosis. It is defined during maximal…

…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…

…and SCORE2 Older Persons (SCORE2 OP) are European risk prediction models designed to estimate 10 year risk of both fatal and non fatal CVD events…

…and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The association is mediated by…

…sodium pump. Digoxin binds reversibly to a specific high affinity site on the extracytoplasmic face of the alpha subunit of the Na+ K+ ATPase. This…

…Natriuretic peptide concentrations reflect haemodynamic stress, but their release is not specific to left ventricular systolic dysfunction. Levels may also rise with: Left ventricular diastolic…

…dyslipidaemia, obesity, smoking and other conventional risk factors, together with diabetes specific vascular and metabolic abnormalities. Diabetes is associated with inflammation, thrombosis and accelerated atherosclerosis…

…which scenario head tilt chin lift should only be used if other methods fail to open the airway. Figure 1. Methods to open the airway…

…examination, other examinations (which are not included in the standard examination), may be warranted. For most pathological conditions, there are specific guidelines (see links below)…

…vagal tone does not necessitate treatment but it might be wise to observe the patient for 24 hours (including ECG monitoring). In all other situations…

…unlikely to be the cause of the ST segment depression. The horizontal ST segment depression is more specific than the downsloping depression. Refer to Figure…

…of the cylinder area (a) and flow velocity (v): Q = a • v This principle can be used to estimate blood flow across the valves…

…or prolonged endoscopic intervention a need for general anaesthesia for other reasons. Extubate as soon as it is safe to do so after the endoscopy…

…other chest discomfort, dyspnoea, or no symptoms. Although chronic coronary disease may remain stable for prolonged periods, it can progress or destabilize abruptly, leading to…

…does not provide specific details regarding the physical examination or general evaluation of patients with bradycardia. Diagnostics Electrocardiographic assessment is fundamental to the diagnosis and…

…should influence the choice between PCI and CABG. Physical examination findings are not specific to left main disease. The examination should nevertheless assess the consequences…

…Other guideline formulations similarly define resistant hypertension as blood pressure above goal despite three or more antihypertensive drugs from different classes at maximally tolerated doses…

…driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke and systemic embolism. The contemporary understanding of AF has evolved…

…ECG changes and symptoms. Troponins and other biomarkers of myocardial necrosis (infarction) Myocardium can endure 20 to 30 minutes of complete ischemia. After this period…

…listed above. Many of the diagnoses mentioned below are discussed in detail in other chapters, to which links are provided throughout the text. Heart rate…

…discussions of specific arrhythmias in subsequent chapters. Cardiac arrhythmias can be subdivided into the following categories: Bradyarrhythmia s (bradycardia): arrhythmias commonly due to dysfunctional automaticity…

…with suspected pericardial disease. In addition to echocardiography, ECG and clinical examination, blood tests and other radiological examinations are most often required, in particular computed…

…patient to recite the months of the year backwards. A normal result does not exclude delirium, however, and an abnormal result is not specific to…

…Unlike many other intravenous medications where rapid boluses risk hemodynamic instability or transiently toxic concentrations, adenosine requires a rapidly delivered bolus to achieve sufficiently high…

…herpes zoster pain are other considerations when assessing chest pain [2]. Autoimmune/Malignancy: A history suggesting an autoimmune disorder or known malignancy may suggest specific…

…proteins in the hepatic LDL receptor pathway. Reduced cellular uptake and clearance of LDL leads to increased circulating LDL C. The principal genetic mechanisms involve:…

…syndrome are fairly specific to the disorder, provided that the clinical characteristics are in line with the disorder. There are however other disorders that may…

…potentially indicating microvascular dysfunction or other pathologies. The software allows for detailed regional analysis of myocardial perfusion, highlighting specific segments of the left ventricle that…

…owing to changes in intra and extracellular electrolyte concentrations. Some electrolyte imbalances are clinically negligible (from an electrophysiological standpoint), whereas others may be life threatening…

…are common to all protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and…

…INR), older age, drugs predisposing to bleeding and alcohol use. A high bleeding risk score should prompt correction of modifiable risk factors and closer surveillance…

…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…

…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…

…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…

…Ask the patient to keep the eyes open and look straight ahead — without open eyes there is no diagnosis. Procedure The Dix–Hallpike test 1…

…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…

…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…

…with homozygous FH typically die from acute myocardial infarction at 20 to 30 years of age. People with familial hypercholesterolemia have no other metabolic aberration…