…Such thrombi may leave the appendage and enter the systemic circulation which causes thromboembolic occlusions of arteries in the brain, limbs or other organs. However…

…primary hyperparathyroidism or neoplastic etiologies. Other causes include immobilization, sarcoidosis, thyrotoxicosis, familial hypocalciuric hypercalcemia, Addison's disease, renal insufficiency, therapeutic interventions with tamoxifen or lithium…

…electrolyte imbalances are clinically negligible (from an electrophysiological standpoint), whereas others may be life threatening. The most common and clinically most relevant electrolyte imbalances concern…

…accompany other ischemic ST T changes. They may occur in both NSTEMI and STEMI. QTc prolongation The QT (QTc) interval may be prolonged, shortened or…

…sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive…

…at high risk of developing a new event. Administration Ticagrelor can be administered with or without food. For patients who cannot swallow the tablets whole…

…other inheritance patterns, de novo variants, incomplete penetrance and variable phenotypic expression complicate risk prediction. Familial clustering may also reflect shared environmental or behavioural factors…

…in addition to LDL and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years without diabetes and with LDL…

…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…

…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…

…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…

…mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing…

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…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…

…drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be prescribed routinely to individuals without established ASCVD…

…DUS), pre operative assessment, or evaluation of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of severe asymptomatic stenosis is low…

…abdomen, or epigastrium. Dyspnoea, nausea, vomiting, diaphoresis, fatigue, faintness, and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency…

…Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction…

…to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI), or medical management. The standard post ACS…

…monoamine oxidase inhibitor crisis, cocaine intoxication, or other sympathomimetic exposure, including methamphetamine. Abrupt withdrawal of antihypertensive medication, particularly clonidine, can also precipitate a hypertensive crisis…

…left ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator or institutional experience Assessment…

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

…electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other circumstances that may affect cessation or treatment…

…most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals…

…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…

…is given. An ECG without ischemic ST T changes when recording during chest pain is not consistent with myocardial ischemia. In other words, chest pain…

…two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves. The cardinal difference between continuous wave…

…radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect…

…repolarization or even early phases of ischemia). To conclude, concave ST segment elevation is atypical of ischemia, but they do not rule out ischemia. Other…

…QRS complexes may be normal or wide. P waves have constant PP interval and ride straight through the strip, without any relation to QRS complexes…

…expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90…

…The other DOACs are possible according to FASS, but the documentation is insufficient; check more frequently. Warfarin is often preferable <15 or dialysis DOACs are…

…Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather…

…incompatible infusions. Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure…

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

…of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked obstructive…

…PO 5–7 days or doxycycline 200 mg × 1 on day 1, then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway…

…cotton wool spots or papilloedema. Intravenous treatment is required if there is concomitant acute life threatening organ damage. Isolated malignant retinopathy without other acute organ…

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

…other acute causes, for example hypoglycaemia, poisoning, stroke, meningitis and a postictal state. 3. Check a repeat plasma sodium if the result is unexpected or…

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

…a blood gas, coagulation tests and other investigations according to the clinical picture 5 Take cultures or molecular tests from the suspected focus, but avoid…

…despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is a clinical diagnosis supported by echocardiography: Finding Comment : : Hypotension, distended neck…

…Contraindications Absolute: Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in the…

…newly discovered complete heart block without current symptoms, alternating bundle branch block in acute anterior infarction, and before drugs or procedures with a known risk…

… risk of tetany and seizures. Anuria or established renal failure. Without urine production there is no urine to alkalinise, and the sodium and volume load…

…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…

…4 2.6% High risk 5 or more 5.8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment…

…AF patients. Evidence suggests that the increased stroke risk in women is more closely associated with other comorbidities and age rather than sex alone. Consequently…

…of the type of oral anticoagulant used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES…

…Components of the HEMORR₂HAGES Score The acronym HEMORR₂HAGES represents the following parameters: H epatic or renal disease (1 point) E thanol abuse (1 point) M…

…the sensitization of sensory nerve endings due to the accumulation of bradykinin. ACE is responsible for metabolizing bradykinin and other tachykinins, such as substance P…

…Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis…

…and death. The clinical consequences are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of…

…eight drinks weekly in females or at least 15 drinks weekly in males, or binge drinking in either sex. Other definitions of unhealthy drinking include…

…Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory…

…ischaemic electrocardiographic changes during rapid AF. ST segment depression or T wave inversion can occur without coronary artery disease. Proposed explanations in the source material…

…and increased vulnerability to adverse outcomes. It is dynamic and may improve or worsen with illness, treatment, or other interventions. Frailty commonly overlaps with multimorbidity…

…Continous medical discussion: the ECG blog Infectious diseases Cardiovascular effects of COVID 19 Coronavirus disease 2019 (COVID 19) has caused a global public health crisis…

…or both. A person may also be considered at increased cardiovascular risk without a calculated SCORE2 or SCORE2 OP estimate when certain clinical conditions are…