…course. An AST/ALT ratio 2 with moderately raised values suggests alcohol related liver disease; a ratio < 1 suggests steatohepatitis or viral hepatitis. An…

…other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive ventilation is not…

…of blood flow to vital organs than systolic blood pressure alone. Predictive Value : Elevated MAP has been associated with an increased risk of cardiovascular diseases…

…must therefore be managed as neutropenic sepsis even if the temperature criterion is not met. The first hour Step Action : : 1 ABCDE, full vital signs…

…associations include: Idiopathic or viral pericarditis Malignant pericardial disease Tuberculosis Purulent or bacterial pericarditis Trauma Cardiac surgery and other iatrogenic cardiovascular procedures Acute aortic disease…

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

…outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections…

…However, it is often difficult to differentiate pericarditis and myocarditis, and they tend to accompany each other. Therefore, the term perimyocarditis is often used in…

…the condition is classified as cardiac tamponade. The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other frequent symptoms…

…A diagnosis of delirium is therefore the beginning of the investigation, not the end. In a frail older patient an apparently small insult — sleep deprivation…

…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…

…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…

…Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease…

…is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease (ASCVD)…

…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…

…ataxia Posterior circulation stroke Unilateral hearing loss or tinnitus Ménière's disease, vestibular schwannoma, labyrinthitis Continuous vertigo that does not come in attacks Vestibular neuritis…

…artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity: Do not…

…maintenance treatment. The source material does not specify the loading dose. Efficacy and harms In secondary prevention trials involving patients with previous vascular disease, aspirin…

…C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB…

…that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic cardiovascular disease (ASCVD…

…Asymptomatic disease may be discovered during targeted duplex ultrasound (DUS), pre operative assessment, or evaluation of other atherosclerotic disease. Routine population screening is not recommended…

…discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome (ACS). Other cardiopulmonary causes , including myopericardial disease, pulmonary embolism, aortic emergencies…

…cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However, association is not the same as causation . A…

…representation of patients with STEMI or other very high risk features. Noninferiority studies designed mainly around bleeding outcomes may not reliably exclude clinically important differences…

…acute HMOD, although other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence of ongoing acute organ injury is decisive. The pathophysiology…

…health status, but it should not be undertaken when symptoms are present without anatomical or physiological criteria supporting revascularization. In less severe coronary disease, PCI…

…manifestation of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial disease…

…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…

…ischemic heart disease. However, most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur…

…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…

…but they do not rule out ischemia. Other features of ischemic ST segment elevations In STE ACS (STEMI) the level of the J point is…

…atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular…

…population measure that performs poorly at the level of the individual: it does not distinguish muscle from fat and takes no account of fat distribution…

…other DOACs are possible according to FASS, but the documentation is insufficient; check more frequently. Warfarin is often preferable <15 or dialysis DOACs are not…

Procedurer Aspirate and biopsy answer different questions and do not replace one another: the aspirate shows cellular morphology and provides material for flow cytometry and…

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

…with poor circulation, above all the lower leg in a patient with peripheral arterial disease or diabetes — the wound may not heal. Over superficial nerves…

…sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real…

…3 IV Pneumonia, in chronic lung disease amoxicillin 750 mg × 3 PO 5–7 days or benzylpenicillin 3 g × 4 IV Pneumonia, suspected atypical pathogen…

…levels, particularly in pregnancy [1,2]. Malignant hypertension is not entirely synonymous with a hypertensive emergency. The term denotes severe hypertension with advanced hypertensive retinopathy…

…assessment [1]. Treat immediately when there are symptoms and a low glucose. Do not wait for the venous laboratory result. 1. Assess and stabilise the…

…The aim is to relieve the cerebral oedema quickly, not to normalise the plasma sodium. Chronic or minimally symptomatic hyponatraemia must be corrected in a…

Procedurer Pericardiocentesis is performed on the basis of the haemodynamics, not the volume of fluid. A litre that has accumulated slowly can be asymptomatic, while…

…an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or…

…a pulse that can be felt. The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous)…

…urine stays acidic however much bicarbonate is given. Potassium replacement is not the management of a side effect; it is part of the treatment itself…

…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…

…dL in men or <12 g/dL in women (3 points) Severe Renal Disease: Estimated glomerular filtration rate (eGFR) <30 mL/min or dialysis dependent…

…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…

…higher indicates high risk of major bleeding Note that a high HAS BLED score should not be used as a reason to withhold anticoagulation therapy…

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

…therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial…

…acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease, active cancer, and other conditions incorporated into validated clinical risk tools Acute RV failure…

…exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…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…