…attacks of vertigo, seconds to a minute or so, that are provoked by a change of position — turning over in bed, lying down, standing up…

…hard, visible nail. The nail bed is the tissue beneath the nail plate; a laceration here heals with a deformed nail unless it is sutured…

…the brief attacks. Lying down, turning over in bed or looking up triggers a new attack. A patient with vestibular neuritis or stroke, by contrast…

…the ratio of the pressure difference (ΔP) and the flow over the vascular bed (Q): R = ΔP/Q Both ΔP and…

…Started within 48 h where possible Thromboprophylaxis Low molecular weight heparin unless contraindicated Head of the bed 30–45° Stress ulcer prophylaxis During mechanical ventilation…

Cardiology Definition and purpose Cardiovascular risk assessment estimates an individual’s probability of experiencing cardiovascular disease (CVD) over a defined period. SCORE2 and SCORE2 Older…

Myocardial ischemia and infarction ECG Definition and Pathophysiology The conceptual understanding of myocardial infarction (MI) has evolved significantly over the past century. Initial post mortem…

…Congenital Heart Disease (CHD) and Grown Up Congenital Heart (GUCH) disease Survival in congenital heart disease (CHD) has increased dramatically over the past few decades…

…test, exercise stress ECG) Exercise stress testing has been used routinely for over 60 years to evaluate cardiopulmonary function and to diagnose cardiovascular disease. The…

…due to trauma In cases of traumatic cardiac arrest, addressing reversible etiologies takes precedence over chest compressions. If trauma is not definitively established as the…

…litre that has accumulated slowly can be asymptomatic, while 150 mL collected over an hour causes tamponade. The indication rests on the clinical picture together…

…heart failure armamentarium. Its use has declined over time due to the advent of more efficacious agents with wider therapeutic to toxic windows, and its…

…caused by stenosis or occlusion of the aorta or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause…

…vasovagal syncope is reported to occur in over 40% of females and 30% of males due to a lack of effective reflex response to posture…

…coronary lesion, with anatomic and functional assessment discordant in a substantial minority of intermediate lesions. Over the past three decades, invasive physiological indices, led by…

…However, stroke volume can also be calculated by quantifying the blood volume flowing over the mitral valve or the tricuspid valve. This is explained by…

…a nuanced, multidisciplinary approach to diagnosis and management. Over the past decade, the landscape of VT management has undergone a profound paradigm shift. Driven by…

…a rapid rise in potassium is suspected. 7. Review all medication, including over the counter preparations, herbal remedies, contrast media and recently stopped drugs. 8…

…cast or has extensive wounds so that the cuff cannot be applied. Place the cuff over a protective dressing, or measure at the toe instead…

…as part of fluid management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation to the hand. Vascular disease in the limb…

…respiratory disturbance, by contrast, develops over hours to days [1,2]. Six steps Step Question Practical interpretation : : : 1 Is the pH low or high? pH…

…a ligament injury, a tendon injury, or after suturing over a joint. Pain relief and stabilisation for transfer in a suspected fracture. Clinical suspicion of…

…govern which site is chosen. Infection, burns or trauma over the insertion site. Thrombosis or known stenosis in the target vessel. Coagulopathy or ongoing anticoagulation…

…and validated marker of perfusion Lactate < 1.6 mmol/L Clearance over time is more informative than a single value Urine output 0.5…

…the baseline plasma sodium, the target for the first few hours, and the maximum permitted correction over 24 and 48 hours. 7. Start a fluid…

…protocol Avoid tight targets in inpatients. Hypoglycaemia on the ward is more dangerous than moderate hyperglycaemia over a few days. Principles Insulin component Function Who…

…osteoarthritis related joint disease. Contraindications Infection of the skin or soft tissues over the puncture site — use another approach or refrain. Bacteraemia without suspicion of…

…the threshold, but the threshold varies between regions. Infection of the skin over the puncture site. Marked haemodynamic instability — stabilise the patient first. CT before…

…or modify in: Situation Management : : Disseminated intravascular coagulation or clinically overt bleeding Refrain until the condition has been corrected Marked coagulopathy or thrombocytopenia Routine plasma…

…Relative Skin infection, herpes zoster or burns over the puncture site Relative Mechanical ventilation with a high PEEP (an increased risk of pneumothorax; ultrasound guidance…

…must not be used to rule it out The age adjusted D dimer in patients over 50: the threshold becomes age × 10 micrograms/L (FEU)…

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

…capacity. Suspected asthma or COPD — diagnosis and follow up. Risk groups: current or former smokers over 40 with respiratory symptoms, and occupational exposure to dust…

…measure: early and generous fluid administration. The benefit of alkalinisation over fluids alone is disputed and practice differs between units. Poisoning with other weak acids…

…contamination, not poor suture technique — and the commonest cause of permanent loss of function is a tendon injury that was sutured over without being found…

…and give by slow injection over 5 10 minutes. Dilute immediately before use. PO: Alternatives: Dixarit 25 μg tablets. Catapress 150 μg tablets…

…to onset of action 1 minute Duration of action 20 30 minutes Delivery IV Dose Loading dose: 500 μg/kg bolus over 1 minute…

…large patient cohorts. It incorporates key clinical and echocardiographic parameters to calculate an individual's risk of SCD over the next 5 years. The calculator…

…bolus injections or as a constant dose infusion. Bolus regime : • 20 mg IV bolus over 2 minutes, followed by 20 to 80 mg every 10…

…and vascular resistance. Advantages of measuring MAP over systolic blood pressure While systolic blood pressure (SBP) indicates the maximum pressure during heart contraction, it does…

…Brinavess) is administered as an infusion. The infusion is diluted to 4 mg/ml and administered over 10 minutes. A maximum of two infusions can…

…in therapy: implantable cardioverter defibrillators (ICDs) are highly effective, terminating well over 99% of the ventricular arrhythmias they detect. It lies instead in patient selection…

…aVF, and V2 through V6. These ECG changes were stable over a period of 30 years. The ST segment depressions were accentuated during exercise. The…

…rapidly. Rapid enlargement is defined in the source recommendations as at least 10 mm per year or at least 5 mm over 6 months. Such…

…inflammatory reactions that promote plaque formation and progression. As the burden of retained atherogenic particles accumulates over time, the probability of an acute atherosclerotic cardiovascular…

…a validated upper arm oscillometric device. Ambulatory blood pressure monitoring (ABPM): automated measurement, usually over 24 hours, at predefined intervals. Inter arm difference: a sequential…

… episodic plaque disruption followed by thrombosis. Atherosclerotic disease usually evolves over decades. Intimal thickening may be present during the second and third decades of life…

…or destabilize abruptly, leading to an acute coronary syndrome (ACS). Clinical manifestations may therefore change over time, including transitions between stable angina, angina or ischaemia…

…dietary fat and statins Popular blogs and media reach out to billions of individuals worldwide. They exert enormous influence over their visitors daily lives. However…

…vector typically shifts in the direction of the outer epicardial layers, producing ST elevations over the ischemic zone [15]. In the earliest stages of ischemia…

…risk relative. Across inherited cardiomyopathies, phenotypic expression generally follows a sigmoid pattern over the lifetime. Expression is relatively uncommon in the first decade, rises progressively…

…rises. Early absolute changes over 1 hour provide diagnostic information that supplements the initial concentration and can approximate the information obtained from longer serial intervals…

…conditions that favour thrombus formation. Extensive transmural septal infarction may also permit mural thrombi to develop over infarcted myocardium in either ventricle. With contemporary imaging…

…pay a visit to this maven (which is hebrew for "master"). ECG Wave Maven includes over 500 ECG cases, all interpreted by experts in electrocardiology…

…stenoses. Higher scores indicate more diffuse or technically complex disease and are associated with a greater relative advantage for CABG over PCI in multivessel disease…

…maternal organ involvement. Proteinuria is defined as urinary protein excretion 300 mg over 24 hours or a protein–creatinine ratio ≥0.3. Preeclampsia may nevertheless…

…with resistant hypertension. Dietary sodium and potassium abnormalities and commonly used over the counter medicines may also contribute to apparent treatment resistance. The diagnosis is…

…com. This website provides a comprehensive learning ecosystem. It includes a complete ECG book, enriched with over 600 pages, engaging video lectures, challenging tests, and…

…Mitochondrial abnormalities can occur even earlier after coronary occlusion and progress over time. Experimentally, necrosis advances from the subendocardium towards the subepicardium over several hours…

…for ventricular fibrillation, where urgent reversion to sinus rhythm is required. The rationale for electrical therapy over drugs is that, under monitored conditions, a controlled…