…adults with neutropenia related to cancer treatment. Children, pregnant women, patients after allogeneic stem cell transplantation and patients treated with CAR T cells or other…

…the same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure…

…patient have severe neurological symptoms that may be due to the hyponatraemia? 2. Is the hyponatraemia acute or chronic? Severe symptoms require immediate treatment with…

…findings are absent in roughly half of patients with a central cause. A normal routine neurological examination is therefore not sufficient to exclude stroke [3]…

…to the superior vena cava, compressible if bleeding occurs, low risk of pneumothorax Uncomfortable for an awake patient, harder to keep the dressing clean with…

…test; performed on the wrong patient or by an inexperienced examiner it is unreliable. A single central feature is enough to proceed with urgent investigation …

…should therefore be checked with a capillary or venous measurement [5]. Treatment The awake patient who can swallow safely Give 15 to 20 g of…

…stimulators, and other electronic equipment may also interfere with device function. The clinical consequences depend on the device, the patient's dependence on pacing, the…

…GY. A novel user friendly score (HAS BLED) to assess 1 year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey…

…the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no practical risk prediction tool currently exists. At the other end…

…syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or other symptoms that may be…

…The nasal cannula, the simple mask and the reservoir mask deliver an FiO2 that varies with the patient's minute ventilation: a markedly hyperventilating pati

…Thus, cardiac index is cardiac output normalized to body surface area. The ultrasound system calculates body surface area using the patient's sex, weight and…

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

…procedure is the wrong treatment : Aortic dissection with haemopericardium — drainage can increase the bleeding and worsen the prognosis. The patient must go to cardiothoracic surgery…

…the patient. Multiple potentially high risk plaques may exist throughout the coronary tree, while inflammation and thrombotic susceptibility are often systemic rather than confined to…

…is managed according to the standard CPR algorithm, except that interventions to reoxygenate the patient is of paramount importance. In cardiac arrest due to asphyxia…

…with the intent to perform PCI. The decision to transfer the patient to the ICU or CCU depends on the system of care and patient…

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

…after a few minutes' rest, if the patient's condition allows. 7. With titratable intravenous treatment and an unstable course, an arterial line should be…

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

…studies involving patients with heterozygous familial hypercholesterolaemia or ASCVD found an LDL C reduction of approximately 50.5% when inclisiran was added to maximally tolerated…

…to complement ICA, particularly for intermediate non left main coronary stenoses. Myocardial ischaemia may occur despite the absence of significant epicardial obstruction. In patients with…

…in incorrect recordings. Patient data Gender, age, weight and height are required to evaluate the examination. Most echocardiographic parameters vary with age, gender and body…

…views in order to assess the reliability and reproducibility of the measurements. The parasternal and apical windows are obtained with the patient positioned in the…

…plastic film or a dressing to protect an ulcer, and where needed a photoplethysmograph and a toe cuff. Preparation: The patient must have rested lying…

…its own thresholds in the patient on anticoagulants; see the acute stroke quick reference. Stopping the drug and forgetting to restart it after the procedure…

…bleeding risk assessment tools exist for patients with AF, including HAS BLED, HEMORR2HAGES, and ORBIT scores. Each incorporates various clinical parameters to stratify bleeding risk…

…treated in the same broad category as a patient with coronary artery disease when clinically appropriate. Other coronary anomalies Anomalous coronary origin and course can…

…clinical spectrum of ACS is broad. Patients may be asymptomatic at presentation, have persistent chest discomfort, or present with cardiac arrest, electrical or haemodynamic instability…

…amiodarone, or adrenaline (epinephrine). In the event of a cardiac arrest in a pregnant patient, immediate consultation with an obstetrician, neonatologist, and anesthesiologist is essential…

…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…

…is necessary to weigh the risk of terminating the medication as compared with implanting a permanent pacemaker and continuing the treatment. Commonly, patients with bradycardia…

…ST T changes; the absence of such changes should lead to suspicion of ischemia (if the patient has symptoms consistent with ischemia). The same is…

…over time due to the advent of more efficacious agents with wider therapeutic to toxic windows, and its routine use in adult patients is generally…

…categorised as myocardial injury. Clinical Presentation and Symptoms Patients with Type 2 MI frequently present with acute chest pain and troponin elevation. The clinical manifestation…

…cause may range from benign to highly malignant, which is why expeditious management is warranted. Initial management includes assessing the patient's clinical status (symptoms…

…monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with vasculitis…

…initial dose should be reduced to 3 mg. Heart transplant patients: Due to denervation, which makes the sinus and AV nodes supersensitive to the drug…

…results. Patients with suspected ACS are categorized into a STEMI pathway or an NSTE ACS pathway according to the initial ECG and clinical presentation. For…

…patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification for that treatment decision. Population to which SCORE2 and SCORE2 OP apply…

…discussed in the chapter The ECG Leads. Acquisition of ECGs in pediatric patients is slightly different from adults, due to obvious anatomical differences. There are…

…adult patients with acute coronary syndrome (ACS) or a prior heart attack and a high risk of developing an atherothrombotic event. Contraindications Hypersensitivity to the…

…is a widely recognized and validated tool used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF) who are…

…factor for stroke in AF patients. Evidence suggests that the increased stroke risk in women is more closely associated with other comorbidities and age rather…

…tracings continuously to cloud based platforms, which enables the clinician to examine intracardiac ECGs at any time. However, most clinicians who encounter patients with pacemakers…

…to the left atrial appendage, although competing mechanisms such as large artery atherosclerosis and small vessel disease may also contribute to stroke in patients with…

…instability. Fewer than 1% of patients with ST elevation myocardial infarction (STEMI) who reach the catheterization laboratory are found to have complete LMCA occlusion, likely…

…Other symptoms – such as dyspnea, cold sweat, nausea, etc – are also common in NSTEMI and unstable angina (please refer to Approach to Patients with Chest…

…favorable prognosis, as compared with other forms of ventricular tachycardia. Mechanisms of ventricular tachycardia Ventricular tachycardia (VT) may emerge due to increased/abnormal automaticity, re…

…uniform across the HFmrEF population. Some patients have a pathophysiological profile closer to HFrEF, whereas others have features overlapping with HFpEF, including abnormalities of LV…

…However, in cases of rapid AVNRT or in patients with underlying structural heart disease, the arrhythmia may result in symptoms indicative of reduced cardiac output…

…recent studies challenge these notions. Pathological Q waves may resolve in up to 30% of patients with inferior infarction. The amplitude of Q waves may…

…to infarction due to the collaterals. Occasionally, patients with total and proximal occlusions may present without ST segment elevations (which they should exhibit) due to…

…decreases during expiration (due to increased vagal tone). This results in a slightly irregular rhythm. Sinus arrhythmia occurs in the majority of healthy pediatric patients…

…has had time to adapt. Hypotension and muffled heart sounds are important when present but are relatively insensitive findings. Some patients with subacute tamponade may…

…Refer to Figure 2. Epsilon wave and prolonged TAD strongly suggests ARVC. Low limb lead voltage. Patients with ARVC display frequent premature ventricular contractions (PVC…

…This is due to altered tone in the autonomic nervous system, with increased sympathetic input (leading to stimulation of beta adrenergic receptors) and parasympathetic withdrawal…

ECG Myocardial ischemia and infarction Approach to patients with chest pain: differential diagnoses, evaluation and management Chest pain is one of the most common symptoms…

…a potent P2Y12 inhibitor to clopidogrel; reducing the dose of prasugrel; extending DAPT beyond 12 months in carefully selected patients with high ischemic risk and…