…those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no…

…al . Brugada syndrome was identified in the early 1990s and early repolarization was identified as a risk factor for sudden cardiac arrest in 2008 (1…

…ATRIA Score: The same study found that the ATRIA score had a lower predictive performance for major bleeding compared to HAS BLED. The C indices…

…establish whether the patient has ACS. It is to determine whether the patient is clinically unstable, identify life threatening diagnoses rapidly, and select a safe…

…with the patient fasting or having had a light breakfast according to local practice. Let the patient rest lying down or sitting for at least…

…circumstances surrounding a sudden cardiac arrest, uncertainty may arise with regard to no flow time, low flow time, patient preferences, patient background, and the decision…

…as STE ACS/STEMI until angiography has been performed. Note that troponins may be elevated but the elevation is typically discrete and not on a…

…as follows: Suverein et al (2023) : In a multicenter, randomized trial, the effects of extracorporeal cardiopulmonary resuscitation (ECPR) was compared to conventional CPR in patients…

…prevent one adverse cardiovascular outcome, the potential benefit for an individual patient may remain substantial. At the same time, adverse effects such as hypotension, syncope…

…expression on ECG. Therefore, ischemic ST T changes (ST elevations, ST depressions, T wave changes) are typically concealed in the setting of LBBB. A patient…

…or transaminases, and thrombocytopenia—is generally regarded as a severe preeclamptic phenotype or variant. Pathophysiology The precise mechanism of preeclampsia remains incompletely established. Proposed contributors…

…the recommended dose for extended treatment for patients who had a heart attack at least a year ago and are at high risk of a…

…For example, in the SYNTAX trial, patients with high scores had significantly higher mortality and MACE rates compared to those with low scores. Monitor Quality…

…reflex for predicting a poor neurological outcome was 68.8%. This implies that approximately one third of the patients who ultimately had a favorable neurological…

…minutes, hence its designation as the “widow maker.” Patients who survive long enough for clinical evaluation often have some residual antegrade flow, a dynamic thrombus…

…on the rate of fluid accumulation, pericardial distensibility, and ventricular filling pressures. Effusions may be circumferential or, particularly after trauma or cardiac surgery, loculated. A…

…present data on 416 patients hospitalized with COVID 19. In total, 82 patients (19.7%) had elevated high sensitivity troponin I (TnI) levels. The mortality…

…a pharmacological feature that may limit muscle related toxicity despite bempedoic acid acting within the same broad cholesterol synthesis pathway as statins. The principal molecular…

…Atrial fibrillation (AF) is the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and is also a common tachyarrhythmia requiring treatment in…

…as estimating the extent of ischemia. After revascularization procedures, stress testing is utilized to assess whether there is any residual ischemia or angina pectoris. Patients…

Akutsjukvård Lathundar Basic principle Manage the patient, not the list of poisons. Stabilisation according to ABCDE, the plasma glucose, a blood gas and an ECG…

…A vasopressor (noradrenaline) and cautious fluid administration. Large fluid volumes worsen an already strained right ventricle. Clinical probability in the stable patient The Wells criteria…

…or as an add on Slow onset. Dose reduction in renal failure and in old age Amiodarone In severe haemodynamic compromise where the above cannot…

…blunt the febrile response. A neutropenic patient with a suspected infection and organ dysfunction must therefore be managed as neutropenic sepsis even if the temperature…

…tap. A blood sample at the same time: serum albumin is mandatory in order to be able to calculate the SAAG. The patient lies supine…

…pacing: the relative contraindications are the same as for a central venous catheter — coagulopathy, infection at the puncture site, known thrombosis in the target vein…

…or collapse The classification is based on a combination of clinical findings, oxygenation and objective measurement of airflow. International thresholds vary somewhat, but a PEF…

…defined as a plasma sodium below 135 mmol/L. The biochemical grade alone does not indicate how acute the condition is. A patient with a…

…aspirin given as secondary prevention 8 Contact the endoscopist and the consultant on call early. In cirrhosis or suspected variceal bleeding, also contact a gastroenterologist…

…per patient if no valid result exists Type and screen (BAS test) Blood group confirmation and antibody screening. If the screen is negative, a unit…

…the patient are that it is too tight — the swelling comes after the injury, not before — and that an edge or a fold presses on…

…older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work systematically through the possible causes…

…mobility, a cervical collar, rheumatoid arthritis, ankylosing spondylitis MACOCHA is validated for the intensive care patient and totals 12 points: Mallampati III–IV (5 points)…

…a patient performs progressively increasing external work, usually on a treadmill, while symptoms, a 12 lead ECG, heart rate and blood pressure are monitored. The…

…concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of acute coronary syndrome (ACS)…

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

…up triggers a new attack. A patient with vestibular neuritis or stroke, by contrast, is already continuously dizzy. Head movement then worsens the symptoms but…

…lymphoedema or a dialysis fistula in both arms, an arm circumference too large for the available cuffs, and in a patient who does not tolerate…

…use Do not use Nitrofurantoin: as a general rule the drug is contraindicated at an eGFR <45 mL/min. A short course (no more than…

…tranexamic acid on a pledget or as a solution has a good effect in anterior bleeding. Raise the chair so that the patient's nose…

…Electrolyte disturbance Correct Second or third degree AV block Depending on the indication Marked anaemia Correct A resting ECG that makes ST interpretation impossible — left…

…pneumonitis as a consequence Medicinal charcoal Bowel obstruction, ileus or suspected perforation Gastric lavage An unprotected or unsecured airway in a patient with a reduced…

…has been the primary screening test throughout the country. Cytology is used as a triage test on the same liquid based sample when the HPV…

…a bar to vaccination. Relative: Lymphoedema or previous axillary clearance on the same side. A paretic limb — poorer absorption. Injection into an arm with a…

…determines a lumbar puncture is rarely the needle itself. It is the decision whether to perform it now or after imaging, how the patient is…

…when the patient cannot swallow safely, for example after a stroke. Sampling of gastric contents and evacuation in poisoning (see the separate text on gastric…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…so as not to reduce a fracture dislocation or to miss a posterior dislocation. The exceptions are an obvious recurrent dislocation in a patient with…

…the mouth. Suction the mouth as needed and place the patient in the recovery position when this is practicable. Give oxygen if hypoxaemic. Use a…

…fever — defined as a temperature above about 37.7–37.8 °C — for at least 72 hours in patients who remain unconscious. The evidence is…

…the evening so that a dose change can reach the patient the same day the result arrives. 3. Reduce to 5 mg (two tablets) on…

…is reasonable, although the optimal initial combination strategy remains uncertain. A beta blocker combined with a dihydropyridine CCB is appropriate for many patients. Long acting…

…The specific voltage thresholds vary based on patient age, sex, and lead location, as detailed below [8, 10]: Patient Demographic Lead Group ST Elevation Threshold…

…and patient preferences. The source material describes hypertension using differing thresholds across international guidance. One framework defines confirmed hypertension as blood pressure consistently above 130…

…of the "healthy" range can still harbor significant metabolic risk. 3 For patients with a BMI below 35 kg/m², direct assessments such as waist…

…chest pain. It is appropriate when the expected information is likely to change management. In patients with a very low probability of obstructive CAD, testing…

…or a range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the patient’s clinical context and the…

…preferably while the patient is receiving a stable diuretic dose. Other clinical contexts Secondary causes should be pursued when abnormalities are identified on initial testing…

…although not every patient with an initial STEMI pattern has myocardial infarction as the final diagnosis. The underlying process usually involves acute thrombotic obstruction of…

…is a working diagnosis based on persistent ST segment elevation or an equivalent electrocardiographic pattern in a patient with symptoms of myocardial ischaemia. The immediate…