…through statements made to the next of kin. Active malignancy with a risk of transmission (an individual assessment; certain tumour types are not a bar)…

…not apparent. Such a discrepancy should prompt consideration of an infiltrative cardiomyopathy within the appropriate clinical context. Several patient related factors influence interpretation. Natriuretic peptide…

…of overdose. Sedation precedes respiratory depression; monitor it. Naloxone is titrated to spontaneous breathing, not to wakefulness. It has a short half life, and the…

…Patients with inflammatory rheumatic disease have a higher cardiovascular risk than the general population. This excess risk has been documented across a broad range of…

…caution in patients with asthma/chronic obstructive pulmonary disease (COPD). Dyspnea has been reported in patients treated with ticagrelor. Patients with a history of ischemic…

…Implantation history and current indication. Device function and battery status. Whether the patient is pacemaker dependent. Whether the device has been recently interrogated and whether…

…the patient has sepsis, septic shock, or a need for high dependency or intensive care 3 Take at least two sets of blood cultures from…

…Akutsjukvård Lathundar Immediate management The most dangerous asthma attack is the silent one. A patient who has become calm, quiet in the chest and stopped…

…describes a clinical presentation in which the patient has symptoms suggestive of acute coronary syndrome (ACS), biochemical evidence of myocardial injury with corroborating evidence of…

…vestibular neuritis from posterior circulation infarction. The test presupposes that the patient has spontaneous nystagmus at the time of examination and that the examiner is…

…membrane — including a history of grommets, ear discharge or pain on contact with water. A history of ear surgery in which the middle ear may…

…in patients with previous complicated withdrawal [4]. Untreated delirium tremens has historically carried a high mortality. With modern sedation, supportive treatment and treatment of the…

…patient who declines blood transfusion. The decision must be documented and alternatives (iron, tranexamic acid, cell salvage, haemorrhage control) planned in advance. A history of…

…a clinical tool designed to estimate the risk of major bleeding in patients with atrial fibrillation (AF) undergoing anticoagulation therapy, particularly with warfarin. Developed from…

…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…

…cardiovascular conditions demonstrate autosomal dominant transmission, in which an affected heterozygous individual has a 50% risk of transmitting the relevant variant to each child. However…

…sex , and race based percentile Comparison with the expected score for a person of the same age and sex CAC may also reveal extracoronary findings…

…History taking, physical examination, ECG and laboratory tests are the cornerstones of management of patients with chest pain. A 12 lead ECG recording must be…

…dry. Patients may describe a persistent tickle or sensitivity in the throat. In recent years, the concept of a distinct "cough hypersensitivity syndrome" has emerged…

…or a class 2–3 compression stocking. Tape measure for ankle circumference — this governs the choice of material and bandaging technique. Procedure Assessment 1. History…

…although a smaller number of older patients may need treatment to prevent one adverse cardiovascular outcome, the potential benefit for an individual patient may remain…

…pattern of angina, with increasing frequency or severity Symptoms that awaken the patient from sleep Clinical assessment must be integrated with vital signs, a 12…

…in patients with atrial fibrillation (AF) who are taking anticoagulants. It was developed in 2010, using data from the EuroHeart survey. Components of the HAS…

…effects of COVID 19 Coronavirus disease 2019 (COVID 19) has caused a global public health crisis. It is believed that the virus was transmitted from…

…sex as a risk factor. However, recent studies have questioned the significance of female sex as an independent risk factor for stroke in AF patients…

…congestion may be important mechanisms. Diuretics relieve the hemodynamic consequences of congestion by producing a negative sodium and water balance. They can reduce jugular venous…

…model was developed using a single center longitudinal cohort and subsequently validated with an independent cohort of 1,689 patients from the International LQTS Registry…

…The balance between pro thrombogenic and pro thrombolytic factors determines whether atherothrombosis occurs, and these factors vary from minute to minute. Only a minority of…

…a 3 generation family history and consideration of genetic testing for all patients with non ischemic HFrEF. Toxic and infiltrative causes are increasingly recognized. The…

…to the affected carotid territory. Recent neurological symptoms are particularly important in determining management. The benefit of carotid revascularisation is greatest in patients with a…

…model was developed using a single center longitudinal cohort and subsequently validated with an independent cohort of 1,689 patients from the International LQTS Registry…

…relaxing vascular smooth muscle. They are contraindicated in patients with bronchospastic lung disease, or a history of significant reactive airway disease. Contraindications also include second…

…be useful in patients with symptomatic or asymptomatic peripheral arterial disease, in whom AAA has been reported with a substantial cumulative incidence. The source material…

…Others have no recognized history of angina or MI, making the distinction from primary dilated cardiomyopathy particularly difficult. When present, the clinical picture may include…

…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…

…AF initiated the deterioration or resulted from it. AF has important consequences beyond the arrhythmia itself. It may cause symptoms and impaired quality of life…

…that the clinician must set a lower goal regarding workload (e.g. reaching 70% of maximal pulse instead of 85%). Many patients appreciate the exercise…

…Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the treatment…

…has a different insulin sensitivity from at home: less food, more stress, often corticosteroids, often impaired renal function. Prescribe basal insulin, mealtime insulin and the…

…Assessment of whether residual weakness in a patient with known myasthenia responds to further cholinesterase inhibition. The test has a sensitivity of around 60 % and…

…reliably. Conditions in which oxygen is given irrespective of the saturation (see below). Oxygen does not relieve breathlessness in a patient who is not hypoxaemic…

…has the fibrillation lasted, and does the patient need an anticoagulant? The unstable patient Immediate electrical cardioversion, without delay, in any of the following: A…

…dose of a substance that binds to charcoal, when it can be given early and the patient has an intact or a protected airway. The…

…status again once the cast has set, and document it. 10. Elevate the limb and inform the patient. Backslab or circumferential cast A dorsal backslab…

…can keep a patient alive until a transvenous lead is in place — but only if it is working, and the commonest source of error is…

…to refrain from investigating postmenopausal bleeding or a visible cervical lesion. Contraindications There are no absolute contraindications, but refrain or adapt in: The patient does…

…into a joint in which infection has not been excluded. Indications Acute monoarthritis in which septic arthritis must be distinguished from crystal arthritis — the most…

…and the active prevention of fever — defined as a temperature above about 37.7–37.8 °C — for at least 72 hours in patients who…

…Restoration of patency may be particularly relevant when the occluded artery supplies viable myocardium with demonstrable ischaemia. However, randomized evidence has not shown a reduction…

…central. A simple check is to ask the patient to recite the months of the year backwards. A normal result does not exclude delirium, however…

…a few centimetres away from them Full bladder Have the patient void, or catheterise, before puncture Pregnancy, previous extensive abdominal surgery Ultrasound guidance; choose a…

…most consistent contemporary role is therefore the assessment of functional capacity, symptoms, haemodynamic responses, arrhythmias and prognosis, with diagnostic interpretation reserved for appropriately selected patients…

…and asystole can all occur in one patient. The typical depiction of sudden cardiac death as a gradual transition from sinus rhythm to ventricular tachycardia …

…cannulae 0 to 10 min A blood gas with lactate, two sets of blood cultures, and a culture from the likely focus 0 to 15…

…lactate is an indicator of tissue hypoperfusion and can guide resuscitative efforts. If the patient presents with hypotension or has a lactate level exceeding 4…

…Exercise stress test Evaluation of the exercise stress test (exercise ECG) The ECG reaction has always been a central component of the exercise stress test…

…keep the dressing clean with a tracheostomy or copious secretions Subclavian vein Most comfortable for the patient, the most stable dressing, lowest risk of infection…

…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…

…ranging from bradycardias related to enhanced vagal effect to life threatening tachyarrhythmias. Evaluation and Physical Examination Physical examination of a patient on digoxin therapy should…

…from different classes. By acting on more than one pathophysiological pathway, combinations generally lower blood pressure more effectively than simply increasing the dose of a…