…Symptoms may remain present daily or weekly despite multiple antianginal agents and prior revascularization procedures. In many patients, the burden is sufficiently severe to limit…

…a bronchodilator with a spacer, and current reference values (GLI 2012 is the standard). Patient preparation — given with the appointment letter: Drug or habit Period…

…regardless of etiology, if the initial rhythm is asystole or PEA. Most current protocols for ECMO exclude patients presenting with asystole or PEA. Duration of…

…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…

…3 For patients with a BMI below 35 kg/m², direct assessments such as waist circumference, waist to hip ratio, or dual X ray absorptiometry…

…Hypoglycaemia on the ward is more dangerous than moderate hyperglycaemia over a few days. Principles Insulin component Function Who needs it : : : Basal insulin (intermediate or…

…Symptoms – Patients with acute myocardial infarction may present with typical ischemic chest pain, or with dyspnea, nausea, unexplained weakness, or a combination of these symptoms…

…lavage if gastrointestinal perforation or obstruction is suspected. If the patient is intubated, administer activated charcoal through a gastric tube at a dose of 0…

…9 As above. Very high Oral anticoagulation (warfarin or NOAC) is recommended for all female patients with a score of 3 or more. Very high…

…the patient's sex, weight and height. CI = CO / BSA BSA = Body Surface Area (m 2 ) Ejection fraction (EF) Ejection fraction is the…

…be stored in a database, where the patient's personal identification number or equivalent is used for secure identification. If the examination is performed urgently…

…a) at least once in every adult’s lifetime. Testing is particularly relevant in: individuals with premature atherosclerotic cardiovascular disease; patients with familial hypercholesterolaemia or…

…is a disabling condition with a very negative impact on quality of life. Approximately half of all patients with heart failure die suddenly, as a…

…is a disabling condition with a very negative impact on quality of life. Approximately half of all patients with heart failure die suddenly, as a…

…AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical history (with emphasis on causes of AV blocks; please…

…relying on angiography alone. Factors associated with restenosis The risk of restenosis after metallic stent implantation is increased by: Small reference vessel size A small…

…For patients on beta blocker therapy, consider administering 1 2 mg of glucagon intravenously. Currently, there is insufficient evidence to support the use of steroids…

…stroke or systemic embolization, even in patients in sinus rhythm [8]. Differentiating ATTR and AL Cardiac Amyloidosis Definition and Pathophysiology Cardiac amyloidosis (CA) is a…

…Mortality in pulmonary embolism is up to 20%, and roughly 30% of patients with pulmonary embolism or deep vein thrombosis experience a second thrombotic event…

…suction and emergency drugs in the room. Staff with current CPR competence; a physician available. Patient preparation: A light meal is permitted; no large meal…

…or anuria for at least 12 hours Use whichever criterion gives the higher stage. A patient can thus be stage 3 by urine output despite…

…adrenaline or dopamine according to local practice, and does not replace pacing when the patient is markedly unstable. Transcutaneous pacing Equipment A defibrillator with a…

…in symptomatic patients with LVEF ≤35%, sinus rhythm and a resting heart rate ≥70 beats/min, provided that treatment includes an ACE inhibitor or ARNI…

…is to be performed. Procedure 1. Position the patient correctly. The lateral position with the back towards you, the knees drawn up, the chin on…

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

…failure. These patients experience substantial morbidity and mortality, despite often having a considerable burden of non cardiac comorbidity. HFmrEF has clinical characteristics that, on average…

…The probability of hypertrophic cardiomyopathy is inversely related to age, such that the younger the patient presenting with hypertrophy, the more likely a genetic etiology…

…determining what phase the patient is in. The three phases following a sudden cardiac arrest were described by Weisfeldt and Becker (2002). Drawing on physiology…

…Remove contaminated clothing and wash the skin after external exposure A low Glasgow Coma Scale is not on its own an absolute indication for intubation…

…For patients weighing less than 50 kg, the dosing should be 0.05 to 0.3 mg/kg. Central venous access: When injected into a…

…deficiency, folate deficiency — transfusion is rarely the right measure. Contraindications Anaemia that can be corrected with iron, B12 or folate in a stable patient. Transfusion…

…1 A ). Concave ST segment elevations, on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted…

…Question Appropriate sample : : Metabolic acidosis or alkalosis in a haemodynamically stable patient A venous blood gas is often sufficient as the first sample Precise pCO₂…

…LDL C is markedly elevated. Non HDL C and apoB are secondary targets or risk refining measures, particularly in patients with: Diabetes or other cardiometabolic…

…Assess the pain both at rest and on movement . A patient who is pain free lying still but screams when turned has not finished being…

…and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is an acute or subacute worsening of…

…patients have increased plasma levels of catecholamines. References A recent consensus document has been issued by the European Society for Cardiology: Lyon et al: Current…

…by T wave inversions (or flat T waves), but the primary ECG finding is the ST segment depressions. In STE ACS, on the other hand…

…types are not a bar). Untreated generalised infection, or certain transmissible agents according to the current transmission risk assessment. In DCD: patients in whom death…

…dependence Determining pacing dependence is central to planning. If EMI causes oversensing and pacing inhibition, a patient who has little or no reliable intrinsic rhythm…

…be tailored to the patient's needs. Programming is done through an external device that communicates wirelessly with the pacemaker. A wide range of settings…

…Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and…

…used when referring to exercise stress tests carried out on a treadmill. In many parts of the world, the bicycle is preferred over the treadmill…

…Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather…

…particularly if spontaneous or diuretic induced, but it is absent in most diagnosed patients. Reliance on hypokalaemia alone therefore misses a substantial proportion of cases…

…the need for a structured and guideline directed approach. This chapter focuses on practical diagnostic and therapeutic considerations, with recommendations aligned with current guidelines from…

…to judge whether the QT interval is normal or not, one must adjust for the current heart rate. This is done by adjusting the QT…

…are not restricted to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the documented ischaemic burden…

…or electrical instability. Posterior infarction may occur in patients with a clinically unstable acute coronary syndrome, but the examination does not reliably establish or exclude…

…ventricular fibrillation. The combination of early repolarization pattern on ECG and ventricular fibrillation or sudden cardiac arrest is referred to as early repolarization syndrome . Early…

…its reliance on ST segment elevation as the key trigger for emergent reperfusion therapy. This approach fails to identify a substantial proportion of patients with…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…Renal function biomarkers are essential in the evaluation and ongoing management of patients on sotalol. Because the drug is excreted unchanged primarily by the kidneys…

…VT lasting longer than 30 seconds or requiring termination earlier due to hemodynamic collapse [4] . Sustained VT is a medical emergency that universally warrants acute…

…For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly prolonged QT intervals…

…a high index of suspicion for drug induced arrhythmias in patients receiving agents known to alter the electrical properties of the heart (inducing QRS or…

…is greatest in patients with a recent TIA or stroke, particularly when the event occurred within 3 months and the ipsilateral stenosis exceeds 70%. Patients…

…For patients at elevated risk—such as those with a history of cardiac arrest, recurrent syncope despite beta blocker therapy, or markedly prolonged QT intervals…

…of a risk factor depends not only on the relative risk associated with exposure but also on how common the exposure is. Consequently, a modest…

…trial. These patients were enrolled in a randomized trial that evaluated the efficacy of a CPR adjunct and also recorded the compression rate and depth…