…The critically ill patient in intensive care According to the local protocol Avoid tight targets in inpatients. Hypoglycaemia on the ward is more dangerous than…

…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…

…and illicit substances. Currently, opioid overdose stands as a predominant etiological factor for cardiac arrest within this demographic on a global scale. Numerous substances possess…

…therapy. Secondary prevention Although outside the principal scope of primary prevention, secondary prevention provides an important contrast. Patients with manifest clinical disease are at high…

…with the poison control centre and with anaesthesia or intensive care. If intubation is necessary, a high minute ventilation and careful control of the pH…

…had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no practical risk prediction tool currently exists…

…is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed, with clinicians focusing primarily on…

…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…

…No treatment High 1 Oral anticoagulation (warfarin or NOAK 1 is considered for male patients with a score of 1 or more. Patient preference and…

…is achieved by filtering out signals with low amplitude and high velocity; such signals represent reflections from blood flow. Instead, the ultrasound system focuses on…

…Testing is particularly relevant in: individuals with premature atherosclerotic cardiovascular disease; patients with familial hypercholesterolaemia or very high LDL cholesterol; people with a family history…

…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…

…restenosis after metallic stent implantation is increased by: Small reference vessel size A small post procedural luminal diameter A high degree of residual stenosis Long…

…or a reduced requirement for antihypertensives, should prompt clinical suspicion [1]. Cardiac Signs and Symptoms Patients often present with symptoms of predominant right heart failure…

…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…

…patients with ANOCA/INOCA, symptoms may persist despite non obstructive coronary anatomy. Such patients require a mechanism based assessment rather than reassurance based solely on…

…makes the sinus and AV nodes supersensitive to the drug, the initial dose should be reduced to 3 mg. Dipyridamole therapy: Dipyridamole is a nucleoside

…which describe the current pH of the blood. Acidosis and alkalosis , which describe processes that lower and raise pH respectively. A patient may therefore have…

…High Management should incorporate the estimated risk, risk enhancing factors and a clinician–patient discussion regarding the expected net benefit of therapy. Lifestyle modification is…

…three components: diabetes or hyperglycaemia, ketosis and metabolic acidosis. A very high glucose value is no longer required [1]. Diabetic ketoacidosis, DKA Hyperosmolar hyperglycaemic state…

…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…

…arrest. This is a rather large increase in relative risk , but the absolute risk is still very low among most patients with early repolarization. Difference…

…it aligns with their emphasis on early angiography in high risk patients regardless of ECG findings. Thush, it serves as a valuable diagnostic tool and…

…The explanation for this is simple: transmural ischemia is due to a complete and proximal artery occlusion and such occlusions must be managed with immediate…

…early catheter ablation and sophisticated device therapy [1] [2] . This exhaustive review provides a comprehensive synthesis of the current state of VT management for the…

…of Cardiology (ESC) guidelines advocate for ICD implantation in high risk LQTS patients, emphasizing a comprehensive risk assessment that includes genetic factors and QTc duration…

…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…

…with new onset bradycardia or a high degree of heart block. In patients with severe mental illness (SMI) receiving antipsychotic therapy, sinus tachycardia is common…

…of Cardiology (ESC) guidelines advocate for ICD implantation in high risk LQTS patients, emphasizing a comprehensive risk assessment that includes genetic factors and QTc duration…

…BLS is an exceptionally effective treatment, with a very low number needed to treat (NNT), indicating high effectiveness. Although BLS is primarily developed for out…

…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…

…Survival in cardiac arrest is highly dependent on the initial rhythm (first recorded rhythm). The initial rhythm is a marker of several crucial events and…

…examination. Some patient engagement is required to obtain all views and the best possible image quality. A standard study takes approximately 30 60 minutes. Each…

…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…

…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…

…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…

…wasted patients, an apparently normal creatinine may therefore correspond to markedly impaired renal function [3]. Urine output can change before creatinine but is not a…

…°C — the hypothermic myocardium is irritable and pacing can precipitate ventricular fibrillation. Prioritise rewarming. Bradycardia in a patient with a normal circulation and no symptoms…

…for patients with HFrEF, LVEF <35%, sinus rhythm and resting heart rate 75 beats/min, based on a retrospective subgroup analysis in which a survival…

…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…

…a bacterial filter, a nose clip, a chair with armrests, a bronchodilator with a spacer, and current reference values (GLI 2012 is the standard). Patient…

…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…

…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…

…whom the criteria is ≥1 mm. • Men & women V7 V9: ≥0,5 mm. The ST segment elevations in ischemia are dynamic. A patient may initially…

…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…

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

…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…

…segment depression is more specific than the downsloping depression. Refer to Figure 1 . Figure 1. Characteristics of ischemic ST segment depressions on ECG. Current guideline…

…An intensive care patient in whom a decision has been made to withdraw life sustaining treatment, in whom total brain infarction is not expected to…

…patient's dependence on pacing, the presence of CRT, the type and location of surgery, and the anticipated current pathway. In a pacing dependent patient…

…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…

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

…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…

…LQTS) is manifest when a long QT interval induces ventricular arrhythmias. Figure 1. The QT interval on the ECG. The QT interval is inversely related…

…depends on the integration of revascularisation with guideline directed medical therapy and secondary prevention. Clinical Presentation and Symptoms The clinical presentation is variable. Patients may…