…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…

…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…

…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…

…Not prescribing glucose measurement. Prescribe the measurement times at the same time as the insulin. Giving mealtime insulin to a patient who is not eating…

…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…

…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…

…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…

…high Lp(a); individuals with cardiovascular disease that is not explained by major conventional risk factors; patients at moderate risk or close to a treatment…

…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…

…Optical coherence tomography (OCT) is currently the most suitable imaging modality for detecting neoatherosclerosis, although its resolution does not consistently permit identification of foamy macrophages…

…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…

…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…

…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…

…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…

…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…

…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…

…to echocardiography Hypertrophic cardiomyopathy is a genetic disorder that causes left ventricular hypertrophy under normal loading conditions. Hypertrophic cardiomyopathy should not be confused with hypertrophy…

…fatigue and oedema. The underlying mechanisms are not uniform across the HFmrEF population. Some patients have a pathophysiological profile closer to HFrEF, whereas others have…

…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…

…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…

…unlikely to revert a tachycardia and should not be used. Specific dosing adjustments are required in certain patient populations: Pediatric patients: For patients weighing less…

…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…

…anion gap, is there a further metabolic disturbance? Calculate the delta gap or delta ratio 6 Does the result fit the patient? If not, check…

…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…

…despite normal or low LDL C. HDL cholesterol (HDL C) is inversely associated with cardiovascular risk in observational studies, but it is not a validated…

…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…

…the dose does not arrive until the next flush. Assess the pain both at rest and on movement . A patient who is pain free lying…

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

…is typically discrete and not on a par with the degree of left ventricular impairment. Pathophysiology of takotsubo cardiomyopathy (broken heart syndrome) This topic is…

…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…

…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…

…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…

…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…

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

…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…

…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…

…repolarization pattern on ECG and ventricular fibrillation or sudden cardiac arrest is referred to as early repolarization syndrome . Early repolarization pattern may actually not be…

…does not display ST segment elevations during posterolateral transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and…

…experience. Studies have demonstrated that a significant proportion of patients with acute coronary occlusion (ACO) do not exhibit classic ST segment elevation on ECG, leading…

…repolarization time is extended to a greater degree at slower heart rates. Sotalol does not significantly alter resting membrane potential, action potential amplitude, or Vmax…

…assessment. A carotid bruit is an important marker of cardiovascular risk, although the source material does not provide diagnostic sensitivity or specificity for bruit detection…

…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…

…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…

…is not explained on the basis of morbid anatomy. This is not a new experience for either the pathologist or the internist. That there is…

…skin color is not necessary to confirm cardiac arrest. Skin color is pale or cyanotic, but this may be difficult to discern depending on the…

…are contraindicated in patients with bronchospastic lung disease, or a history of significant reactive airway disease. Contraindications also include second degree or third degree AV…

…V3 in patients with NSTE ACS/NSTEMI are almost invariably accompanied by ST segment depressions in other leads (particularly V5) and that is not consistent…

…Clearly, not all DCM genes have been discovered. Genetic testing for DCM Genetic testing of patients with confirmed or likely dilated cardiomyopathy can be recommended…

…nonsteroidal anti inflammatory drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be prescribed routinely to individuals…

…the tip is in tissue, not in the joint cavity. 6. Withdraw the needle, apply compression and a dressing. The knee The patient lies supine…

…instability, or life threatening arrhythmias. I C A routine primary PCI strategy should be considered in patients presenting late (12–48 h) after symptom onset…

…postpartum. Known hypertension and current antihypertensive treatment. Missed doses or abrupt withdrawal of a beta blocker, clonidine or another sympatholytic drug. Cocaine, amfetamine, other sympathomimetics…

…epinephrine) is the first line treatment and must be given early when anaphylaxis is suspected. Do not wait for a complete diagnosis or for grading…

…°C has not been shown to improve survival or the neurological outcome compared with keeping the patient normothermic — but fever after cardiac arrest is harmful…

…consciousness. Urgent EEG if the patient does not wake or if ongoing electrographic seizure activity is suspected Benzodiazepines are the established first line treatment. Intravenous…

…other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption but to achieve complete abstinence from tobacco and ultimately…