…patient's ongoing consent, and be able to be stopped at any moment. A trauma informed approach also improves the technical quality — a relaxed patient…

…dose of a benzodiazepine About 10 minutes Repeat the benzodiazepine once if the seizure persists, and prepare step 2 at the same time By about…

…A notch is evident in the ascending part of the ST segment. A male patient (Figure 1) presented at age 36 years with an ECG…

…moved very slowly outwards in the horizontal plane , with pauses each time the patient tenses, until the joint slides back — usually at 70–110 deg

…formulation and the estimated quantity the time, and whether the intake was single or repeated a modified release preparation or a combination product concurrent drugs…

…blog Endocrinology & metabolism Cardiovascular medicine is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed…

…at the scene. If an AED (automatic external defibrillator) has been connected, it should be interrogated (if possible) to determine whether it has recorded any…

…in endocarditis In 1973, it was the first time to describe how echocardiography (M mode) can be used to diagnose endocarditis. With 2D and later…

…plan — check any decision to limit treatment when time allows. There is complete upper airway obstruction where laryngoscopy will not succeed; plan for a surgical…

…unknown time of onset when MRI is immediately available and does not delay treatment Saturation Give oxygen in hypoxia, not routinely to a normoxic patient…

…hypovolaemia, requires a vasopressor to maintain a MAP of at least 65 mmHg and at the same time has a lactate above 2 mmol/L…

…threshold: ivabradine was approved for patients with HFrEF, LVEF <35%, sinus rhythm and resting heart rate 75 beats/min, based on a retrospective subgroup analysis…

…Effects on triglycerides and lipoprotein(a) are variable or modest. In phase III studies involving patients with ASCVD or at least one ASCVD risk equivalent…

…arrest (SCA) to death follows a pathophysiological process that affects the effectiveness of the interventions. Numerous studies demonstrate that the available interventions are time sensitive…

…procedure, or over a few days at home for a hard plug. Have the patient lie with the ear uppermost for 5 minutes after instillation…

…This syndrome was first descried in 1991 in Japan and the authors termed it takotsubo , which is the Japanese word for a kind of octopus…

…to misclassification of CKD stages. Population Specificity: The equation was derived from a study population primarily consisting of individuals with CKD, limiting its accuracy when…

…a monoclonal antibody directed against interleukin 1β, provided proof of concept but was not developed for routine coronary prevention because of fatal infections and…

…HBR) should be assessed in a structured manner. Within the ARC HBR framework, HBR is defined by the presence of at least one major criterion…

…20th century, widespread acceptance was delayed, partly due to autopsy studies demonstrating an absence of coronary thrombi in a significant proportion of deceased patients. Historically…

…detail. Symptom during exercise stress testing Perceived exertion The patient's perceived exertion is a way of estimating the intensity of the physical activity. It…

…of hypertension is explained by a cost benefit equation. The benefits of interventions for hypertension exceeds the risks and costs at 140/90 mm Hg…

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

…available at some laboratories. Red flags and pitfalls Failing to ask when the last dose was taken. It matters more than the laboratory value. A…

…and procedural complexity. Overall incidence and major complications Complications during diagnostic coronary angiography occur in approximately 2% of patients. Serious events such as stroke and…

…myocardial territory at risk has been described as approximately 75–100%, depending on coronary dominance. Significant left main stenosis is generally defined as a diameter…

…and Physical Examination The initial evaluation of a patient with suspected syncope aims to determine whether the transient loss of consciousness was due to syncope…

…the absolute majority. The CCU may be suitable for stable (hemodynamically and respiratory) and fully conscious patients who experienced a brief cardiac arrest. Post resuscitation…

…individuals with heart failure. Notably, beta blockers actually increase chronotropic competency in patients with heart failure, despite their negative chronotropic effect. Among persons who do…

…as NSTEMI due to the sensitive troponin assays). Interested readers are referred to E. Braunwald: Unstable angina: is it time for a requiem? Circulation, 2013…

…2023) : In a multicenter, randomized trial, the effects of extracorporeal cardiopulmonary resuscitation (ECPR) was compared to conventional CPR in patients with refractory out of hospital…

…the catheterization laboratory in patients undergoing acute PCI. The PCI operator may use the ECG to obtain immediate confirmation on whether the intervention was successful…

…waves) in a patient with early repolarization. Figure 4. Osborn wave (J wave) in a patient with early repolarization. This patient was 31 years old…

…a large UK clinical database, autoimmune disease was associated with 23.3 cardiovascular events per 1000 patient years, compared with 15.0 per 1000 patient…

…DAPT is generally a temporary strategy. At an appropriate point, it is usually replaced by single antiplatelet therapy (SAPT), most often aspirin. In selected patients…

…because collateral vessels may develop over time. By contrast, an acute thrombus may form at a site that was previously only mildly or moderately stenosed…

…of management of patients with chest pain. A 12 lead ECG recording must be registered and interpreted within 10 minutes of arrival at the hospital…

…been recorded at 27%, while for witnessed cardiac arrests, the survival rate stands at 73% (Podsiadlo et al.). A significant majority of these patients exhibit…

…which at the time was primarily fibrinolysis (Wilner et al.). Their findings revealed that a substantial number of these patients had complete coronary artery occlusions…

…In people with a 10 year cardiovascular risk of approximately 10%, the number of cardiovascular events prevented was similar to the number of major bleeding…

…to have a sensitivity of 60%. 4 points make LVH probable. 5 points make LVH very likely. Romhilt Este's score system Points Any of…

…reperfusion therapy. This approach fails to identify a substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting…

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

…used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF) who are taking anticoagulants. It was developed in 2010…

…The SYNTAX Score was created to address the need for a standardized method to evaluate the anatomical complexity of CAD, particularly in patients with multivessel…

…the neurological status assessed at 30 days was evaluated. The findings were as follows: The absence of a pupillary reflex demonstrated a sensitivity of 72…

…noted that the syndrome – which was named the Brugada syndrome – appeared to be hereditary, since many patients reported a family history of the same symptoms…

…great a risk of all cause death and cardiovascular death, compared to patients without such disturbances, including those with RBBB and LBBB. This was reported…

…particularly regarding the risk stratification of asymptomatic patients, the prognostic utility of electrophysiological studies (EPS), and the transition from a purely device based management strategy …

…aVR was relatively uncommon (7%). Patients with greater ST elevation in aVR had higher crude in hospital and 6 month mortality (up to 18% at…

…rate was observed in patients with elevated TnT levels who had underlying cardiovascular disease, of which 69.4% died. Guo et al also report a…

…et al ). Among patients with coronary heart disease, left ventricular function is actually a stronger predictor of death than the atherosclerotic burden. Assessment of the…

…dispersion in the refractoriness. This means that some myocardial regions will be refractory while others will be excitable at the same time. As previously discussed…

…not disturb the patients' rest. It was believed that the mere presence of physicians and nurses caused harmful stress. Approximately 30% of patients died in…

…Consequently, the CHA₂DS₂ VA score was developed to provide a more accurate risk assessment by omitting the sex category component. Components of the CHA₂DS₂ VA…

…and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and…

…angioplasty to coronary stents Balloon angioplasty was initially limited by acute vessel closure and later restenosis. Coronary stents provided a scaffold that tacked down dissection…

…cardiovascular benefit CLEAR Outcomes CLEAR Outcomes was a randomized, double blind, placebo controlled study of 13,970 patients at high cardiovascular risk who were unable…

…function. Clinical presentation and symptoms The presentation is variable and may evolve over time. Some patients initially have angina as the dominant manifestation of CAD…

…SCAD may occur at any time during pregnancy or after delivery. The clinical context is particularly important. SCAD should be considered in a young or…