…or therapeutic benefit against the patient’s specific procedural risks. Vascular access and access site complications Radial and femoral access Radial access is generally preferred…

…referred to as primary hypertension . Essential hypertension is defined as hypertension without an identifiable underlying cause. Researchers previously believed that this form of hypertension was…

…slurring or notching at the J point. A notch at the J point is actually a J wave. The term “early repolarization” was used to…

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

…to their clinical presentation, these patients are immediately referred to angiography but no coronary artery occlusion can be identified. Injection of contrast media into the…

…several studies have shown that the majority of patients inappropriately referred to the catheterization laboratory with suspicion of STEMI (STE ACS) have left bundle branch…

…should be amenable to reversal. The indication is stronger in younger individuals. Individual patient circumstances and clinical judgment are paramount in determining the appropriateness and…

…Nevertheless, cardiac troponin (T or I) has almost 100% specificity for myocardial cells and is the preferred biomarker according to North American (ACC, AHA) and…

…the ST segment bulges upwards (Figure 1 and 2) in these leads. These ECG changes were previously referred to as strain pattern because it was…

…fibrillation or sudden cardiac arrest is referred to as early repolarization syndrome . Early repolarization pattern may actually not be due to early repolarization The term…

…OHCA) or cardiac arrest team (in IHCA). There are no risks in instructing a layperson to perform chest compressions on an unconscious individual. The potential…

…have been introduced to assess left ventricular function. The majority of these parameters can be calculated or approximated using two dimensional echocardiography. The most widely…

…the ambulance crew The stated dose is often unreliable and must never be used on its own to declare the patient well. Clinical findings, the…

…severe hypothermia No signs of life <24 °C Actions in accidental hypothermia with cardiac arrest or cardiopulmonary depression Use HOPE Score to assess the prognosis…

…transferred to such centers. Post cardiac arrest syndrome (PCAS) Post cardiac arrest syndrome (PCAS) emerges after ROSC or initiation of ECMO. The syndrome was first…

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

…of stent type. The preferred regimen is aspirin plus a potent P2Y12 inhibitor, usually prasugrel or ticagrelor. In patients undergoing PCI for ACS, prasugrel should…

…inclisiran was added to maximally tolerated statin therapy, with or without other lipid lowering treatment. The durability of the response is central to its clinical…

…hospitalisation was related to the magnitude of heart rate reduction. Ivabradine is also a reasonable consideration when a beta blocker cannot be tolerated or is…

…reflex response to posture, venous pooling, or external stimuli. The underlying pathophysiology is rooted in autonomic dysregulation within a structurally normal heart. During an episode…

…The benefit of antiplatelet therapy must always be balanced against bleeding. This balance changes according to the clinical setting, time from MI or percutaneous coronary…

…that is not explained by major conventional risk factors; patients at moderate risk or close to a treatment threshold, when risk refinement may influence management…

…unrecognised oesophageal intubation are the two mechanisms that kill patients during airway management , and both are predictable. Indications Inability to protect the airway: reduced level…

…clinicians focusing primarily on hemoglobin A1c (HbA1c) reduction, blood pressure, lipids and smoking cessation. Weight loss was considered extremely difficult across patient categories. However, the…

…as not to reduce a fracture dislocation or to miss a posterior dislocation. The exceptions are an obvious recurrent dislocation in a patient with known…

…The underlying genetic abnormality is yet to be discovered. Diagnosis of this syndrome is based on ECG, family history and clinical presentation. Patients present with…

…the time of seizure onset, or the time the patient was last known to be well. Protect the patient from injury. Do not restrain the…

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

…in which the middle ear may be open (a mastoid cavity, mastoidectomy). An only hearing ear. Relative (choose a manual technique or refer to ENT…

…Specificity: The equation was derived from a study population primarily consisting of individuals with CKD, limiting its accuracy when applied to healthy populations or those…

…failed to demonstrate clinical benefit in the settings studied. Clinical application and patient populations The evidence for anti inflammatory treatment in coronary disease has principally…

…adjusted). To determine this it is necessary to perform an exercise stress test, during which it is fundamentally important that the patient performs maximally. Only…

…simpler to administer, since the whole dose is given as a bolus [1,2]. In a meta analysis of three phase 3 trials, tenecteplase was…

…Some patient groups have a two to three fold greater prevalence of asymptomatic atherosclerotic cardiovascular disease (ASCVD) than the general population. The evidence for premature…

…revascularization was performed; the type of revascularization; stent related risk; whether long term oral anticoagulation is required; tolerance of treatment during the initial months. Patients…

…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…

…have no critical epicardial stenosis. In some of these patients, microvascular obstruction or epicardial spasm may account for the ischaemia. STEMI usually results from rapid…

…patients with acute coronary syndromes. Moreover, clinicians must clarify whether the ECG was recorded during chest pain, since an ECG without signs of ischemia during…

…passing from the lungs to the left ventricle, which therefore contracts without pre load (the ventricle is empty or nearly empty). In patients with an…

…days, compared to the 30 day mortality of STEMI (ST segment elevation infarction) , which is about 6%. Previously, alpha streptococcus was the most common agent…

…rated as 6 or above (according to the 10 point scale) should prompt termination of the stress test (refer to Termination criteria during stress testing…

…be withheld in order to avoid futile attempts or subjecting the individual (and the relatives) to unwanted interventions. Unfortunately, during the stressful circumstances surrounding a…

…to fuel the contractile machinery and maintain ion channel function. Neumar et al studied how the ATP concentration diminishes during ventricular fibrillation (VF). This was…

…that the patient is not simultaneously on a DOAC, low molecular weight heparin and an antiplatelet agent without an indication. Interactions: strong P gp or…

…the evidence was observational and the results must not be taken to mean that an electronic alert replaces clinical judgement [5]. Recognising sepsis Suspected or…

…events prevented was similar to the number of major bleeding events caused. The evidence is not materially different by age or sex in the overall…

…risks in AF patients, regardless of the type of oral anticoagulant used. Studies have shown that it performs similarly or superiorly to other bleeding risk…

…is a clinical tool designed to assess stroke risk in patients with non valvular atrial fibrillation (AF). It is a modification of the widely used…

…e the risk of atherosclerotic plaque rupture is increased during infections). As noted by Bonow et al, it is also reasonable to believe that patients…

…arrest, or even sudden cardiac death. The Brugada brothers also noted that the syndrome – which was named the Brugada syndrome – appeared to be hereditary, since…

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

…of patients, while clinically evident restenosis, manifested by recurrent angina attributable to the treated segment, occurred in 10–15% during the first year. The dominant…

…or chest discomfort, with associated manifestations of myocardial ischaemia. In pregnancy, the clinical presentation of ACS is generally similar to that in non pregnant patients…

…infarct size and mortality to STEMI patients but significantly delayed treatment. While the OMI/NOMI framework is not yet formally incorporated into major clinical guidelines…

…is highly sensitive to brainstem integrity and cerebral perfusion. During cardiac arrest, circulation to the brain is severely compromised or absent, leading to rapid brainstem…

…designation as the “widow maker.” Patients who survive long enough for clinical evaluation often have some residual antegrade flow, a dynamic thrombus, or collateral circulation…

…compared to patients without such disturbances, including those with RBBB and LBBB. This was reported in the Coronary Heart Disease Study,1 which enrolled 10…

…reduced cardiac output. Most patients experience presyncope or syncope if the arrhythmia is sustained. In its fulminant course, VT degenerates to ventricular fibrillation, which then…

…tool designed to estimate the 5 year risk of life threatening arrhythmic events in individuals with LQT1, LQT2, and LQT3. This model was developed using…

…tool designed to estimate the 5 year risk of life threatening arrhythmic events in individuals with LQT1, LQT2, and LQT3. This model was developed using…