…assessment is required. Patients with NSTE ACS should be admitted for management of acute ischaemia. Those with possible ACS, a non diagnostic ECG, and normal…

…commonest error in paracentesis is not performing it. Every patient admitted with ascites should undergo a diagnostic paracentesis , because spontaneous bacterial peritonitis often lacks abdominal…

…procedures likely to generate EMI. Assess pacing dependence Determining pacing dependence is central to planning. If EMI causes oversensing and pacing inhibition, a patient who…

…delaying time to treatment. History taking, physical examination, ECG and laboratory tests are the cornerstones of management of patients with chest pain. A 12 lead…

… switching from a potent P2Y12 inhibitor to clopidogrel; reducing the dose of prasugrel; extending DAPT beyond 12 months in carefully selected patients with high ischemic…

Nitroglycerin Patients using nitroglycerin regularly may have developed tolerance and require higher doses, alternatively nitroprusside to achieve desirable blood pressure lowring effect. Drug Nitroglycerin Brand…

All patients with NSTE ACS (NSTEMI or unstable angina) are treated similarly with respect to anti ischemic and anti thrombotic drugs. Management must, however, be…

…requires a cervical sample. Screening is for the asymptomatic. Symptoms must be investigated wherever in the screening interval the patient happens to be — a recently…

…and a prostate that can grip; the female urethra is only 3–5 cm and almost straight, but the meatus can be hard to find…

Info This drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is…

…Patients with previous acute coronary syndromes (ACS) Exercise stress testing is routinely performed after acute myocardial infarction in order to assess the presence of myocardial…

Cardiology This drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is…

…of cardiac arrest. Recurrent VT or VF after ROSC in a patient with a coronary risk profile should lead to consideration to perform early angiography.

…discussed in the chapter The ECG Leads. Acquisition of ECGs in pediatric patients is slightly different from adults, due to obvious anatomical differences. There are…

…varies from one minute to another, which may cause variations in the size of the thrombus. This means that a patient who experienced chest pain…

…BLED Score: In a study evaluating bleeding risk prediction in AF patients, the HAS BLED score demonstrated superior predictive performance compared to both HEMORR₂HAGES and…

…to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS have more comorbidities and a…

…to antiarrhythmic drugs or repeated ablation procedures should raise suspicion, especially in patients in their mid 60s or older [10]. Physical examination may reveal a…

…is a comprehensive, multidisciplinary secondary prevention intervention for patients with cardiovascular disease, including those recovering from myocardial infarction. It extends beyond exercise training to incorporate…

…of a non statin agent when LDL C is 55–69 mg/dL (≥1.4 to <1.8 mmol/L). Non statin treatment for patients…

…metabolic abnormalities; and abnormal pain perception in patients without demonstrable ischaemia. The absence of obstructive disease therefore does not establish a benign diagnosis. ANOCA/INOCA…

…tolerated doses, including a diuretic appropriate for kidney function. In patients with an estimated glomerular filtration rate below 30 mL/min/1.73 m², an…

…may be used in patients with heart failure, atrial fibrillation, atrial flutter, and in selected cases of paroxysmal supraventricular tachycardia. Due to its profound pro…

…recommended as the initial study in patients with low to moderate risk of CAD. In patients with a high to very high risk of CAD…

…3) Evaluation of patients with suspected AV blocks requires a thorough medical history (with emphasis on causes of AV blocks; please refer to theCauses of…

…after one to three days but can start earlier in patients with previous complicated withdrawal [4]. Untreated delirium tremens has historically carried a high mortality…

…A short course (no more than 7 days) may be given to selected patients with an eGFR of 30 40 mL/min for lower urinary…

…that are common to all protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol…

…an independent risk marker for both kidney failure and cardiovascular death — a patient with an eGFR of 70 and A3 is at higher risk than…

…prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity: Do not administer to patients with a history…

…individual patient characteristics and preferences when making therapeutic decisions. References 1. Fang MC, Go AS, Chang Y, et al. A new risk scheme to predict…

…This aims to prevent unnecessary anticoagulation in low risk female patients, thereby reducing the potential for bleeding complications. The CHA₂DS₂ VA score is a clinical…

…HAS BLED score is a widely recognized and validated tool used to assess the one year risk of major bleeding in patients with atrial fibrillation…

…is safe in patients with coronary artery disease since it does not increase heart rate, and reduces myocardial oxygen consumption. Time to onset of action…

…to the active metabolite of prasugrel. Patients weighing < 60 kg Initial dose : 60 mg single loading dose. Maintenance dose : 5 mg once daily. A…

…can vary depending on the heart rate and individual patient characteristics. Bazett’s formula has a tendency to overcorrect or undercorrect at extreme heart rates…

…has been reported in patients treated with ticagrelor. Patients with a history of ischemic stroke can be treated with ticagrelor for up to 12 months…

…10 minutes. A maximum of two infusions can be given. Each infusion should be completed, even if the patient reverts to sinus rhythm. Th e…

…refers to cardiac troponin release that does not fulfil the criteria for ischaemic myocardial infarction. It may be acute, when serial troponin values show a…

…daily is an established alternative to aspirin. In patients with previous MI, stroke, or peripheral arterial disease, clopidogrel produced a modest reduction in ischaemic events…

…rate or decreasing blood pressure, making it a consideration for patients with low blood pressure secondary to a low cardiac output. Its primary clinical utility…

…results. Patients with suspected ACS are categorized into a STEMI pathway or an NSTE ACS pathway according to the initial ECG and clinical presentation. For…

…Demonstration of both significant myocardial ischaemia and viability in the territory supplied by the occluded artery is generally accepted as a useful way to bal

…is an important clinical clue. Haemodynamic severity The presentation may range from mild right ventricular impairment to cardiogenic shock. Patients with hypotension, marked low output…

…seeks to prevent the emergence of risk factors. It includes maintenance of favourable blood pressure, body mass index, cholesterol and glucose levels, together with a…

…obstruction of an epicardial coronary artery. A vulnerable atherosclerotic plaque and thrombogenic blood interact to initiate and extend thrombosis. Plaque vulnerability is influenced by inflammation…

…Pathophysiology Stress echocardiography is a functional cardiac imaging technique used primarily to identify inducible myocardial ischaemia and to estimate prognosis in patients with suspected or…

…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…

…typically causes a short lasting second or third degree AV block which may be unpleasant to the patient. This side effect lasts a few seconds…

…Prognosis in aortic stenosis according to type of stenosis. The patients with low flow (stroke volume index <35 ml/m²) and low gradient (<40 mmHg…

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

…Coimbra R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life upon hospital arrival: a retrospective multicenter study. Crit Care…

…A significant majority of these patients exhibit satisfactory neurological function upon discharge. Figure 1 . Expected cardiopulmonary function and alertness in decreasing body temperature according to…

…echocardiography is to investigate if there are sources of emboli in the heart and, if the patient has suffered a stroke/TIA, to assess whether…

…is a common cause of chronotropic incompetence. Definition of chronotropic incompetence: the age expected maximal heart rate Chronotropic incompetence is defined as failure to reach…