…angina, with increasing frequency or severity Symptoms that awaken the patient from sleep Clinical assessment must be integrated with vital signs, a 12 lead ECG…

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

…a patient who has little or no reliable intrinsic rhythm may develop prolonged pauses. Pacing dependent patients therefore require protection against inhibition during the period…

…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…

…but high risk patients should be evaluated with angiography earlier. Guidelines recommend the use of validated risk models to estimate the risk of acute myocardial…

…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…

…Charrière (Ch), where the figure corresponds to the circumference in millimetres — a Ch 16 therefore has a diameter of about 5 mm. Indication Size Comment…

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…

…usually takes 2 to 3 days and the patient must not have experienced chest pain during the last 12 hours before exercise. Patients with unstable…

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…

…affect the management of cardiac arrest. Recurrent VT or VF after ROSC in a patient with a coronary risk profile should lead to consideration to…

…the youngest) can be distracted by a parent or other personnel. Distracting the child during ECG recording may be recommended to reduce muscle disturbances. To…

…of the thrombus. This means that a patient who experienced chest pain at home may be asymptomatic during the assessment in the ER, only to…

[calc_hemorrhages] The HEMORR₂HAGES bleeding risk score is a clinical tool developed to assess the risk of major bleeding in patients with atrial fibrillation (AF…

…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…

…Amyloidosis: Associated with more rapid progression of heart failure and a worse prognosis compared to ATTR [6]. Untreated, the median time from heart failure presenta

…new symptoms during exercise may signal an adverse clinical response. Recreational activity should therefore be increased at an appropriate intensity, with attention to the emergence…

…In treatment naïve patients unlikely to achieve the LDL C goal with statin therapy alone, initiation of high intensity statin plus ezetimibe during hospitalization should…

…arteries (INOCA) denotes the subgroup in whom objective myocardial ischaemia is demonstrated. ANOCA may occur in up to 70% of patients undergoing invasive coronary angiography…

…to six fold higher in affected adults. True, apparent, and pseudo resistant hypertension The term resistant hypertension should be reserved for patients in whom the…

…patients who do not achieve satisfactory effects using first line therapies. Digoxin is also used frequently in the emergency setting to control ventricular rate during…

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

…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…

…and several syndromes can overlap [1,4]. Time after a clear reduction or the last intake Common clinical picture : : 4 to 12 hours Tremor, sweating…

…rule the drug is contraindicated at an eGFR <45 mL/min. A short course (no more than 7 days) may be given to selected patients…

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

…to body surface area — the difference is substantial in very small and very large people. Acute kidney injury (KDIGO) Stage Creatinine Urine output : : : 1 A…

…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…

…in Atrial Fibrillation) Bleeding Risk Score is a clinical tool designed to estimate the risk of major bleeding in patients with atrial fibrillation (AF) undergoing…

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

…it serves as a tool to identify patients who may require more careful monitoring and management of modifiable risk factors. The HAS BLED score has…

…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…

…individual patient characteristics. Bazett’s formula has a tendency to overcorrect or undercorrect at extreme heart rates. Thus, it should not be used during bradycardia…

…rise during treatment with ticagrelor. The mechanism is unclear. Kidney function should be monitored according to clinical practice. Special attention should be given to patients…

…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…

…expression. Clinical presentation and symptoms Clinical presentation is heterogeneous. Patients may have: Chest pain, pressure, tightness, heaviness, or discomfort. Pain radiating to the neck, jaw…

…approximately a 25% reduction in recurrent infarction, stroke, or cardiovascular death. In the cited evidence, this corresponded to 36 fewer events per 1000 treated patients…

…toxicity. Several underlying conditions increase a patient's sensitivity to digitalis related arrhythmias. The clinician must evaluate for the presence of worsening renal function, advanced…

…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…

…during angiography performed for another indication. When clinically significant, it may present with chronic angina, an anginal equivalent or exertional dyspnoea. Patients may continue to…

…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…

…during exertion, the symptoms generally do not resolve simply with cessation of activity, unlike typical exertional angina. A precipitating factor is identifiable in up to…

…In the presence of a flow limiting coronary stenosis, supply cannot increase adequately. Ischaemia begins in the subendocardium, which contributes substantially to systolic wall thickening…

…classification to the OMI/NOMI approach is primarily supported by observational studies and clinical experience. Studies have demonstrated that a significant proportion of patients with…

…block which may be unpleasant to the patient. This side effect lasts a few seconds. Case reports have indicated that the risk of high degree…

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

…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…

…J, Toivio T, et al. Does appropriate treatment of the primary underlying cause of PEA during resuscitation improve patients' survival? Resuscitation 2012; 83:81922. Mroczek…

…hypothermia with cardiac arrest or cardiopulmonary depression Use HOPE Score to assess the prognosis. A long no flow time can sometimes be compatible with survival…

…sources The aim of echocardiography is to investigate if there are sources of emboli in the heart and, if the patient has suffered a stroke…

…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…