…or discomfort; an accelerating pattern, with increasing frequency or severity; angina that awakens the patient from sleep. Patients receiving modified antiplatelet therapy require clinical surveillance…

…50% from baseline. In patients who experience a recurrent atherothrombotic or cardiovascular event within 2 years while receiving maximally tolerated statin based treatment, an LDL…

…Patients receiving medications that increase bleeding risk, including oral anticoagulants, clopidogrel, NSAIDs, or fibrinolytics. For patients with active bleeding requiring reversal of prasugrel's pharmacological…

…drug induced arrhythmias in patients receiving agents known to alter the electrical properties of the heart (inducing QRS or QT prolongation) or causing electrolyte abnormalities…

…fibrillation, particularly when other therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across multiple organ systems…

…double blind, placebo controlled study of 13,970 patients at high cardiovascular risk who were unable or unwilling to take statins. Approximately 70% were in…

…specified by the guideline. PCSK9 inhibitors are also relevant in statin intolerant patients who remain above goal despite alternative lipid lowering therapy. Evolocumab and alirocumab…

…a 50% reduction from baseline. For a patient who experiences a recurrent atherothrombotic event while receiving maximally tolerated statin therapy, an LDL C goal below…

…lipoprotein(a) are variable or modest. In phase III studies involving patients with ASCVD or at least one ASCVD risk equivalent who were receiving statins…

…the patient is receiving a stable diuretic dose. Other clinical contexts Secondary causes should be pursued when abnormalities are identified on initial testing or when…

…A referral or notification to the anticoagulation clinic, and a decision on who will dose during the first week. Written patient information: the Waran booklet…

…flutter. Each P wave is followed by a QRS complex; atrioventricular block is uncommon unless the patient is receiving digoxin. The ventricular rate is regular…

…of angina may differ between patients. Myocardial ischaemia may result predominantly from obstructive epicardial coronary disease, coronary vasospasm, microvascular dysfunction, or combinations of these mechanisms…

…temporal pattern. Duration and recurrence. Provoking and relieving factors. Associated symptoms. Similarity to previous documented angina or myocardial infarction. Atherosclerotic and thromboembolic risk factors. Relevant…

…clinical populations include only a minority with symptoms having all of the traditional aggravating and relieving characteristics of angina; many patients report less characteristic symptoms…

…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…

…when encountering a patient with chest pain the primary task is to exclude or verify the following potentially life threatening causes of chest pain: 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…

…screening interval the patient happens to be — a recently taken normal smear is no reason to refrain from investigating postmenopausal bleeding or a visible cervical…

…retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient…

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…

…testing is utilized to assess whether there is any residual ischemia or angina pectoris. Patients may undergo repeated stress tests to assess symptoms and signs…

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…

…The COACT, PEARL and TOMAHAWK trials studied patients with ROSC who did not display ST segment elevations and randomized them to urgent angiography. These trials…

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

…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…

…HEMORR₂HAGES bleeding risk score is a clinical tool developed to assess the risk of major bleeding in patients with atrial fibrillation (AF) on anticoagulation therapy…

…than in patients who remain in sinus rhythm. Several mechanisms may account for apparent ischaemic electrocardiographic changes during rapid AF. ST segment depression or T…

…relaxation [10]. There is also an increased risk of intracardiac thrombus and stroke or systemic embolization, even in patients in sinus rhythm [8]. Differentiating ATTR…

…to work or recreational exercise Frailty or loss of muscle mass, particularly in older adults Patients require individualized progression because new symptoms during exercise may…

…and Pathophysiology Angina with non obstructive coronary arteries (ANOCA) describes anginal symptoms in patients whose epicardial coronary arteries are normal or show no obstructive disease…

…a distinct disease. It identifies patients whose blood pressure remains uncontrolled despite intensive antihypertensive treatment and who therefore require assessment for pseudo resistance, secondary hypertension…

…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…

…contraindications: Adenosine, Dipyridamole, Regadenoson : Should be avoided in patients with active bronchospasm, severe hypotension, or high degree AV block. Caffeine and other methylxanthines, which antagonize…

…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…

…drug, dosing, route of administration and criteria for intermediate care or intensive care. Time course after the last intake The times given are approximate. Symptoms…

…73 m². Recalculate in patients who are markedly larger or smaller than average. Higher doses may be required in the critically ill patient. Intravenous antibiotics…

…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…

…patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2…

…TIA). Stroke Contraindications Cross reactivity: Do not administer to patients with a history of asthma, rhinitis, or urticaria triggered by: Acetylsalicylic acid (aspirin). Other non…

…5 or more 5.8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist for patients with…

…As of 2025, it is recommended to use the CHA₂DS₂ VA score for stroke risk assessment in atrial fibrillation patients. By excluding the sex parameter…

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

…in patients with asthma (due to risk of bronchospasm). • Used cautiously in bradycardia due to negative chronotropic effect. • In patients with pheochromocytoma, cocaine or methamphetamine…

…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…

…developing a new event. Administration Ticagrelor can be administered with or without food. For patients who cannot swallow the tablets whole, they can be crushed…

…should be completed, even if the patient reverts to sinus rhythm. Th e infusion must be aborted if hypotension or bradycardia occurs. A defibrillator should…

…or coronary microcirculation. These abnormalities can produce a transient and reversible mismatch between myocardial oxygen demand and blood supply, generally during exertion, emotional stress, or…

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

…low risk: patients with NSTE ACS may have substantial myocardial ischaemia, dynamic ECG abnormalities, myocardial necrosis, haemodynamic deterioration, heart failure, malignant arrhythmias, or mechanical complications…

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

…Patients with hypotension, marked low output, or persistent severe symptoms require close monitoring and consideration of invasive haemodynamic assessment when precise measurements are needed to…

…cardiovascular risk factors. Primary prevention Primary prevention targets people without clinical CVD who nevertheless have established risk factors or an elevated estimated risk. It combines…

…or subxiphoid pain may be mistaken for indigestion. Associated manifestations include: Sweating Nausea and vomiting Anxiety A sense of impending doom When STEMI begins during…