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

…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…

…of therapy : Premature discontinuation of antiplatelet therapy, including prasugrel, in ACS patients treated with PCI can increase the risk of thrombosis, myocardial infarction, or death…

…index of suspicion for drug induced arrhythmias in patients receiving agents known to alter the electrical properties of the heart (inducing QRS or QT prolongation…

…Diagnostics Electrocardiography and Electrophysiology Electrocardiographic evaluation of patients receiving digoxin reveals specific electrophysiologic profiles. Digoxin's autonomic actions largely slow the sinus node discharge rate…

…The composite major adverse cardiovascular outcome—cardiovascular death, nonfatal myocardial infarction, nonfatal stroke or coronary revascularization—occurred in 819 patients receiving bempedoic acid (11.7…

…and prevent its interaction with the hepatic LDL receptor. They lower LDL C by approximately 50–60%, including in patients receiving background statin therapy and…

…goal. For statin intolerant patients, ezetimibe may be used initially. If LDL C remains above target, bempedoic acid is recommended in the relevant guideline setting…

…equivalent who were receiving statins, inclisiran produced a further reduction in LDL C of approximately 50%. The effect was consistent in patients with and without…

…the clinical picture. A 24 hour urine collection for electrolytes can be used to quantify sodium and potassium intake, preferably while the patient is receiving…

…effect is wanted and the patient is also receiving LMWH, for example in newly diagnosed venous thromboembolism. 1. Check the INR before the first dose…

…followed by a QRS complex; atrioventricular block is uncommon unless the patient is receiving digoxin. The ventricular rate is regular, typically ranging from 100 to…

…is reasonable, although the optimal initial combination strategy remains uncertain. A beta blocker combined with a dihydropyridine CCB is appropriate for many patients. Long acting…

…ischaemia. A focused history should establish: Quality of the discomfort. Location and radiation. Onset and temporal pattern. Duration and recurrence. Provoking and relieving factors. Associated…

…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…

…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…

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…

…1 year mortality in patients with NSTE ACS. TIMI, GRACE and PURSUIT are such risk models. The higher the estimated risk, the earlier should angiography…

…are no absolute contraindications, but refrain or adapt in: The patient does not consent — the examination must then not be carried out. Vaginismus or marked…

…impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient. Perioperatively and postoperatively in longer procedures…

…the maximum dose per 24 hours is 1000 mL. Adverse effects Headache. Nausea. Fever. Atrial fibrillation. Worsening of heart failure. Caution • Used cautiously in patients…

…pain during the last 12 hours before exercise. Patients with unstable angina pectoris with high risk should not undergo exercise stress tests; these patients should…

…the maximum dose per 24 hours is 1000 mL. Adverse effects Headache. Nausea. Fever. Atrial fibrillation. Worsening of heart failure. Caution • Used cautiously in patients…

…T waves) do not affect the management of cardiac arrest. Recurrent VT or VF after ROSC in a patient with a coronary risk profile should…

…in children and adult patients. Recommendations for ECG recording in children Pediatric patients frequently have difficulties being still during clinical examinations. The youngest children often…

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

…GY. A novel user friendly score (HAS BLED) to assess 1 year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey…

Arrhythmias and arrhythmology Critical care Definition and pathophysiology Atrial fibrillation (AF) is the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and…

…ejection fraction (HFpEF) at hospitalization warrants evaluation [5]. Heightened awareness is essential in patients with severe aortic stenosis, particularly the low flow, low gradient phenotype…

…The post infarction patient may experience: Reduced exercise tolerance Physical deconditioning Activity related anxiety Depression or psychological distress Loss of confidence in resuming normal activity…

…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…

…should be reserved for patients in whom the diagnosis has been carefully confirmed. Apparent resistant hypertension may result from: Inaccurate or inconsistent blood pressure measurement…

…digoxin has been ousted repeatedly from the standard of care for these conditions. However, digoxin is still used in patients who do not achieve satisfactory…

…is currently the first line investigation for patients with low risk of CAD. Risk stratification : Myocardial perfusion imaging is valuable for assessing the risk of…

…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…

…in patients with previous complicated withdrawal [4]. Untreated delirium tremens has historically carried a high mortality. With modern sedation, supportive treatment and treatment of the…

…to selected patients with an eGFR of 30 40 mL/min for lower urinary tract infection. At an eGFR <30 mL/min the antibacterial effect…

…and HHS if the patient has marked hyperosmolality together with significant ketosis and acidosis. With blood ketones ≥ 3 mmol/L and acidosis, the ketosis must…

…1 % suggests a prerenal cause, above 2 % acute tubular necrosis — but the value is unreliable during diuretic therapy, where a fractional excretion of urea below…

…Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon…

…GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur…

…GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182,678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur…

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

…efficacy as compared with nicardipine. Labetalol is safe in patients with coronary artery disease since it does not increase heart rate, and reduces myocardial oxygen…

…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…

…been reported in patients taking ticagrelor. If suspected, further clinical evaluation is recommended. Creatinine levels may rise during treatment with ticagrelor. The mechanism is unclear…

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

…longer episodes, a lower threshold for provocation, or symptoms that awaken the patient from sleep. Initial symptoms of NSTEMI and UA may be similar. NSTEMI…

…aspirin is also preferred in patients with intracoronary stents. In acute ACS, aspirin should be administered as soon as possible in the absence of contraindications…

…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…

…discovered incidentally during diagnostic angiography. Collateral vessels may maintain distal perfusion and permit visualization of the vessel beyond the occlusion when the patent donor artery…

…observed during the first 24 hours in patients with RVI. The ECG should therefore include right sided precordial leads when RVI is suspected in the…

…which seeks to prevent the development of cardiovascular risk factors themselves, and from secondary prevention, which addresses patients with established disease to reduce recurrent events…

…Nausea and vomiting Anxiety A sense of impending doom When STEMI begins during exertion, the symptoms generally do not resolve simply with cessation of activity…