…or severity; angina that awakens the patient from sleep. Patients receiving modified antiplatelet therapy require clinical surveillance for both recurrent ischemia and bleeding. The source…

…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…

…ulcer). Patients weighing < 60 kg (maintenance dose of 5 mg recommended instead of 10 mg). Patients receiving medications that increase bleeding risk, including oral…

…should maintain a high index of suspicion for drug induced arrhythmias in patients receiving agents known to alter the electrical properties of the heart (inducing…

…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…

…nonfatal myocardial infarction, nonfatal stroke or coronary revascularization—occurred in 819 patients receiving bempedoic acid (11.7%) and 927 receiving placebo (13.3%). Bempedoic acid…

…C by approximately 50–60%, including in patients receiving background statin therapy and in those unable to tolerate statins, provided that hepatic LDL receptor expression…

…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…

…variable or modest. In phase III studies involving patients with ASCVD or at least one ASCVD risk equivalent who were receiving statins, inclisiran produced a…

…be used to quantify sodium and potassium intake, preferably while the patient is receiving a stable diuretic dose. Other clinical contexts Secondary causes should be…

…dose in parallel. Procedure Initiation with a loading dose Used when a rapid effect is wanted and the patient is also receiving LMWH, for example…

…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…

…infarction Pharmacology & dosing Definition and therapeutic objectives Antianginal therapy in chronic coronary syndrome (CCS) is directed primarily at reducing myocardial ischaemia and relieving anginal symptoms…

…remains consequential, and historically 2–6% of patients discharged with presumed non ischaemic chest pain were subsequently found to have had an infarction. Pathophysiological Considerations…

…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…

…electrocautery performed away from the device and with monopolar electrocautery below the umbilicus. Nevertheless, perioperative planning should be individualized according to the patient, device, procedure…

ECG Myocardial ischemia and infarction Approach to patients with chest pain: differential diagnoses, evaluation and management Chest pain is one of the most common symptoms…

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…

Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

Procedurer Catheterisation is straightforward in most patients and dangerous in a few. The male urethra is about 25 cm long with two curves and a…

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…

…85%). Many patients appreciate the exercise test because it offers them an opportunity to evaluate their performance and symptoms under the supervision of their clinician…

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…

ECG ECG leads and recording ECGs in pediatric patients (children) Principles of ECG leads, lead anatomy and electrical vectors have been discussed in the chapter…

…of upper abdominal pain. An ECG recording costs approximately $10 (10€) and may reduce morbidity and mortality substantially in patients with acute coronary syndromes. Importantly…

…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…

…in patients with acute coronary syndromes (ACS) and is also a common tachyarrhythmia requiring treatment in decompensated heart failure (DHF). In the critically ill patient…

…Cardiac Amyloidosis Demographic and Clinical Context Cardiac amyloidosis should be suspected in patients older than 65 years presenting with heart failure and increased left ventricular…

…and infarction Definition and Purpose Cardiac rehabilitation is a comprehensive, multidisciplinary secondary prevention intervention for patients with cardiovascular disease, including those recovering from myocardial infarction…

…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…

Drugs and electrolyte imbalance ECG Digoxin ECG changes: arrhythmias, conduction defects and waveform changes Digoxin may be used in patients with heart failure, atrial fibrillation…

…grafting (CABG) or percutaneous coronary intervention (PCI). Contraindications for myocardial perfusion imaging Exercise stress testing is contraindicated in patients with acute myocardial infarction, unstable angina…

…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…

…can develop despite a measurable or high blood alcohol concentration, particularly in patients with marked tolerance. The most important measures in severe or complicated withdrawal…

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

…protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA…

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

…cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity: Do not administer to patients with a history of asthma, rhinitis, or urticaria…

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

…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…

…widely recognized and validated tool used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF) who are taking anticoagulants…

…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…

…s formula. Note that a QTc interval 480 is always considered pathological. For patients with bundle branch blocks, the corresponding figure is 500 ms. The…

…is indicated for the prevention of atherothrombotic events in adult patients with acute coronary syndrome (ACS) or a prior heart attack and a high risk…

…onset atrial fibrillation to sinus rhythm. Vernakalant is used in the following settings: Non surgery patients: atrial fibrillation ≤7 days duration. Post cardiac surgery: atrial…

…presentations caused by suspected acute myocardial ischaemia. It includes patients with recent changes in symptoms or clinical signs, with or without diagnostic electrocardiographic abnormalities and…

…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…

…the absence of persistent ST segment elevation. This does not imply low risk: patients with NSTE ACS may have substantial myocardial ischaemia, dynamic ECG abnormalities…

…diagnostic angiography. Collateral vessels may maintain distal perfusion and permit visualization of the vessel beyond the occlusion when the patent donor artery is injected. The…

…pressure. Evaluation and physical examination Initial assessment should establish whether the patient has clinically significant right ventricular failure and whether haemodynamic instability is present. Physical…

…and from secondary prevention, which addresses patients with established disease to reduce recurrent events and mortality. Risk factor modification is therefore directed at identifying individuals…

…Most patients with this working diagnosis subsequently develop myocardial necrosis and cardiac troponin elevation, although not every patient with an initial STEMI pattern has myocardial…