…in clinical practice and it is fundamental to be able to differentiate benign from serious etiologies. Therefore, when encountering a patient with chest pain the…

…to clopidogrel; reducing the dose of prasugrel; extending DAPT beyond 12 months in carefully selected patients with high ischemic risk and low bleeding risk. These…

…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…

…Exercise stress testing in patients with previous acute coronary syndromes (myocardial infarction), women, elderly and revascularized individuals Clinicians should be familiar with the special challenges…

…proximally on the upper arm. Placement of chest (precordial) electrodes are not changed but additional leads may be attached in children under the age of…

…cap. Lidocaine 10 mg/mL for local anaesthesia in the awake patient — the anaesthetic also improves the chance of success by counteracting vascular spasm. Pressure…

…to the local protocol. An anticoagulant is given as soon as possible, but must not delay cardioversion in an unstable patient. Rate control in the…

…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…

…stenoses. Myocardial ischaemia may occur despite the absence of significant epicardial obstruction. In patients with anginal symptoms and unobstructed or non obstructive coronary arteries, possible…

…emphasizing concurrent rapid rewarming of the patient. Consider extracorporeal membrane oxygenation (ECMO) in unstable patients. The administration of medications (such as amiodarone and epinephrine) and…

…offers visual and numerical insights into myocardial blood flow under rest and stress conditions. MPI uses radiotracers in combination with single photon emission computed tomography …

…in ACS patients treated with PCI can increase the risk of thrombosis, myocardial infarction, or death. Treatment for up to 12 months is recommended unless…

…5 mm All patients Other leads Greater than or equal to 1 mm These criteria for the other leads apply in the absence of left…

…particularly important. The precise initiating mechanism is incompletely defined. Several associations have been described: Female sex, particularly in patients aged approximately 40–50 years. Hormonal…

…protocols. Note that while cardioversion restores sinus rhythm in up to 95% of patients, long term maintenance (particularly in persistent AF) remains the greater challenge.

…in patients without structural heart disease and is the leading cause of SCD in men under the age of 40 in endemic regions [3] . The…

…sex differences in cardiovascular aging, including smaller ventricular cavities, greater age related vascular stiffening, and distinct microvascular responses to systemic inflammation [7] . The dominant risk…

…of morbidity in patients with structural heart disease, VT necessitates a nuanced, multidisciplinary approach to diagnosis and management. Over the past decade, the landscape of…

…six months, a BMI < 20 in people under 70 years or < 22 above 70 years, and reduced food intake together form the basis…

…rheumatoid arthritis, ankylosing spondylitis MACOCHA is validated for the intensive care patient and totals 12 points: Mallampati III–IV (5 points), obstructive sleep apnoea syndrome…

…Reduced compression (20–30 mmHg) under vascular surgical supervision Diabetes with neuropathy Reduced compression, closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of…

…the first trimester under specialist care). Rheumatic mitral stenosis with atrial fibrillation. In uncomplicated atrial fibrillation and in ordinary venous thromboembolism, a DOAC is the…

…cornerstone in managing patients with intracardiac shunts. By integrating anatomical measurements and Doppler hemodynamics, clinicians gain valuable insights into shunt severity and directionality. While the…

…ACS) in patients with a low to intermediate likelihood of CAD when cardiac troponin and/or the ECG is normal or inconclusive. The principal diagnostic…

…although the available material does not establish a significant increase in late morbidity or mortality attributable to these events. Clinical presentation and symptoms Most patients…

…on exertion, RAD demonstrates a high predictive value for the condition [9]. Furthermore, RAD is frequently observed in adult patients with severe pulmonary stenosis, alongside…

…carotid sinus syncope and in patients older than 40 years with recurrent syncope of unknown etiology. This test should be performed under continuous ECG and…

…agents, including epinephrine—administered to the vast majority of cardiac arrest patients—can induce such pupillary responses. In a comprehensive study by Javaudin et al.…

…R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life upon hospital arrival: a retrospective multicenter study. Crit Care 2020…

…al (2023) : In a multicenter, randomized trial, the effects of extracorporeal cardiopulmonary resuscitation (ECPR) was compared to conventional CPR in patients with refractory out of…

…placed under the patient's head. This stretches in the chest wall, such that the distances between the ribs increase, providing larger windows for the…

…effusion is detected randomly (for example, in CT, MRI, echocardiography). In other cases, the effusion is detected under more dramatic circumstances, as is the ca

…characteristics and ECG changes in takotsubo cardiomyopathy The typical patient presents with severe chest pain, dyspnea and occasionally hemodynamic compromise. The ECG shows localized ST…

…elective cardioversion. AVNRT and AVRT that respond to adenosine — try adenosine first in the stable patient. Sinus tachycardia and multifocal atrial tachycardia — treat the cause;…

…pitfall arises because typical circuits occurring in diseased atria—most frequently following surgery or extensive ablation, or under the influence of antiarrhythmic drugs—can produce…

…whereas clinical restenosis refers to recurrent angina caused by disease in the treated segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary…

…of healthy pediatric patients. P waves precede all QRS complexes and the PR interval is constant. Although sinus arrhythmia can be pronounced in pediatric patients…

…be included in the measurement. This may result in an overestimation of the QT interval. If the patient uses QT prolonging drugs, the QT interval…

…Measure PEF or FEV1 if the patient can manage it without delaying treatment. 10. Call anaesthetics and intensive care early with life threatening features or…

…a patient with adrenal insufficiency during acute illness. Confusing dexamethasone 0.75 mg with prednisolone 0.75 mg. A tenfold difference in effect. Giving the…

…Patient characteristics and the degree of hypertrophy can be used to distinguish hypertrophic cardiomyopathy from hypertrophy caused by loading conditions. In the presence of increased…

…and stress images to assess myocardial ischemia and infarction. The key steps in this process are outlined below. Image acquisition and evaluation Stress Imaging : Initially…

…can only function under aerobic conditions (oxygen is required for ATP synthesis [ATP is the primary energy source in all cells]). The heart consumes approximately…

…the cavity and its distance to vessels. Contraindications and when to involve a surgeon The following locations must not be handled routinely in primary care…

…infarct related artery in a stable and asymptomatic patient is by contrast not recommended [1,5]. STEMI criteria and occlusion patterns on the ECG Classic…

…the patient in the lateral position with the knees drawn up , or prone with a pillow under the pelvis. The lateral position is usually the…

…the cholinesterase inhibitor, under monitoring in a setting where the airway can be secured. Preparation and equipment Edrophonium 10 mg/mL, 1 mL (named patient…

…acuity in each eye separately , with the patient's usual glasses and then through a pinhole. This is done before any drops. 2. Inspect the…

…the dilution instructions and the local protocol before prescribing. Basic principles of treatment The patient should be managed in an emergency department, an intensive care…

…in a large patient. The anterior approach, just lateral to the coracoid process, is an alternative but lies closer to the brachial plexus and the…

…time and read out the number of attempts. Laryngeal mask sizes Size Patient weight Maximum cuff volume (air filled mask) : : : 1 under 5 kg 4…

…useful in practice: An examination couch that can be approached from all sides and on which the patient's head can hang over the end…

…Rest your hand against the patient's cheek so that the otoscope moves with the head if it moves. 4. Insert the speculum under vision…

…is the wrong treatment : Aortic dissection with haemopericardium — drainage can increase the bleeding and worsen the prognosis. The patient must go to cardiothoracic surgery. In…

…the type and location of surgery, and the anticipated current pathway. In a pacing dependent patient, inhibition of pacemaker output may result in clinically important…