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

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

…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…

…of patients will not survive post resuscitation care. Among those who survive to hospitalization, 50 65% die within 24 hours ( Soar et al ). The causes…

…treatment and who therefore require assessment for pseudo resistance, secondary hypertension, treatment related contributors, and excess cardiovascular risk. The European definition requires failure to reduce…

…to 1.73 m². Recalculate in patients who are markedly larger or smaller than average. Higher doses may be required in the critically ill patient…

…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…

…cerebral injury may contribute to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS have…

…the recommended goal is: LDL C <1.4 mmol/L (<55 mg/dL); and A reduction of at least 50% from baseline. In patients who…

…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…

…tracings continuously to cloud based platforms, which enables the clinician to examine intracardiac ECGs at any time. However, most clinicians who encounter patients with pacemakers…

…beta blockers actually increase chronotropic competency in patients with heart failure, despite their negative chronotropic effect. Among persons who do not suffer from heart failure…

…factors varies from one minute to another, which may cause variations in the size of the thrombus. This means that a patient who experienced chest…

…adult patients with acute coronary syndrome (ACS) or a prior heart attack and a high risk of developing an atherothrombotic event. Contraindications Hypersensitivity to the…

…its reliance on ST segment elevation as the key trigger for emergent reperfusion therapy. This approach fails to identify a substantial proportion of patients with…

…All patients with severe acute heart failure who receive levosimendan should be monitored invasively (e.g. arterial line, PiCCO, central venous catheter). The hemodynamic effects…

…activated, similar to those seen in heart failure. A thorough review on the pathophysiology of tachycardia induced cardiomyopathy is provided by Gopinnathair et al. All…

…to hypothermia , caution applies in: Ongoing uncontrolled bleeding or marked coagulopathy. Severe sepsis and septic shock. Already marked hypothermia from another cause — warm the patient…

…root morphology. Age stratified formulas help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of aortic root dilation. Key…

…includes stable patients who are not low risk but have either RV dysfunction or elevated biomarkers, or neither of these abnormalities in the presence of…

…burden Life expectancy Patient priorities and preferences Patients who are fit and independent generally benefit from guideline directed blood pressure treatment similar to that used…

…ranging from bradycardias related to enhanced vagal effect to life threatening tachyarrhythmias. Evaluation and Physical Examination Physical examination of a patient on digoxin therapy should…

…during hospitalization. Patients who develop shock often have severe multivessel coronary disease and progressive, “piece meal” necrosis extending beyond the original infarct zone. Coronary Occlusion…

…intolerance: inability to tolerate the dose required to achieve the patient’s LDL C goal. Complete intolerance is uncommon. Most patients who report intolerance can…

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

…early due to the massive ischemia. Complete LMCA occlusion is typically fatal within minutes, hence its designation as the “widow maker.” Patients who survive long…

…to provoke overt ischemic signs during stress testing (Bourque et al.). Thus, patients who undergo exercise stress testing must achieve at least 85% of the…

…those who are otherwise haemodynamically unstable. The benefit of its administration in these patients should be carefully balanced against the potential risks resulting from hypotension…

…whom absolute cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast, patients with confirmed hypertension generally require BP…

…Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease…

…likely to benefit from preventive drug therapy. Secondary prevention Although outside the principal scope of primary prevention, secondary prevention provides an important contrast. Patients with…

…threatening complications. Among patients with established peripheral artery disease, those who stop smoking have approximately twice the five year survival of those who continue. After…

…depending on the size of the thrombus and the plaque. The patient will experience severe chest pain due to the abrupt reduction of coronary blood…

…Data from the TRED HF trial demonstrated that withdrawal of guideline directed medical therapy (GDMT) in these patients leads to a high rate of relapse…

…treatment inertia, in which patients remain on an inadequate single drug regimen for prolonged periods. The evidence supports improved blood pressure control and adherence, although…

…symptomatic atherosclerotic disease, the international guideline identifies benefit from adding PCSK9 inhibition to statin therapy when LDL C is ≥1.8 mmol/L. In peripheral…

…status and walking capacity, because these may reveal “masked” PAD in patients who do not exert themselves sufficiently to provoke symptoms. Intermittent claudication Intermittent claudication…

…can refine the decision to test and may identify patients who require preventive therapy even when functional testing is normal. Probability categories The source material…

…Patients who have been prescribed sublingual nitroglycerin should be instructed in its appropriate use, although specific dosing instructions are not provided in the source material…

…The absence of obstructive disease generally indicates a more favourable course than VA accompanied by severe fixed lesions. Nevertheless, patients who develop serious arrhythmias during…

…will extend from the endocardium to the epicardium in the affected myocardial region, which results in ST elevations on the ECG. Virtually all patients with…

…will extend from the endocardium to the epicardium in the affected myocardial region, which results in ST elevations on the ECG. Virtually all patients with…

…and the law Swedish law is based on presumed consent : a person who has not expressed opposition is presumed to have consented to donation. The…

…tests from the suspected focus, but avoid sampling that delays antibiotics 6 Take a targeted history and examine the patient, with particular attention to the…

…of myocardial fibrosis). Risk stratification The calculator helps identify patients at high risk of SCD who may benefit from preventive interventions, such as ICD implantation…

…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…

…studies from China and Italy (1–5). Two recent studies published in JAMA Cardiology are summarized below. Shi et al present data on 416 patients…

…dL), and at least a 50% reduction from baseline. For a patient who experiences a recurrent atherothrombotic event while receiving maximally tolerated statin therapy, an…

…is required. Combination therapy should be selected according to the magnitude of additional LDL C lowering needed and the patient’s prior treatment. Inclisiran is…

…an implantable loop recorder is essential to accurately establish the diagnosis. Electrophysiology In patients with presyncope or syncope—especially older individuals with BBB or intraventricular…

…cardiovascular disease, an exercise test may provide objective information on peak exercise capacity and the heart rate, blood pressure and symptom responses to exertion. These…

…related to the left atrial appendage, although competing mechanisms such as large artery atherosclerosis and small vessel disease may also contribute to stroke in patients…

…is not necessary to confirm cardiac arrest. Skin color is pale or cyanotic, but this may be difficult to discern depending on the skin tone…

…ecotdense masses on valves should lead to suspicion of endocarditis (the masses are vegetations). The risk of endocarditis is especially high for patients with valve…

…myocardial infarction is based on the following three components: Cardiac troponins – Elevation of cardiac troponins in peripheral blood is mandatory to establish a diagnosis of…

…In such scenarios, it is very common to provide the patient with a permanent pacemaker to continue optimal medical treatment. Sick sinus syndrome (sinus node…

…alert the EMS (in OHCA) or cardiac arrest team (in IHCA). There are no risks in instructing a layperson to perform chest compressions on an…

…ticagrelor. In patients undergoing PCI for ACS, prasugrel should be considered in preference to ticagrelor, although the comparative evidence between prasugrel and ticagrelor is conflicting…

…occur in one patient. The typical depiction of sudden cardiac death as a gradual transition from sinus rhythm to ventricular tachycardia (VT), to ventricular fibrillation…

…to the anticoagulation clinic, and a decision on who will dose during the first week. Written patient information: the Waran booklet (the Swedish warfarin patient…